Achalasia is defined as failure to relax on the part of the cardiac "sphincter"; this term has replaced the older term, cardiospasm, in Standard Nomenclature of Diseases and Operations. The patients usually complain of dysphagia but may or may not have spasmodic substernal pain. They gradually become emaciated. The cause of this condition is unknown, but in these patients ganglion cells of the myenteric plexus in the lower portion of the esophagus are absent and the neuromuscular mechanism of the esophagus is disturbed. The disease may occur at any age but is relatively rare in patients under 30. Although emotional factors may aggravate the condition, there is no evidence that such factors have ever caused it.1 It has been experimentally produced in cats by a high vagotomy.2
In patients with achalasia the diagnosis is often not made at once. It is important, however, to establish the diagnosis and
ACHALASIA. JAMA. 1957;163(10):840. doi:10.1001/jama.1957.02970450042011
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