Pediatric achalasia

What is pediatric achalasia?

Achalasia causes the lower esophageal sphincter, called the LES, to remain closed during swallowing, preventing the esophagus from propelling food toward the stomach. The normal function of peristalsis is also affected.

Risk factors

Achalasia is diagnosed in about 2,500 people in the United States every year. Only about 10% of cases occur in children.

What are the signs and symptoms of pediatric achalasia?

Common signs and symptoms may include:

• Coughing spells after eating

• Dysphagia (difficulty swallowing)

• Halitosis and heartburn

• Regurgitation of undigested food

• Thoracic (chest) pain

• Weight loss

How is pediatric achalasia diagnosed?

An upper gastrointestinal (GI) X-ray is the first step to obtain a general diagnosis of the disorder. It is usually followed by an esophageal manometry to measure esophageal tone, pressure, and coordinated motion of the esophagus.

An endoscopy is also used to get a close-up image of the problem.

How is pediatric achalasia treated?

Surgery

Most children with achalasia require surgery to relieve the high pressure at the LES. Dilation of the LES may offer some benefit, but often the results are short term. Technological advances in minimally invasive surgery make these procedures simpler and easier for patients.

Medication

Medications such as calcium-channel blockers, botulinum toxin and slow-release nitrates rarely provide long-term relief of symptoms.

For most patients, surgery and medication provide a moderate level of long-term dysphagia control. This will allow your child to have an improved quality of life.