Diseases, Conditions & Injuries

Diseases, Conditions and Injuries has been designed as a comprehensive and concise quick-reference guide. The authors and physician reviewers have provided up-to-date information that is consistent with consensus interpretations for accuracy and practical considerations. This information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health care professional before starting any new treatment or with any questions you may have regarding a medical condition.

A

Aarskog Syndrome
Achalasia
Achilles Tendinitis
Achondroplasia
AcneAcoustic Neuroma
Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV)AcromegalyActinic Keratosis
Acute Cystitis
Acute Lymphoblastic Leukemia
Acute Myelogenous Leukemia
Addison's DiseaseAdjustment Disorder
Adrenoleukodystrophy
Adult Macular Degeneration (AMD)
Adult Respiratory Distress Syndrome
AgoraphobiaAlbinismAlcohol Abuse and Alcoholism
Allergic Bronchopulmonary Aspergillosis (ABPA)
Allergic Rhinitis
AlopeciaAlzheimer's Disease
AmblyopiaAmyloidosis
Amyotrophic Lateral Sclerosis (ALS)
Anal FissureAnaphylaxis
Anemia of Chronic DiseaseAnginaAnimal Bites
Ankle Fracture
Ankle Sprain
Ankylosing Spondylitis
Anorexia Nervosa
Anoxic Brain Damage
Anterior Cruciate Ligament (ACL) Injury
AnthraxAntisocial Personality Disorder
AnxietyAortic Aneurysm
Aortic Dissection
Aortic Regurgitation
Aortic Stenosis
Aphthous Ulcers
Aplastic
Anemia
Appendicitis
Arrhythmias
Arsenic Toxicity
Arteriovenous Malformations
Asbestosis
Ascariasis
Aseptic Necrosis of the HipAsperger Syndrome
Aspergillosis
Aspiration Pneumonia
Asthma
Astigmatism
Astrocytoma
Atelectasis
Atherosclerosis
Athlete's Foot
Atrial Fibrillation
Atrial Flutter
Atrophic Vaginitis
Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD)
Atypical Pneumonia (Mycoplasma and Viral)
AutismAutoimmune Hemolytic
AnemiaAvian Influenza

B
Bacterial Endocarditis
Bacterial Meningitis
Bacterial Vaginosis
BarotraumaBarrett's EsophagusBatten Disease
Bed-WettingBehcet’s Disease
Bell's PalsyBenign Essential TremorBenign Prostatic Hyperplasia (BPH)
BerylliosisBinswanger’s Disease
Bipolar DisorderBirthmarks
Bladder Cancer
Blepharitis
Blisters
Blood Poisoning
Boils
Bone Cancer
Borderline Personality Disorder (BPD)
Botulinum Toxin
Botulism
Bradycardia
Brain Tumor and Brain Cancer
Breast Cancer
Bronchiolitis
Bronchitis
Bronchopulmonary Dysplasia
Brucellosis
BruxismBulimia Nervosa
BunionBurner or StingerBurnsBursitis

C

Cadmium Toxicity
Calf Muscle Strain
Calluses and CornsCarbon Monoxide Poisoning
Cardiac Arrest
Cardiomyopathy
Carpal Tunnel Syndrome
Cat Scratch Fever
Cataract
Celiac Disease
Cellulitis
Cerebral Palsy
Cerumen Impaction
Cervical Cancer
Cervical Dysplasia
Chalazion
Charcot-Marie-Tooth Disease
Chickenpox
Chlamydia
Cholera
Chondromalacia Patella
Chorioretinitis
Chronic Fatigue Syndrome
Chronic Lymphadenitis
Chronic Lymphocytic Leukemia
Chronic Myelocytic Leukemia
Chronic Obstructive Pulmonary Disease
Chronic Venous Insufficiency
Cirrhosis
Claustrophobia
Clavicle Fracture
Cluster Headache
CMV Infection
Coccyx Fracture
Cold Sores
Colic
Colon Polyps
Colorectal
Cancer
Coma
Common Cold
Complex Regional Pain Syndrome
Concussion
Congenital Adrenal Hyperplasia
Congenital Hypothyroidism
Congenital Syphilis
Congestive Heart Failure
Conjunctivitis
Constipation
Contact Dermatitis
Contractures
Contusion (General)
Conversion Disorder
Corneal Abrasion
Corneal Opacity
Coronary Artery Disease (CAD)
Costochondritis
Cough
Crab Lice
Creutzfeldt-Jakob Disease
Crohn's Disease
Croup
Crouzon Syndrome
Cryptosporidiosis
Cushing's Syndrome
Cystic Fibrosis (CF)
Cystocele/Rectocele

