Achalasia in Children

Overview

Achalasia is a condition that affects how the esophagus (the tube that carries food from the mouth to the stomach) works. Normally, the muscles in the esophagus move food down, and the muscle at the bottom, called the lower esophageal sphincter (LES), relaxes to let food into the stomach. In achalasia, the esophagus muscles don’t move properly, and the LES doesn’t relax as it should, creating a blockage where the esophagus meets the stomach. This makes it hard for food and liquids to pass through.

At Gertrude’s Children’s Hospital, we understand how achalasia can affect your child’s quality of life, from trouble swallowing to discomfort after meals. Our team is here to help, with the expertise to manage this condition effectively.

Symptoms

Children with achalasia may experience various symptoms, which can worsen over time. Common symptoms include:

  • Difficulty swallowing (dysphagia), which may feel like food is stuck in the throat or chest.
  • Regurgitation of food or liquids back up into the mouth.
  • Chest pain, particularly after eating.
  • Coughing or choking, especially during or after meals.
  • Unexplained weight loss or poor growth.
  • Heartburn or discomfort after eating.
  • Difficulty burping or a feeling of fullness after eating small amounts.
  • Hiccups 

If your child is showing any of these symptoms, it’s important to seek medical advice for proper diagnosis and care.

Causes

The exact cause of achalasia in children is not well understood, but it’s thought to be linked to nerve damage in the esophagus. There is some evidence that achalasia may be caused by the immune system mistakenly attacking the body’s own tissues. 

Achalasia is a rare disorder that affects how the esophagus works in children, and it’s even less common in kids under 5 years old. Each year, only about 1 in a million children develop achalasia. Fewer than 5% of people with achalasia show symptoms before the age of 15, and the condition is seen more often in boys. 

Most cases have no clear cause, but it has been linked to conditions like Down syndrome (Trisomy 21), problems with breathing control, hormone deficiencies, certain immune disorders, and diseases like Chagas’ disease and AAA syndrome (which affects tear production, hormone regulation, and the esophagus).

Diagnosis

Diagnosing achalasia involves several tests to confirm how well the esophagus is functioning. At Gertrude’s Children’s Hospital, our specialists use advanced diagnostic tools to ensure accurate detection. The diagnosis process may include:

  • Esophageal Manometry: This test measures the pressure in the esophagus and checks how well the muscles are contracting. It’s the most definitive test for achalasia.
  • Barium Swallow Test: In this test, your child drinks a special liquid that coats the esophagus. X-rays are then taken to see how the liquid moves down the esophagus.
  • Endoscopy: A small camera is inserted into the esophagus to look for any abnormalities or blockages. Biopsies (small tissue samples) may also be taken to rule out other conditions.

These tests help our doctors determine if achalasia is the cause of your child’s symptoms and guide the best course of treatment.

Treatment Options

At Gertrude’s Children’s Hospital, we offer a range of treatments for achalasia, depending on the severity of the condition and the needs of the child. Our goal is to relieve symptoms, improve swallowing, and restore a normal eating experience for your child.

Common Treatments Include:

  • Pneumatic Dilation: This is a non-surgical procedure where a balloon is inserted into the esophagus and inflated to stretch the lower esophageal sphincter, allowing food to pass through more easily. This procedure is effective for many children but may need to be repeated over time.
  • Heller Myotomy Surgery: This minimally invasive surgery is often the preferred treatment for children with achalasia. The surgeon cuts the muscles at the bottom of the esophagus to help the lower esophageal sphincter relax and allow food to pass. This surgery has a high success rate and provides long-lasting relief.
  • Botox Injections: In some cases, Botox can be injected into the lower esophageal sphincter to temporarily relax the muscle. This treatment is usually considered if other methods aren’t suitable or if surgery is not an immediate option.
  • Medications: Although less common, some medications may be used to help relax the lower esophageal sphincter. These are usually considered when other treatments are not an option or as a temporary measure.

At Gertrude’s, our specialists will work with your family to choose the most appropriate treatment, focusing on what’s best for your child’s long-term health and comfort.

Patient Success Stories

At Gertrude’s Children’s Hospital, we are committed to providing the best possible care for children with Achalasia. Here’s why families trust us:

“When our son was diagnosed with Achalasia, we were terrified. The doctors at Gertrude’s Children’s Hospital acted quickly, and thanks to their expertise, he made a full recovery. We are so grateful for their care and support during such a difficult time.”

Markparent of a child with Achalasia

Achalasia in Children

Achalasia is quite rare in children, but it can occur. Our specialists are experienced in diagnosing and managing this condition in young patients.

The success rate for treatments like Heller Myotomy surgery is very high, with most children experiencing significant improvement in swallowing and quality of life after treatment.

Recovery depends on the type of treatment. After pneumatic dilation, most children can resume normal activities within a few days. Following surgery, recovery may take a bit longer, but children usually heal within a few weeks.

We monitor all our patients after treatment to ensure that symptoms don’t return. Some children may need follow-up treatments, especially if they had pneumatic dilation. Regular check-ups help us keep your child’s progress on track.

Yes, most children can return to a regular diet after treatment, although we may recommend starting with soft foods during the early recovery period.

If symptoms return, we will reassess your child’s condition and may recommend additional treatments, such as a repeat dilation or further surgical options.

Contact Us

If your child is showing signs of achalasia or experiencing difficulty swallowing, contact Gertrude’s Children’s Hospital today to schedule an evaluation. Early diagnosis and treatment can significantly improve your child’s comfort and quality of life.

Contact us today to learn more about our Achalasia in Children treatment options.

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