ESOPHAGEAL MOTILITY DISORDERS

FAQ

What are Esophageal Motility Disorders?

These are conditions where the food pipe muscles do not move properly.
Because of this, food and liquids do not pass smoothly into the stomach.

In simple words:
“The food pipe loses its normal pushing movement.”

3. What happens when motility is abnormal?

• Food may get stuck

• Difficulty in swallowing

• Chest discomfort

• Regurgitation (food coming back up)

• Weight loss in severe cases

4. What are the main types of Esophageal Motility Disorders?

Common types include:

1. Achalasia Cardia – most important and common

2. Diffuse Esophageal Spasm

3. Nutcracker (Hypercontractile) Esophagus

4. Ineffective Esophageal Motility

ACHALASIA CARDIA – MOST COMMON

5. What is Achalasia Cardia?

Achalasia Cardia is a condition where the lower end of the food pipe does not open properly to allow food into the stomach.

Two main problems occur:

• The lower valve (LES – Lower Esophageal Sphincter) stays tight.

• The food pipe muscles lose their normal movement.

So food gets stuck in the lower part of the esophagus.

6. Why does Achalasia happen?

The exact cause is not fully known.
It usually happens because of damage to the nerves controlling the food pipe muscles.

It is not cancer and not an infection in most cases.

7. What are the symptoms of Achalasia?

Common symptoms:

• Difficulty swallowing both solids and liquids

• Food coming back into the mouth

• Chest pain or burning

• Weight loss

• Cough at night

• Bad breath

• Feeling of food stuck in chest

8. Who usually gets Achalasia?

• Can occur at any age

• Common in young adults and middle age

• Affects both men and women equally

9. How is Achalasia diagnosed?

Doctors use a few tests:

1. Barium Swallow X-ray

• Patient drinks white liquid.

• Shows “Bird Beak” appearance at lower esophagus.

2. Endoscopy (OGD Scopy)

• A camera test to look inside the food pipe.

• Done to rule out cancer or blockage.

3. Manometry (Pressure Test)

• Measures muscle pressure.

• This is the best test for diagnosis.

10. What complications can happen if untreated?

• Severe weight loss

• Aspiration (food entering lungs)

• Lung infections

• Mega-esophagus (very dilated food pipe)

• Rare risk of cancer in long term

11. How is Achalasia treated?

Treatment aims to relax or open the lower valve.

There is no permanent cure, but good control is possible.

Non-Surgical Options

• Medicines – temporary relief only

• Botox Injection – short-term relief

• Balloon Dilatation – stretches the tight valve

Surgical Options (Best Long-Term)

• Laparoscopic Heller’s Myotomy

  • Tight muscle is cut.

  • Usually combined with Fundoplication to prevent reflux.

  • Most effective treatment.

12. What is the success rate of surgery?

• Very good success (85–95%)

• Most patients can eat normally after recovery.

13. What lifestyle advice helps patients?

• Eat slowly

• Chew food well

• Drink water with meals

• Avoid very dry foods

• Sleep with head elevated

• Small frequent meals

14. Is Achalasia dangerous?

It is not immediately life-threatening, but if ignored, it can cause serious nutrition and lung problems.
Early treatment gives excellent quality of life.

15. Key Message 

Achalasia Cardia is a swallowing problem caused by a tight lower food pipe valve and weak food pipe muscles.
It is diagnosable and treatable, especially with surgery, and most patients live normal lives after treatment.