D

De Quervain's Tenosynovitis
Deafness
Decompression Sickness
Deep Vein Thrombosis
Dehydration
Delayed Sexual Development
Delirium
Delirium Tremens (DTs)
Dementia
Dengue Fever
Depression
Dermatofibroma
Dermatomyositis
Detached Retina
Deviated Nasal Septum
Diabetes Insipidus
Diabetic Foot Ulcer
Diaper RashDiarrhea
DiphtheriaDiseases, Conditions and Injuries Conditions InBrief
Disseminated Intravascular Coagulation
Diverticulitis
Down Syndrome
Drowning
Drug Abuse and Drug Addiction
Dupuytren's Contracture
Dyslexia
Dysmenorrhea
Dyspareunia
Dysphagia
Dysthymia

E

Ectopic Pregnancy
Eczema
Ehlers-Danlos Syndrome
Elbow Fracture
Elbow Sprain
Emphysema
Encephalitis
Encopresis
Endocarditis
Endometriosis
Eosinophilia
Epidermal Cyst
Epididymitis
Epiglottitis
Erythema Infectiosum
Erythema Multiforme
Erythema Nodosum
Esophageal Cancer
Esophageal Stricture
Esophageal Variceal Injection
Esophageal Varices
Eustachian Tube Dysfunction
Eye Contusion

F

Fabry Disease
Failure-to-Thrive
Fainting
Familial Adenomatous Polyposis
Febrile Seizures
Female Sexual Dysfunction
Femoral Fracture
Fetal Alcohol Syndrome
Fever of Unknown Origin
Fibrocystic Disease
Fibromyalgia
Finger Dislocation
Finger Fracture
Finger Sprain
Flat Foot
FluFolic Acid Deficiency
Food Allergy
Food Poisoning
Foot Fracture
Forearm Fracture
Fracture
Fragile X Syndrome
Friedreich’s Ataxia
Frostbite
Frozen Shoulder

G

Galactorrhea
Galactosemia
Gallbladder Cancer
Gallstones
Ganglion Cyst
Gangrene
Gastritis
Gaucher Disease
Generalized Anxiety Disorder (GAD)
Genital Herpes
Genital Warts
Gestational Diabetes
Giardiasis
Gilbert's Syndrome
Gingivitis
Glaucoma
Glioblastoma Multiforme (GBM)
Glomerulonephritis
Gluteal Strain
Glycogen Storage Diseases
Gonorrhea
Gout
Groin Hernia
Groin Strain
Group B Streptococcal Disease (GBS)
Guillain-Barre Syndrome
Gynecomastia

H

Hairy Cell Leukemia
Hammer Toe
Hamstrings Strain
Head Lice
Hearing Loss
Heart Attack
Heart Block
Heart Murmur
Heartburn
Heat Exhaustion and Heat Stroke
Heavy Metal Poisoning
Hemangioma
Hematuria
Hemochromatosis
Hemophilia
Hemorrhoidectomy
Hemorrhoids
Henoch-Schonlein Purpura
Hepatitis A
Hepatitis B
Hepatitis C
Herniated Disk
Hiatal Hernia
Hiccups
High Blood Pressure
High Cholesterol
Hip Dislocation
Hip Fracture
Hirschsprung’s Disease
Hirsutism
Histoplasmosis
Hives
Hodgkin's Lymphoma
Homocystinuria
Hordeolum
Huntington's Disease
Hydradenitis Suppurativa
Hydrocele/Varicocele
Hydrocephalus
Hydronephrosis
Hyperemesis Gravidarum
Hyperhidrosis
Hyperlipidemia
Hyperparathyroidism
Hyperthyroidism
Hypochondria
Hypoglycemia
Hypoparathyroidism
Hypopituitarism
Hypothermia
Hypothyroidism

