The oesophagus or gullet (食道 in Mandarin) is a muscular tube which carries food from the mouth into the stomach. Once food enters the oesophagus, it is then moved down through a series of muscular contractions called ‘peristalsis’.
An upper endoscopy is a common test used to examine the upper digestive tract. The procedure is usually performed in an outpatient setting. It involves the insertion of an endoscope, which is a thin flexible tube with a camera at the tip, to allow for a visual examination of the oesophagus and stomach. The procedure takes less than 10 minutes and is often performed under light sedation. It is very useful for excluding any tumour or blockage of the oesophagus. In Achalasia, the oesophagus will be wider than usual, and is sometimes filled with residual food (Fig. 1a and Fig. 1b).
Commonly known as Botox, a Botulinum Toxin Injection blocks the release of chemicals in the muscle which induces contractions, hence resulting in relaxation of the LES. It is a safe and effective treatment for Achalasia. Side-effects are minimal but relief is temporary.