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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.
Diseases can cause muscles to waste away or can make movement difficult, leading to muscle atrophy. These include: 1  amyotrophic lateral sclerosis (ALS, also known as Lou Gehrigâs disease), which affects nerve cells that control voluntary muscle movement. 2  dermatomyositis (a muscle disease).