I

Ichthyosis
Idiopathic Pulmonary Fibrosis
Idiopathic Thrombocytopenic PurpuraIgA Nephropathy
Ileus
Iliotibial Band Friction Syndrome
Impetigo
Impotence
Infertility in Men
Infertility in Women
Ingrown Toenail
Insect Allergy
Insomnia
Intellectual Disability
Interstitial Cystitis
Intervertebral Discectomy
Intussusception
Iron-Deficiency Anemia
Irritable Bowel Syndrome (IBS)
Ischemic Bowel Disease (IBD)

J

Jaundice
Jock Itch
Juvenile Rheumatoid Arthritis

K

Kaposi's Sarcoma
Kawasaki Disease
Keloid
Keratoconjunctivitis Sicca
Kidney Cancer
Kidney Failure
Kidney Infection
Kidney Stones
Kleptomania
Klinefelter Syndrome
Knee Sprain
Korsakoff's Syndrome

L

Labyrinthitis
Lactose Intolerance
Laryngeal Cancer
Laryngitis
Lateral Epicondylitis
Lead Poisoning
Legionnaire's Disease
Lesch-Nyhan Syndrome
Leukoplakia
Lichen Planus
Ligament Sprains
Lipoma
Little League Elbow
Liver Cancer
Low Back Pain
Lung Cancer
Lyme Disease

M
Malabsorption
Malaria
Malignant Hypertension
Mallet Finger
Marfan Syndrome
Mastitis
Measles
Mechanical Bowel Obstruction
Meckel’s Diverticulum
Medial Epicondylitis
Melanoma
Meniere's Disease
Meningioma
Meniscal Tear
Menkes Syndrome
Menopause
Menorrhagia
Mercury Toxicity
Metabolic Encephalopathy
Metabolic Syndrome
Middle Ear Infection
Migraine
Mild Cognitive Impairment
Miscarriage
Mitral Regurgitation
Mitral Stenosis
Mitral Valve Prolapse
Moles
Molloscum Contagiosum
Mononucleosis
Morton's Neuroma
Mosquito-borne Viral Encephalitis
Motion Sickness
Multiple Myeloma
Multiple Sclerosis
Mumps
Muscle Strain
Muscular Dystrophy
Myasthenia Gravis
Myelodysplastic Syndromes (MDS)
MyocarditisMyoclonus

N

Narcolepsy
Narcotic Abuse
Nasal Polyp
Nearsightedness and Farsightedness
Neck Fracture
Neck Sprain
Necrotizing Enterocolitis
Neonatal Sepsis
Nephrotic Syndrome
Neurofibromatosis
Neurogenic Bladder
Newborn Jaundice
Niemann-Pick Disease
Night Blindness
Nocturnal Leg Cramps
Non-Hodgkin's Lymphoma (Adult)
Nontoxic Nodular Goiter
Nose Fracture
Nosebleed
Nystagmus

O

Obesity
Obsessive-Compulsive Disorder (OCD)
Onychomycosis
Ophthalmia Neonatorum
Oppositional Defiant Disorder (ODD)
Optic Neuritis
Oral-Facial Clefts
Orbital Cellulitis
Orthostatic Hypotension
Osgood-Schlatter Disease
Osteoarthritis
Osteochondroma
Osteogenesis Imperfecta
Osteomyelitis
Osteoporosis
Otitis Externa
Otosclerosis
Ovarian Cancer
Ovarian Cyst

