Infants and children with achalasia have difficulty swallowing food. This rare disorder occurs when the esophagus — which is the “food pipe” between the mouth and the stomach — narrows and tightens at the bottom. As a result, food and liquids cannot easily pass into the stomach.

Having achalasia is distressing for children and their parents. Your child may lose weight, choke or vomit more than usual.

Fortunately, achalasia can be successfully treated in most children with state-of-the-art, minimally invasive procedures. While not a cure, these treatments will allow your child to swallow food and get the necessary nutrients for proper growth and development.

At the University of Chicago Medicine Comer Children’s Hospital, we are highly experienced in managing all types of swallowing disorders in infants and children, including achalasia. At our Pediatric Aerodigestive Clinic, patients benefit from our team approach to managing children with complex disorders of the upper digestive tract, upper airway and lungs. Our pediatric specialists — gastroenterologists, otolaryngologists, pulmonologists, surgeons and speech therapists — work together to accurately diagnose your child’s condition and provide treatment in a timely manner.  

At Comer Children’s we believe in a family approach to care. Our clinicians truly care about what parents want for their children and what children want for themselves. We work together with families to ensure we are on the same page and doing all we can to help your child experience a healthy childhood.  

 

Common Questions about Pediatric Achalasia

Infants and toddlers with achalasia may have trouble feeding or eating. Parents may notice:  

  • Frequent vomiting or spitting up of food or liquid
  • A frequent, unexplained cough
  • Weight loss
  • Frequent choking

Older children and teenagers will have difficulty swallowing, which is known as dysphagia. They may even have trouble swallowing soft pureed food and liquids. They may also complain of heartburn or acid reflux. Parents might notice that children refuse to eat certain foods that are harder to swallow — such as steak — and gravitate towards foods that are easier to get down, such as chicken noodle soup.

Achalasia is sometimes confused with gastroesophageal reflux disease (GERD) which causes many of the same symptoms. However, achalasia causes worse swallowing problems than GERD. Left untreated, achalasia symptoms tend to worsen. Many children with achalasia have so much trouble swallowing that they have to be temporarily restricted to liquid formulas or have food delivered through a nasogastrictube (NG-tube) into their stomach. 

Achalasia can develop at any age, from infancy through adulthood. The exact cause is unknown, but physician experts believe there are many factors involved, including:

  • Genetics: If one parent has achalasia, their children may develop it.  
  • Certain syndromes: People with certain syndromes, such as Down syndrome and Parkinson’s disease, may be more prone to develop achalasia.
  • Autoimmune disorders: Many patients with achalasia have autoimmune disorders, which suggest there may be an autoimmune trigger.
  • Potential viral infection

Our physicians conduct special tests, including imaging, motion studies, and an upper endoscopy, to diagnose achalasia in children. Once the diagnosis is made, we will talk with you and your child about achalasia treatment options, which include minimally invasive surgery.  

The treatments for achalasia, including esophagomyotomy and balloon dilation, can relieve symptoms in most children. Your child will feel much better after these procedures, but these treatments may need to be repeated in the future. There is not yet a cure for achalasia. 

Our pediatric gastroenterologist typically will see your child every two to six months after treatment. Follow-up decreases to once a year after your child has no symptoms.

If your child starts to complain again of trouble swallowing and other symptoms, we will run some tests to determine if more treatment is needed.

Pediatric specialists at Comer Children’s work closely with adult achalasia specialists at the UChicago Medicine Center for Esophageal Diseases. As children reach their late teens, they can transfer over to the adult program, which offers the most advanced diagnostic and treatment options.

Meet Our Pediatric Achalasia Physician Team