Idiopathic esophageal achalasia in a young patient: a case report

Introduction: Esophageal achalasia is a condition characterized by impaired esophageal motility, defined by incomplete or absent relaxation of the lower esophageal sphincter (LES) associated with a lack of peristalsis in the esophageal body. It is a rare disorder that significantly impacts the patient's quality of life and nutritional status due to the presence of symptoms such as dysphagia, heartburn, regurgitation, weight loss, and other manifestations. Methods: Patient records were reviewed, and an extensive literature search was conducted to investigate the prevalence, etiology, pathophysiology, clinical manifestations, diagnosis, and treatment of achalasia, while correlating these findings with the presented case. Case Report: A 22-year-old female patient presented with a 6-month history of progressively worsening dysphagia, initially for solids and subsequently for liquids. This was accompanied by regurgitation, night cough, and an 8-kilogram weight loss within the period. Following upper gastrointestinal endoscopy, esophagram, and high-resolution esophageal manometry, a diagnosis of esophageal achalasia was made. Surgical treatment was chosen, resulting in clinical improvement and symptom resolution. Conclusion: This case emphasizes the importance of recognizing, diagnosing, and understanding the pathophysiology of achalasia to facilitate appropriate investigation and treatment, given its significant morbidity.