P
Paget's Disease
Pancreatic Cancer
Pancreatitis
Panic Disorder
Parkinson's Disease
Paronychia
Parotitis
Paroxysmal Supraventricular Tachycardia
Passive-Aggressive Personality Disorder
Patellar Tendinitis
Patellofemoral Pain Syndrome
Patent Ductus Arteriosus
Pelvic Fracture
Pelvic Inflammatory Disease (PID)
Pemphigus
Peptic Ulcer
Pericarditis
Periodic Paralysis Syndrome
Peripheral Neuropathy
Peripheral Vascular (Arterial) Disease
Peritonitis
Pernicious Anemia
Phantom Limbsyndrome
Pharyngitis/Tonsillo
pharyngitis
Phenylketonuria
Pheochromocytoma
Pilonidal Cyst
Pinworms
Pituitary Adenoma
Pityriasis Rosea
Placenta Previa
Plague
Plantar Fasciitis
Plantar Warts
Pleural Effusion
Pleural Mesothelioma
Pleurisy
Pneumocystis
PneumoniaPneumonia
Pneumothorax
Poison Ivy, Poison Oak, Poison Sumac
Poliomyelitis
Polyarteritis Nodosa
Polycystic Kidney Disease
Polycystic Ovary Syndrome (PCOS)
Polymyalgia Rheumatica and Giant Cell Arteritis
Polymyositis
Porphyria
Postconcussion Syndrome
Posterior Tibial Tendinitis
Postpartum Depression
Post-polio Syndrome
Post-Traumatic Stress Disorder (PTSD)
Prader-Willi Syndrome
Precocious Sexual Development
Pre-eclampsia
Premature Ejaculation
Premature Ventricular Beats
Premenstrual Syndrome
Presbycusis
Presbyopia
Pressure Sores
Primary Biliary Cirrhosis (PBC)
Primary Polycythemia
Primary Pulmonary Hypertension
Progressive Multifocal Leukoencephalopathy
Prostate Cancer
Prostatitis
Pruritis Ani
Pseudogout
Psittacosis
Psoriasis
Psychosexual Dysfunction
Pterygium
Pulmonary Embolism
Pulmonary Hypertension
Pyloric Stenosis

Q
Quadriceps Strain
Quadriplegia and Paraplegia

R
Rabies
Raynaud's Disease and Phenomenon
Reiter’s Syndrome
Renal Artery Stenosis
Renovascular Hypertension
Respiratory Distress Syndrome in Newborns
Respiratory Syncytial Virus
Restless Legs Syndrome (RLS)
Retinitis Pigmentosa
Retinoblastoma
Rett Syndrome
Reye's Syndrome
Rh Incompatibility
Rhabdomyolysis
Rheumatic Fever
Rheumatoid Arthritis
Rib Fracture
Rickets and Osteomalacia
Ringworm
Rocky Mountain Spotted Fever
Rosacea
Roseola
Rotator Cuff Injury
Rubella

S

Sacroiliac Joint Pain
Salmonella
Sarcoidosis
Scabies
Scarlet Fever
Schizophrenia
Sciatica
Scleroderma
Scoliosis
Seasonal Affective Disorder (SAD)
Seborrheic Dermatitis
Seborrheic Keratosis
Seizure Disorder
Self-Mutilation
Septal Defects
Severe Acute Respiratory Syndrome
Shaken Baby Syndrome
Shin Splint
Shinbone Fracture
Shingles
Short Stature
Shoulder Dislocation
Shoulder Instability
Shoulder Sprain
Shoulder Tendinitis
Shy-Drager Syndrome
Sick Sinus Syndrome
Sickle Cell Anemia
Sinus Headache
Sinusitis
Sjogren's Syndrome
Skin Cancer
Sleep Apnea
Small Bowel Obstruction
Smallpox
Snoring
Social Anxiety Disorder
Soft Tissue Sarcoma
Somatization Disorder
Spina Bifida
Spinal Stenosis
Spondylolysis
Stomach Cancer
Strabismus
Strep Throat
Stress Fracture
Stroke
Stuttering
Sudden Infant Death Syndrome (SIDS)
Sunburn
Syphilis
Systemic Lupus Erythematosus

