Achalasia, it turns out there are these symptoms

Achalasia is caused by a decrease or even disappearance of the ganglion cells in the esophageal wall nerve plexus, and is often manifested by difficulty in swallowing, pain, food reflux, weight loss, bleeding and anemia. In the later stages, the extremely dilated esophagus can compress the organs in the chest cavity and cause dry cough, shortness of breath, cyanosis and hoarseness.

(I) Dysphagia: Painless dysphagia is the most common and earliest symptom of this disease, accounting for more than 80% to 95%. The onset is usually slow, but it can also be acute. It may be mild at first, with only a feeling of fullness after a meal. Dysphagia is often intermittent and is often triggered by mood swings, anger, anxiety, fear, or eating irritating foods such as cold and spicy foods. Dysphagia is sometimes present and sometimes absent at the beginning of the disease, sometimes mild and sometimes severe, but becomes persistent in the later stages. A small number of patients have more difficulty swallowing liquids than solid foods. Some people use this sign to distinguish dysphagia caused by other organic esophageal stenosis, but most patients have more difficulty swallowing solids than liquids, or have equal difficulty swallowing solid and liquid foods. Patients have psychological barriers due to eating difficulties and are only willing to eat alone.

(ii) Pain: It accounts for about 40% to 90% of the cases and has different properties, such as dull pain, burning pain, stabbing pain, cutting pain or piercing pain. The pain is mostly located behind the sternum and in the upper and middle abdomen; it can also occur in the chest and back, right chest, right sternal margin and left hypochondrium, and lasts for several minutes to hours. It often occurs in the early stages of the disease, especially in patients with severe achalasia. It is not necessarily related to eating. The pain attacks are sometimes similar to angina pectoris, and can even be relieved by taking nitroglycerin tablets under the tongue. Manometry examinations reveal high-amplitude contractions, which may be related to esophageal muscle spasms. Some pain may occur due to eating too fast or food stuck in the lower esophageal sphincter. As the difficulty in swallowing gradually worsens and the esophagus above the obstruction further expands, the pain may gradually subside.

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(IV) Weight loss: Weight loss is related to dysphagia which affects food intake. Although patients with dysphagia often choose their food carefully, eat slowly, drink plenty of soup during or after meals to wash down the food, or straighten their chest and back after meals, take deep breaths or hold their breath to assist swallowing and allow food to enter the stomach to ensure nutritional intake, patients with a long course of illness may still experience weight loss, malnutrition, and vitamin deficiency, while cachexia is rare.

(V) Bleeding and anemia : Patients often suffer from anemia and occasionally bleeding caused by esophagitis.

(VI) Other symptoms: Due to the increased tension of the lower esophageal sphincter, patients rarely experience hiccups, which is an important feature of this disease. In late cases, the extremely dilated esophagus may compress the organs in the chest cavity and cause dry cough, shortness of breath, cyanosis and hoarseness.