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Swallowing is a seemingly simple action that many of us take for granted. However, for those with achalasia cardia, this basic process can become a daily challenge. Achalasia cardia is a rare but serious condition that affects the esophagus, making it difficult for food and liquids to pass into the stomach. In this blog, we will explore what achalasia cardia is, its symptoms, and how esophageal manometry plays a crucial role in its diagnosis and management.



At Kaizen Gastro Care Clinic, the best gastro physiologist in Pune, Maharashtra, Dr. Rupali Bandgar-Jankar offers esophageal manometry tests to diagnose causes of diseases like Heartburn or acid reflux.

Understanding Achalasia Cardia:

Achalasia cardia is a disease where the muscles of the esophagus (the tube that carries food from the mouth to the stomach) lose their ability to move food down. The lower esophageal sphincter (LES), a valve that allows food to enter the stomach, fails to relax properly. This results in difficulty swallowing (dysphagia), regurgitation of food, and occasionally chest pain.

Symptoms of Achalasia Cardia:

The symptoms of achalasia cardia can vary in severity and may develop gradually. Key symptoms to watch for include:

Difficulty Swallowing (Dysphagia): The most common symptom, is where patients feel like food is stuck in their throat or chest.

Regurgitation: Food and liquids back up into the esophagus, and sometimes into the mouth.

Chest Pain: Often mistaken for heart pain, this pain is caused by the esophagus's abnormal contractions.

Weight Loss: Due to problems in eating and fear of swallowing, patients may experience significant weight loss.

Heartburn: Although less common, some patients may feel a burning sensation due to acid reflux.

Coughing or Choking: Especially at night or after eating, due to food being stuck in the esophagus.

The Role of Esophageal Manometry:

Esophageal manometry is a diagnostic test that calculates the pressure and movement of the esophagus. It is particularly useful in diagnosing achalasia cardia because it provides detailed information about the function of the esophageal muscles and the LES.

What Happens During an Esophageal Manometry Test?

Preparation: Before the test, patients are instructed not to eat or drink for a few hours.

Procedure: A thin, flexible tube with pressure sensors is inserted through the nose and passed down into the esophagus. While this might sound painful, the process is usually well-tolerated.

Measurement: Once in place, the patient is asked to swallow water. The detectors on the tube count the muscle contractions and pressure at various points in the esophagus.

Analysis: The data collected is then studied to determine the pattern of esophageal contractions and the functionality of the LES.

Results: The data collected can indicate abnormalities in the esophageal muscle contractions and determine issues with the LES, confirming a diagnosis of achalasia or other motility conditions.

Why Esophageal Manometry is Essential for Achalasia Diagnosis?

Accurate Diagnosis: It helps in confirming the diagnosis of achalasia by identifying the absence of normal esophageal peristalsis (wave-like muscle contractions) and the failure of the LES to relax.

Differentiation: The test can differentiate achalasia from other conditions with similar symptoms, such as esophageal spasms or pseudoachalasia (secondary achalasia due to cancer).

Guiding Treatment: Understanding the specific dysfunction in the esophagus helps doctors tailor the most effective treatment plan, whether it be pneumatic dilation, surgical myotomy, or pharmacological interventions.

Monitoring Progress: Post-treatment, esophageal manometry can be used to observe the effectiveness of the treatment and make required adjustments.

Living with Achalasia Cardia:

Managing achalasia cardia involves both medical treatment and lifestyle adjustments. Here are some suggestions for those living with the condition:

Dietary Changes: Eat smaller, more frequent meals. Avoid very hot or cold foods and drinks.

Chewing Thoroughly: Take time to chew food well before swallowing.

Staying Upright: Avoid lying down instantly after eating to prevent regurgitation.

Hydration: Drinking water with meals can help food pass through the esophagus more smoothly.