T

Tardive Dyskinesia
Tay-Sachs Disease
Teething
Temporal Arteritis
Temporomandibular Joint (TMJ) Syndrome
Tendinitis
Tenosynovitis
Tension Headache
Testicular Cancer
Tetanus
Tetralogy of Fallot
Thalassemia
Thoracic Outlet Syndrome
Throat Cancer
Thrush
Thyroid Cancer
Tinea Capitis
Tinea Nigra
Tinea Versicolor
Tinnitus
Toe Fracture
Toe Sprain
Tongue Cancer
Tooth Abscess
Tooth Decay
Torticollis
Tourette Syndrome
Toxic Hepatitis
Toxic Shock Syndrome (TSS)
Toxoplasmosis
Transient Ischemic Attack (TIA)
Transient Tachypnea of Newborn
Traveler’s Diarrhea
Trichomoniasis
Tricuspid Valve Disease
Trigeminal Neuralgia
Trigger Finger
Tuberculosis
Tuberculosis'
Tularemia
Turf Toe
Turner Syndrome
Type 1 Diabetes
Type 2 Diabetes
Typhoid Fever

U

Ulcerative Colitis
Undescended Testes
Urethral Syndrome
Urethritis
Urinary Incontinence
Urinary Tract Infection (UTI)
Usher Syndrome
Uterine Cancer
Uterine Fibroids
Uterine Prolapse

V

Vaginal Cancer
Vaginal Yeast Infection
Vaginismus
Variant Creutzfeldt-Jakob Disease
Varicose Veins
Ventricular Fibrillation
Vertebral Fracture
VertigoVesicoureteral Reflux
Viral Gastroenteritis
Viral Meningitis
Viral Pharyngitis
Vitamin B-12 Deficiency
Vitiligo
Von Hippel-Lindau Disease
Von Willebrand Disease

W

Wegener’s Granulomatosis
West Nile Virus
Whiplash
Whipple’s Disease
Whooping Cough
Wilms' Tumor
Wilson’s Disease
Wolff-Parkinson-White Syndrome
Wound Dehiscence
Wrist Fracture
Wrist Sprain

Y

Yellow Fever

Z
Zollinger-Ellison Syndrome


Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your doctor or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Disease, Conditions and Injuries:


Aarskog Syndrome
(Faciodigitogenital Dysplasia)
En Español (Spanish Version)

Definition
Aarskog syndrome is an extremely rare genetic disorder. This syndrome causes changes in the size and shape of certain bones and cartilage in the body. The face, fingers, and toes are most often affected.

Causes
Aarskog syndrome is an inherited disorder. It is caused by a gene mutation that is passed from mothers to male children.

Risk Factors
A risk factor is something that increases your chances of getting a disease or condition. This disorder mainly affects males.
Those at risk of inheriting Aarskog syndrome are male children of:
Mothers who do not have the disorder, but who carry the gene for it

Symptoms
The main symptoms of Aarskog syndrome are:
Disproportionately short stature
Abnormalities of the head and face, including:
Rounded face
Wide-set eyes
Slightly slanted eyes
Drooping eyelids
Small nose
Front facing nostrils
Mid-portion of the face is underdeveloped
Wide groove above the upper lip
Crease below the lower lip
Folding of the top portion of the ear
Delayed teeth growth
In some cases, cleft lip or palate
Other symptoms may include:
A malformed scrotum
Undescended testicles
Small, wide hands and feet
Short fingers and toes
In some cases, mild webbing of fingers and toes
Abnormalities of the sternum
Protruding navel
Inguinal hernias
Ligament problems, resulting in hyperextension of the knees
Mild mental deficiencies (in about one-third of those affected)

Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. The diagnosis of Aarskog syndrome is usually based on facial characteristics. The diagnosis can be confirmed by x-rays of the face and skull.

