Health condition
Achalasia
Achalasia is a rare motility disorder where the lower oesophageal valve fails to relax and the oesophagus loses its pumping action, causing progressive difficulty swallowing; several definitive treatments exist.
Why trust this guide
- 01
Editorial team
Written by our editorial team from the UK sources listed on each page.
- 02
Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
- 03
Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
-
Typical symptoms: difficulty swallowing solids and liquids, regurgitation of undigested food, chest discomfort and weight loss
-
Symptoms progress gradually and are often mistaken for reflux for years
-
Specialist: a consultant gastroenterologist; high-resolution manometry confirms the diagnosis
-
Treatment options include pneumatic dilatation, peroral endoscopic myotomy (POEM) and laparoscopic Heller myotomy
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
In achalasia the nerves controlling the lower oesophageal sphincter degenerate, so the valve stays tight and the gullet above it gradually dilates and loses coordinated contractions. Food and even liquids queue above the closed valve, causing regurgitation, gurgling, night-time coughing and slow weight loss.
Diagnosis and treatment routes
Endoscopy and a barium swallow raise suspicion, but high-resolution manometry is the definitive test and classifies the subtype, which guides therapy. Treatment aims to open the valve permanently: balloon (pneumatic) dilatation, surgical Heller myotomy with an anti-reflux wrap, or POEM, an endoscopic myotomy performed through the mouth, all offer durable relief in experienced hands. In many parts of the UK, routine NHS referrals for this kind of problem currently take 20-45+ weeks, whereas an initial appointment with a private consultant is typically available within around two weeks.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant gastroenterologist. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Achalasia.
Quick, plain-English answers to what people ask us most.
-
What is achalasia?
Achalasia is a rare swallowing disorder in which the muscle at the bottom of the oesophagus fails to open properly, and the normal squeezing motion that pushes food down is lost, making swallowing progressively difficult.
-
What causes achalasia?
In most cases the cause is unclear, but it involves damage to the nerves controlling the oesophagus, possibly from an autoimmune reaction, and is not caused by anything the person has done.
-
What are the symptoms of achalasia?
Typical symptoms include difficulty swallowing food and drink, bringing food back up (regurgitation), chest discomfort, heartburn, and gradual, unintentional weight loss.
-
Is achalasia dangerous?
It is not immediately life-threatening, but untreated achalasia can cause malnutrition, chest infections from aspirated food, and a small increase in long-term oesophageal cancer risk, so treatment and monitoring matter.
-
Is achalasia genetic?
It is not considered a straightforwardly inherited condition; most cases occur without any family history, although research continues into subtle genetic and immune factors that may increase susceptibility.
-
Can achalasia be cured or prevented?
There is no way to prevent achalasia and no cure that restores the oesophagus to normal, but effective treatments can relieve the blockage so most people can eat and swallow comfortably again.
-
How is achalasia treated?
Treatment options range from Botox injections and balloon dilation to surgical myotomy or the endoscopic POEM procedure, selected based on symptom severity, age, and personal preference after specialist assessment.
-
How long does treatment take to improve symptoms?
Many people notice significant swallowing improvement within days of a procedure such as dilation or POEM, although full recovery and adjustment of eating habits can take a few weeks.
-
Achalasia vs oesophageal stricture — what's the difference?
A stricture is a physical narrowing of the oesophagus, often from scarring or acid damage, that can usually be stretched open, whereas achalasia is a functional nerve and muscle problem where the sphincter fails to relax, even though there's no physical narrowing on imaging.
-
When should I see a doctor about achalasia, and how quickly can I be seen privately?
See a doctor if swallowing becomes progressively difficult or you're losing weight unintentionally. NHS gastroenterology referral can take 20 to 45 or more weeks, while private specialist assessment is often available within about two weeks.