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1 Achalasia. 2  Achalasia is a condition that affects the smooth muscle portion of the esophagus, that is, the lower esophagus and the lower esophageal sphincter. 3  Specifically, the peristaltic wave disappears, and the lower sphincter does not relax.
1 The cause of achalasia is not clear but probably involves abnormalities of the nerves within the smooth muscle that lead to abnormal function of the muscle. 2  In one sense, therefore, achalasia may be considered primarily a neurological problem.