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Gastroesophageal Motility Disorders Laboratory

Achalasia

For appointments and information, please call (212) 746-5130

NewYork-Presbyterian Hospital/Weill Cornell Medical Center offers comprehensive services, resources and expertise for the diagnosis and treatment of achalasia and other disorders of the esophagus. Our team includes some of the most experienced surgeons and gastroenterologists for treating achalasia, a rare disorder characterized by difficulty swallowing.

A key feature of achalasia care at NewYork-Presbyterian/Weill Cornell is our team approach: surgeons use minimally invasive surgical techniques and gastroenterologists use endoscopic techniques for treating this condition. Minimally invasive surgery offers patients a faster and more comfortable recovery, with less pain than traditional open surgery and minimal scarring.

About Achalasia

Achalasia is a disorder of the esophagus that makes it difficult to swallow solid or liquid foods. This condition occurs most often in middle-aged adults or older adults but can occur in children and young adults. This condition occurs because the lower esophageal sphincter fails to relax during swallowing. Also the esophagous has difficulty contracting to allow passage of food from the mouth to the stomach. The cause of this disease is not known.

The difficulty swallowing experienced by most patients with achalasia may last months or even years before a person seeks help. Other symptoms include:
  • Regurgitation of food
  • Heartburn
  • Chest pain after eating
  • Cough
  • Weight loss

Achalasia is a rare disorderaffecting about 2,000 people in the U.S. yearly. Because the condition is so rare, it's important to choose a medical center with experience in diagnosing and treating this disorder and other problems of the esophagus.

Diagnosing Achalasia

Proper diagnosis is the first step toward appropriate and effective treatment. Physicians at NewYork-Presbyterian/Weill Cornell may recommend any of several tests to determine the exact nature of the problem and to rule out the presence of esophageal cancer. Diagnostic testing may include:

  • X-ray/barium swallow. This test provides information about the chest and upper GI (gastrointestinal/digestive system) tract
  • Endoscopy. During endoscopy, a thin, flexible tube is inserted down the throat, through the esophagus and into the stomach. The endoscope is equipped with a tiny camera that enables the physician to actually see inside the esophagus and other organs. This test is important to make sure cancer is not present.
  • Manometry. This is a test that measures the strength and coordination of the muscles in the esophagus. For this test, a very thin tube is passed through the nose and down to the stomach. The test then measures esophageal muscle function while the patient swallows sips of water. Manometry also evaluates the function and relaxation of the valve (lower esophageal sphincter) located between the esophagus and stomach.

Treating Achalasia

A surgical procedure called laparoscopic esophageal myotomy can decrease the pressure of the lower esophageal sphincter muscle and make it easier to swallow.

Laparoscopic esophageal myotomy is a minimally invasive surgical procedure performed through 5 tiny incisions measuring between 5mm and 1cm. The surgeon releases the muscles around the lower esophageal sphincter relaxing this valve allowing food to pass into the stomach much more easily. To prevent patients suffering from reflux after the procedure the surgeons will typically perform a partial wrap of the stomach around the esophagous.

This technique typically takes 1 to 2 hours to perform. Nearly all patients are eating a regular diet within a day of surgery and back home within a day of surgery. Most patients will feel markedly better right after surgery. In addition to laparoscopic esophageal myotomy, NewYork-Presbyterian/Weill Cornell offers a full range of treatment options, including:

  • Endoscopic dilation to widen the lower esophagus.
  • Botulin toxin (Botox®) injection to paralyze the sphincter muscle and prevent muscle spasms.

Oral medications are not effective for treating achalasia.

Follow-up After Surgery

Once the operation is performed, follow-up is regularly done every six months to monitor the patient's swallowing ability. Patients who come to NewYork-Presbyterian/Weill Cornell for surgical treatment but who live far away can receive follow-up care from their local doctor. The NewYork-Presbyterian team will, however, remain in contact with the patient by phone or e-mail as needed over the long term.

Contact

Gastroesophageal Motility Disorders Facility
Directions
(212) 746-5130
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