Often the loss of peristalsis is accompanied by an increase in the pressure of the lower esophageal sphincter.
Patients usually complain of dysphagia and retention of undigested food in the lower esophagus .
The pathologic finding in esophageal specimens is the loss of nerve fibers in the wall of the esophagus. The cause remains unknown. The first is called Vigorous Achalasia and has the features of achalasia, but in addition the patients experience episodes of chest pain due to intermittent, strong, but non-propulsive contractions of the esophagus . The second is called Chagas Disease . This entity is also characterized by a loss of nerves in the wall of the esophagus and presents with similar symptoms.