MedPix COW 2013 - Dysphagia and Trouble Swallowing

Achalasia may be secondary to infection (Chagas, Varicella Zoster, Cancer) or Primary - due to loss of the inhibitory nitrergic ganglion cell neurons of the esophagus. This results in both loss of normal peristalsis - as well as failure of relaxation of the LES (lower esophageal sphincter) resulting in a dilated esophagus with retained food.