It is a specific motility disorder of the oesophagus, which means if affects the nerves and muscles of this organ which adversely affects its function.
The main purpose of the oesophagus is to allow swallowed food and liquid to pass from the mouth into the stomach. It does this by peristalsis, which is ordered and automatic contraction and relaxation of its muscles, supported by appropriate opening and closing of valves at its upper and lower ends, the oesophageal sphincters.
In achalasia, two things happen.
Firstly, the lower oesophageal sphincter (LOS) becomes too tight, and fails to relax during swallowing.
Secondly, the oesophagus itself is affected, its nerves fail to fire in co-ordination and muscles become too weak to effectively contract. What causes achalasia is not clearly understood.
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Achalasia affects swallowing function. Patient complain of difficulty in swallowing (dysphagia). As the condition gets worse, food and liquid pile up in the oesophagus and then come back into the mouth (regurgitation). This is particularly unpleasant as it has festered in the oesophagus. Sometimes due to regurgitation, breathing problems such as choking, breathlessness and chest infections can occur as fluid enters the lungs. Te presence of noxious fluid in the oesophagus can create similar symptoms to reflux.
Ultimately weight loss and nutritional problems will develop as patient are unable to maintain a normal diet. The condition deteriorates over time.