Achalasia or Anorexia Nervosa?

anatomy of achalasia

One of the issues that clinicians face is that eating disorders are not simple to diagnose.

Take for instance, achalasia. This is a rare physical disorder that affects the oesophagus muscles and sphincter (yes, we have sphincters all over our body). Although a full medical description is far more detailed, essentially, your muscled oesophageal lining no longer functions and what is eaten doesn’t make it down to the stomach. Some of the physical symptoms and the psychological changes that accompany them – such as an avoidance of food because of the discomfort and trapped, tight feeling this causes – mimic eating disorders (Reas et al., 2014). The researchers of the article I read call for a greater awareness, particularly in eating disorder treatment settings as they may be able to detect achalasia; however, they also suggest that people with eating disorders are screened for achalasia because purging behaviours may cause oesophageal degeneration when sustained over long periods of time.

Rare but fascinating and another example of how practitioners, and even us patients, may struggle to make an ‘easy’ clear-cut diagnosis within minutes – which is often what we unfortunately expect when accessing healthcare services. sometimes to get to the true nature of a problem the only option is persistent coupled with trial and error.


Reference: Reas, Deborah L., Stephan Zipfel, and Øyvind Rø. (2014) ‘Is It an Eating Disorder or Achalasia or Both? A Literature Review and Diagnostic Challenges.’ European Eating Disorders Review. 22 (5): 321–330.