Achalasia vs Scleroderma: Difference and Comparison

Key Takeaways

1. Achalasia is a rare disorder affecting the esophagus, causing difficulty swallowing, while scleroderma is an autoimmune disease affecting the skin and connective tissue.
2. Achalasia primarily impacts the lower esophageal sphincter, whereas scleroderma can affect various organs and body systems.
3. Treatment for achalasia focuses on alleviating symptoms and improving esophageal function, while scleroderma treatment aims to manage symptoms, prevent complications, and address underlying autoimmune issues.

What is Achalasia?

Achalasia is a disorder in which the esophageal motor is impaired. This condition occurs due to less or insufficient relaxation of esophageal muscles and loss of esophageal peristaltic. The distal esophageal peristalsis is mainly affected in achalasia. There is an elevation of resting pressure in LES (lower esophageal sphincter) and failure of LES relaxation with swallowing.

Patients suffering from achalasia cannot swallow food or liquid through the esophagus into their stomach. Symptoms of the disease include heartburn, chest pain, coughing pneumonia, weight loss, vomiting, regurgitating saliva, inability to swallow, etc. Symptoms of the disease achalasia also include mild to severe chest pain.

There is no such cure for the disorder, but only surgeries can help in the case of achalasia. Surgeries are carried out to widen the esophagus by removing the excess tissue causing the esophagus’s narrowing. After cutting out the tissue, balloon inflation in the esophagus area is also carried out to widen the esophagus passage.

What is Scleroderma?

 Scleroderma is an autoimmune disease characterized by excessive deposition of collagen and other connective tissue molecules in the skin and multiple integral organs. It is a systemic disease that affects almost all the organs in the body. In 90% of patients, systemic sclerosis only involves the gastrointestinal tract, wherein esophageal motility is most frequently affected. This tendency of the scleroderma to mainly affect the esophageal passage is why people confuse scleroderma with achalasia.

The exact cause of scleroderma is not always identifiable, but sometimes it is seen that it has been linked to gene mutations that affect Fibrillin 1 protein. It is the protein that is involved in forming connective tissue fibers. Exposure to some chemicals, such as vinyl chloride, is also suspected to be related to the development of scleroderma disease.

Diagnosis of the disease scleroderma is possible using the antibody testing method. Antibodies are proteins that can react with specific protein sequences. In the case of scleroderma disease, specific anti-nuclear antibodies such as anti-Scl-70 ( topoisomerase 1) and U3 RNP (fibrillin) indicate scleroderma disorder.

Symptoms of the disease include tightening of the skin, swelling of the extremities, painful joints problem in swallowing, heartburn, Raynaud’s phenomenon, etc. Along with the following symptoms, scleroderma can also cause damage to organs such as the Kidneys, heart, and lungs. In some instances, the disease can also be fatal.

Difference Between Achalasia and Scleroderma

1. Achalasia causes insufficient lower esophageal sphincter relaxation, while Scleroderma leads to low LESP.
2. There is elevated resting pressure in LES in Achalasia. On the other hand, There are low amplitude contractions and a decrease or absence of coordination between esophageal contractions and LES relaxations.
3. Treatment for achalasia includes surgery or a dilation technique, whereas treatment for scleroderma includes immune suppression medicine, Calcium channel blockers, and corticosteroids.
4. Achalasia is characterized by the inability to swallow food, while scleroderma in esophagus is characterized by dysphagia (sensation of food being stuck in the chest).
5. There are three types of achalasia based on their severity and the part of the esophagus it affects. On the other hand, scleroderma has two types only.

Comparison Between Achalasia and Scleroderma

Parameter of Comparison	Achalasia	Scleroderma
Definition	Achalasia is an issue with the esophagus muscles.	Scleroderma is a disorder related to connective tissue wherein the skin becomes hard.
Cause	Allgtove’s syndrome and cancer	Specific Genetic mutations
Prevalence	Equal prevalence in males and females.	More prevalent in females
Organs affected	Esophagus	All organs of body
Diagnosis	Endoscopy	Antibody test, x-ray, and endoscopy

References

1. https://link.springer.com/article/10.1007/s10620-007-9845-x
2. https://journals.lww.com/jcge/fulltext/2015/01000/Upper_Esophageal_Sphincter_Abnormalities__Frequent.6.aspx

Last Updated : 30 July, 2023