Achalasia means 'failure to relax'. It is associated with failure of sphincters to relax from contracted state eg. cardiac sphincter (achalasia of the cardia or cardiospasm). It is an idiopathic pathology (primary achalasia) or may be due to esophageal cancer or Chagas' disease (secondary achalasia).
Cardiospasm is characterized by :
1. The failure of weak muscles of the cardia to relax
2. Disturbed peristaltic activity of the esophagus
3. Deranged reflex opening of the cardia on swallowing
4. Impaired passage of food into the stomach
5. Dilatation of the esophagus due to food's retention in it
Clinical Pictures :
1. Retrosternal paroxysmal pain (occurs usually at night)
2. Dysphagia (may intensify by emotional stress)
3. Regurgitation (may cause aspiration pneumonia)
Prognosis :
1. Progresses rapidly
2. Weight loss is progressive
3. Aspiration pneumonia and chronic bronchitis may supervene due to regurgitated
masses from esophagus
Treatment :
1. The efficacy of medication is low.
2. Surgery : Using Einhorn's dilator, balloon dilatation, Heller myotomy
Source : Wikipedia, Internal Diseases ; An Introductory Course
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