Achalasia is caused by degeneration of the nerve cells that normally signal the brain to relax the esophageal sphincter. The ultimate cause of this degeneration is unknown. Autoimmune disease or hidden infection is suspected. Symptoms Dysphagia, or difficulty swallowing, is the most common symptom of achalasia. Heartburn and difficulty belching are common.
Symptoms usually get steadily worse.
Other symptoms may include nighttime cough or recurrent pneumonia caused by food passing into the lower airways. Diagnosis Diagnosis of achalasia begins with a careful medical history. The history should focus on the timing of symptoms and on eliminating other medical conditions that may cause similar symptoms. In this test, a thin tube is passed into the esophagus to measure the pressure exerted by the esophageal sphincter. X ray of the esophagus.