Treatment
There is no known cure for Aarskog syndrome. Treatment is limited to surgical procedures to treat conditions caused by the disorder and supportive treatment. Orthodontic treatment is often needed as well. Researchers have located abnormalities in the FGD1 gene in people with this syndrome, and genetic testing for mutations in this gene may be available.
Treatment may include:
Surgery
Conditions that may be treated with surgery include:
Inguinal hernia
Cleft lip or palate
Undescended testicles
Orthodontics
In some cases, orthodontic treatment may help certain facial and dental abnormalities caused by the disorder.
Supportive Treatment
Supportive treatment generally includes educational assistance to those afflicted with mental deficiencies. Parents often need advice and supportive treatment.

Prevention
There is no known way to prevent Aarskog syndrome. If you have Aarskog syndrome or have a family history of the disorder, you can talk with a genetic counselor when deciding to have children.

Human Health EffectsOverview of Health Effects What the chemicals actually do Statistics
Hazardous waste has been linked with many horrible health related problems (Regenstein, 1982; Levine, 1982; Wildavsky & Schleicher, 1995). The evidence of this link can be seen in increased rates of respiratory problems, skin disorders, miscarriages, birth defects, neurological disorders and cancer clusters in areas near to hazardous waste sites. Larry Wilson (in Bradford & Gwynne, 1995) describes an small area where there are 15-20 houses where he can only name 2 that do not have one of the above listed problems. He lives in Appalachian Kentucky near a leather tanning company that polluted the river near his home where many people get there drinking water. The EPA has developed a method to distinguish the "carcinogenic potency factor" of chemicals often found in Superfund sites (Wildavsky & Schleicher, 1995).

There are four categories:
Group A-Human carcinogen. Sufficient evidence from epidemiological studies to support a causal association between exposure and cancer in humans.
Group B1-Probably human carcinogen. Limited evidence of carcinogenicity in humans from epidemiological studies.
Group B2-Probable human carcinogen. Sufficient evidence of carcinogenicity in animals; inadequate evidence of carcinogenicity in humans.
Group C-Possible human carcinogen. Limited evidence of carcinogenicity in animals.

What do the chemicals actually do?

The chemicals from hazardous waste sites leach into the ground, air and water. Sometime, they can even be stored in buildings and get into the cinder blocks. When these cinder blocks start to deteriorate, the dust that is formed gets into the air and can easily be breathed in. The same thing can happen chemicals in the ground although there is also a high risk of getting chemical burns from touching the contaminated soil. In the water, the chemicals can be consumed or absorbed just as they can in the air. With so many pathways into the body its not surprising that they eventually cause problems in our systems. These chemicals are often considered to be carcinogens. Carcinogens work by causing mutations in your%2

how are u guys

Definition
Achilles tendinitis is an inflammation and/or degeneration of the Achilles tendon. The Achilles tendon connects the calf muscles to the heel bone.

Achilles Tendinitis

Causes
The Achilles tendon can become irritated for several reasons including:

Increasing your speed or running long distances too quickly
Suddenly adding strenuous hills or stair climbing to your exercise routine
Doing too much too soon after taking time away from exercising
A sudden or violent contraction of the calf muscles, such as during an all-out sprint
Running too much—overuse
Lack of flexibility of the calf muscles

Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.

Improper or badly worn footwear
Improper warm-up for your activity
Inflexibility of the calf muscles
Improper cool-down
An improper training program

Symptoms
Symptoms may include:

Tenderness usually located one to two inches above the point where the Achilles tendon attaches to the heel bone (noticeable in the morning upon rising)
Stiffness that gradually eases as the tendon is warmed-up
Pain after activity that gradually worsens
Radiating or localized pain along the tendon during and/or after running
Swelling in the area of the Achilles

Diagnosis
The doctor will ask about your symptoms and exercise habits, and perform a physical exam.

Tests may include:

X-rays to see if there is calcium in the tendon
MRI Scan to view areas of interior damage to the tendon

Treatment
Rest
Take a break from the activity that caused the tendinitis. Switch to an activity, such as swimming, that doesn't put stress on the tendon.

Orthoses
You may be advised to wear a shoe insert that will place your foot in the correct position for walking and running.

