Chalasia is a condition most commonly identified in infants and young children, and is related to congential incompetence of the lower esophageal sphincter, allowing unrestricted reflux of gastric contents. This contrasts with achalasia, where there is restriction at the gastroesphageal junction limiting esophageal emptying.
As infants mature and gain better neuromuscular control and coordination, normally sphincter tone gradually increases reducing reguritation. Persistence of reflux and vomiting after several months of age is abnormal and chalasia becomes a concern.
Chalasia is suspected in children of several months of age that present with frequent and persistent regurgitation after feeding, and when placed in a horizontal position.
Affected children are typically unremarkable aside form the symptoms related to chalasia, but may have a familial predisposition, or may have a predisposing neurological impairment with chalasia as a complication.
Reflux esophagitis may lead to pain, blood loss, and esophageal strictures. As the condition persists, continued vomiting may lead to growth failure, anemia, respiratory complications, and rarely sudden infant death syndrome.