Digestive

Medicines for Achalasia

A rare condition where the muscle at the bottom of the food pipe fails to relax and the food pipe loses its normal movement, making swallowing difficult — treated by procedures that ease the blockage.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Quick answer

What is Achalasia?

Achalasia is an uncommon disorder of the oesophagus (food pipe) in which the ring of muscle at its lower end fails to relax to let food into the stomach, and the food pipe itself loses its normal squeezing movement. As a result, food and drink build up, causing increasing difficulty swallowing both solids and liquids, bringing up undigested food, chest discomfort, and sometimes weight loss.

  • How it is treated: Achalasia cannot be cured, but effective treatments relieve the obstruction and improve swallowing by reducing the tightness of the lower muscle.
  • Self-care: Eating slowly, chewing well, drinking fluids with meals, eating smaller amounts, and sitting upright after eating can ease swallowing.
  • When to seek help: See a doctor about persistent or worsening difficulty swallowing, bringing up undigested food, or unexplained weight loss — any new swallowing difficulty should be assessed promptly.

What it is

Achalasia is an uncommon disorder of the oesophagus (food pipe) in which the ring of muscle at its lower end fails to relax to let food into the stomach, and the food pipe itself loses its normal squeezing movement. As a result, food and drink build up, causing increasing difficulty swallowing both solids and liquids, bringing up undigested food, chest discomfort, and sometimes weight loss. It develops gradually and can be mistaken for reflux at first. Diagnosis uses tests such as a barium swallow X-ray, endoscopy (to exclude other causes) and a test measuring the pressure and movement in the food pipe (manometry).

How it is treated

Achalasia cannot be cured, but effective treatments relieve the obstruction and improve swallowing by reducing the tightness of the lower muscle. Options include stretching the muscle with a balloon (pneumatic dilatation), a surgical procedure to cut the muscle (myotomy, including a keyhole technique), and, in some people, injections into the muscle. The choice depends on age, fitness and preference, and is made with a specialist. Because the condition can allow food to linger, follow-up is important, and reflux after treatment is managed if it occurs.

For this condition, these medicines

Medicine classes used for Achalasia

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Beyond medication

Lifestyle and self-care

Eating slowly, chewing well, drinking fluids with meals, eating smaller amounts, and sitting upright after eating can ease swallowing. Reporting worsening swallowing or weight loss ensures timely treatment.

When to get help

When to see a doctor

See a doctor about persistent or worsening difficulty swallowing, bringing up undigested food, or unexplained weight loss — any new swallowing difficulty should be assessed promptly.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Achalasia: frequently asked questions

What are the main symptoms of achalasia?

Gradually worsening difficulty swallowing both solids and liquids, bringing up undigested food, chest discomfort and sometimes weight loss. New swallowing difficulty should always be assessed.

Can achalasia be cured?

It cannot be cured, but treatments that ease the tight lower muscle — such as balloon stretching or a surgical myotomy — can greatly improve swallowing, with specialist follow-up.

Sources

Where this is drawn from

  • NHS — Dysphagia (swallowing problems)
  • NICE — interventional procedure guidance on achalasia

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