Achalasia Cardia in children is a rare swallowing disorder in which the lower esophageal sphincter (LES), the muscle connecting the esophagus to the stomach, fails to relax properly during swallowing. At the same time, the muscles of the esophagus lose their normal ability to push food toward the stomach.
As a result, food and liquids remain trapped inside the esophagus instead of passing easily into the stomach. Over time, the esophagus becomes enlarged, causing difficulty swallowing, vomiting, poor nutrition, and weight loss.
Although achalasia cardia is more common in adults, it can also affect children and adolescents. Early diagnosis and timely treatment help improve swallowing, nutrition, and overall quality of life.
The symptoms of achalasia cardia usually develop gradually and may worsen over time.
Common symptoms of achalasia cardia in children include:
Some children may avoid eating because swallowing becomes uncomfortable.
The exact cause of achalasia cardia is not completely understood.
Possible causes and contributing factors include:
In most children, no definite cause can be identified.
Based on esophageal muscle function, achalasia cardia is classified into three types.
The esophagus loses almost all muscle movement, and the lower esophageal sphincter does not relax properly.
The esophagus shows poor muscle movement with increased pressure inside the esophagus during swallowing. This type generally responds well to treatment.
The esophagus develops abnormal muscle spasms along with poor relaxation of the lower esophageal sphincter.
Certain factors may increase the risk of achalasia cardia.
Risk factors include:
However, most children develop achalasia without any identifiable risk factors.
If left untreated, achalasia cardia may lead to serious complications.
Difficulty swallowing may reduce food intake and affect growth.
Poor nutrition may result in significant weight loss.
Food may enter the lungs during swallowing, leading to chest infections.
The esophagus may gradually become stretched and enlarged.
Repeated aspiration increases the risk of respiratory infections.
Retained food may irritate and inflame the lining of the esophagus.
Doctors use several tests to confirm achalasia cardia and rule out other swallowing disorders.
Diagnosis may include:
Esophageal manometry is considered the gold standard test for diagnosing achalasia cardia.
Treatment aims to improve swallowing by reducing pressure at the lower esophageal sphincter.
In selected children, medicines may temporarily help relax the lower esophageal sphincter, although they are generally less effective than procedural treatments.
A balloon is inserted through an endoscope and inflated to widen the narrowed lower esophageal sphincter.
This is the most commonly recommended surgical treatment for achalasia cardia in children.
During this procedure:
In selected children, POEM may be performed as a minimally invasive endoscopic procedure to divide the tight esophageal muscle without external incisions.
Most children experience significant improvement in swallowing after treatment.
Parents are usually advised to:
Recovery is generally faster after minimally invasive procedures.
Helpful care measures include:
Proper nutrition and regular monitoring help support healthy growth and development.
Parents should seek medical attention if the child develops:
Early diagnosis of achalasia cardia in children helps prevent nutritional deficiencies and long-term complications.
No, achalasia cardia is a rare swallowing disorder in children.
While the underlying nerve damage cannot be reversed, treatment can effectively relieve symptoms and improve swallowing.
Laparoscopic Heller myotomy is considered one of the most effective treatments. POEM and balloon dilatation may also be suitable for selected children.
Most children eventually require a procedure such as balloon dilatation, POEM, or Heller myotomy because medications provide only temporary relief.
Yes. Difficulty swallowing can lead to poor nutrition, weight loss, and delayed growth if left untreated.
Yes. With timely treatment and regular follow-up, most children experience significant improvement in swallowing and lead healthy, active lives.
Dr. Muni Varma is an experienced Pediatric Surgeon specializing in the diagnosis and treatment of achalasia cardia and other complex pediatric gastrointestinal disorders. With expertise in pediatric minimally invasive surgery, laparoscopic Heller myotomy, neonatal surgery, and advanced digestive tract procedures, Dr. Varma provides comprehensive child-focused care using modern diagnostic and surgical techniques. From accurate diagnosis with esophageal manometry to advanced surgical treatment and long-term nutritional follow-up, he focuses on restoring normal swallowing, improving nutrition, and ensuring healthy growth and development. Early expert treatment helps children regain comfortable eating and enjoy an improved quality of life.
