Achalasia

Achalasia

This is the very bottom of the esophagus, and compared to the photograph we saw in gastroesophageal junction, this is very tightly shut; in fact, there is only a pinhole opening. In patients with this condition, achalasia, there is difficulty in swallowing food and it backs up into the esophagus. We often have to operate on patients to open this area up, but there are more recent therapies one of which is shown in the next photograph.

Achalasia after Botox injection

This is the same patient in whom we saw achalasia, but we have injected Botox, which is used for many different medical and cosmetic purposes, it is in the very bottom of the esophagus where the muscle was extremely tight. Botox stops the muscle from being quite as tight and allows it to open up. This effect is temporary, but typically lasts several months and gives remarkable relief of the symptoms. If you simply compare the opening in this patient, you can see a dramatic difference.