Physical Therapy
Stretching
Massage
Ultrasound
Strengthening exercises
Medications
Non-steroidal anti-inflammatory drugs (NSAIDS) to ease the pain and decrease inflammation. This is not curative and must be combined with other treatment.

Prevention
To decrease your chances of getting Achilles tendinitis:

Take the time to warm-up and cool-down properly.
Wear appropriate footwear for your sport.
Do not use shoes beyond the recommended duration. This will depend on:
How frequently you exercise
The surface on which you exercise
The conditions in which you exercise
Gradually add hill work, stairs, speed, and distance to your exercise routine.
Stretch and strengthen the calf muscles regularly.

Achalasia
(Esophageal Achalasia)

Definition
Achalasia is a relatively rare disorder of the smooth muscle of the esophagus. The esophagus is a muscular tube that carries food and liquids from the mouth to the stomach. Achalasia makes it difficult for food and liquid to pass into the stomach from the esophagus.

Causes
At the bottom of the esophagus where it meets the stomach is a muscle called the lower esophageal sphincter (LES). When not swallowing, the LES remains closed to keep food, liquid, and stomach acid from moving back into the esophageal tube. When swallowing, nerve signals tell muscles to contract to push food down the esophagus (an action called peristalsis), and allow the LES to open.

In people with achalasia, the nerve cells in the lower esophageal tube and the LES do not work correctly. This results in:
Uncoordinated peristaltic (muscular) activity
Failure of the LES to open completely
While achalasia is associated with the loss of nerve cells in the esophagus, the cause of this process is unknown.

Risk Factors
A risk factor is something that increases your chances of getting a disease or condition. Because the exact cause of achalasia is unknown, risk factors are unknown.

Symptoms
Symptoms of achalasia can occur between the ages of 25 and 60. Symptoms rarely develop in children. Symptoms tend to be mild at first, and then grow worse over months or years. The main symptom is difficulty swallowing solids and, as the disorder progresses, liquids. As many as 70-97% of patients with achalasia have difficulty swallowing both solids and liquids.
Other symptoms may include:
Discomfort or pain in the chest (under the breastbone, especially after meals)
Coughing, especially when lying down
Heartburn
Weight loss (as the disorder progresses)
Vomiting or regurgitating food or liquids; in some people this occurs during sleep. This can result in inhalation of food particles or liquid, which can lead to aspiration pneumonia and other respiratory infections.

Diagnosis
The doctor will ask about your symptoms and medical history and perform a physical exam. Tests may include:
Manometry – a tube is inserted down the throat to test the pressure in the esophagus and the stomach when swallowing
Esophagram – x-rays are taken of the esophagus while you swallow barium (a thick liquid that lights up on x-rays)
Upper Gastrointestinal Endoscopy (Esophagoscopy) – the esophagus is viewed directly through a fiberoptic tube to look for other causes of the symptoms

Treatment
The goal of treatment is to make it easier for the LES to open. Treatment may include:
Pneumatic dilation – this treatment stretches the LES muscle. A thin tube is inserted into the throat. At the end of this tube is an un-inflated balloon. Once the tube reaches the point of the LES muscle, the balloon is inflated. Pneumatic dilation has a high success rate. It is the primary treatment in most patients, although the procedure may need to be repeated.

Botulinum toxin – tiny amounts of botulinum toxin, type A, are injected into the LES. Botulinum causes the LES to relax, which makes it easier to open. Since the effect is temporary, repeat injections are almost always needed, but the response decreases with successive injections.

Surgery – small incisions are made in the LES to help it to relax. This is called Heller cardiomyotomy surgery. This can usually be performed via laparoscopy, making it a relatively minor surgical procedure. Because the LES is partially cut, about 15% of patients experience gastroesophageal reflux symptoms (i.e., acid reflux) after this surgery.

Medication – in mild cases, certain medications may help relieve symptoms temporarily. Drugs that reduce LES pressure include:
Nifedipine
Nitroglycerin

Prevention
There are no guidelines for the prevention of achalasia because the cause is usually not known.