Pediatric Achalasia DiagnosisIf achalasia is suspected, your child will likely undergo some or all of the following tests.
This radiology study allows our radiologists to see the structure of your child’s esophagus. When a child has achalasia, the shape of the esophagus is shaped like a funnel, getting more and more narrow towards the bottom. Your child will need to swallow a small amount of barium contrast for this study.
Your child’s physician may recommend an upper endoscopy to see inside the esophagus, which involves threading a thin tube (endoscope) with a tiny camera down the throat and into the esophagus. Children are sedated so they will not feel any pain. This test helps rule out inflammatory conditions that could be causing swallowing problems, including eosinophilic esophagitis.
This specialized test allows us to test the pressure in different areas of the esophagus, which can help diagnose achalasia.
Treatment Options for Pediatric Achalasia
Two treatments are available that can temporarily relieve achalasia symptoms in infants and children. Each of these treatments will open up the esophagus for a period of time, ranging from approximately two to 10 years. When symptoms recur, the procedures can be repeated.
Our pediatric gastroenterologists and surgeons can provide more details about each of these procedures and help you determine the best option for your child. When possible, we encourage older children to learn about treatment options and be involved in choosing the one that will work best for them.
Pediatric surgeons at Comer Children’s perform this surgery through small incisions near the bottom of the esophagus. They insert a thin tube, or laparoscope, which contains tiny surgical instruments. Then the surgeon makes little cuts in the muscle of the esophagus, which helps open up the esophagus so food can pass through more easily.
We use a minimally invasive approach so children recover faster than they do after traditional open surgery. Although, children may need to stay in the hospital for a day or two. This surgical procedure is considered the gold standard treatment for achalasia in children because it can provide symptom relief for five to 10 years.
In this procedure, we will insert a thin tube (endoscope) down the throat and thread it to the lower esophagus. Then, a small balloon is slowly inflated from the endoscope and slowly inflated. This stretches the lower esophagus so that food can pass through. Children usually go home the same day. While this procedure can successfully treat achalasia, symptoms may return in two to five years.