com_global_diseases

Achalasia

The food you eat is carried from the throat to the stomach by a tube called esophagus. Achalasia is a rare condition in which your esophagus is affected. Achalasia is also called as achalasia cardia. It affects 1 in every 100, 000 individuals. The lower esophageal sphincter (LES) is an opening (valve) that opens into your stomach. The food that you eat is pushed into the stomach by the opening of LES. But, if you have Achalasia, your LES fails to open up during swallowing. This leads to a pile up of food within your esophagus. Most commonly, this condition can be a result of damage to your esophageal nerves, or due to the damage to LES.

Symptoms

In achalasia, you would feel it difficult to swallow; it feels like the food is struck in your food pipe. This condition is referred to as ‘dysphagia.' This happens because of the reduced movement in the esophagus (peristalsis). Due to dysphagia, there can be an increased risk of aspiration (inhalation of gastric contents).

The common symptoms include:

  • Cough
  • Hiccups
  • Chest pain
  • Heartburn
  • Weight loss
  • Sensation of fullness
  • Difficulty in swallowing
  • Regurgitation (reverse flow) of food

Causes

The cause of achalasia is unknown. So, it could be difficult for your doctor to find out the specific cause. The most common causes include:

  • Heredity
  • Chagas’ disease
  • Autoimmune condition
  • Damage to esophageal nerves
  • Lack of normal contractions in esophageal muscles

Risk factors

The most common risk factor for Achalasia is the presence of autoimmune disorders.

Achalasia mostly occurs in your middle to old age i.e. 25 to 60 years. It can also occur in the children although.

Complications

Some of the most common complications of achalasia include:

  • Weight loss
  • Malnutrition
  • Oesophagitis
  • Breathlessness
  • Pulmonary infection
  • Aspiration pneumonia

Medical help

Call you health care provider if:

  • You have difficulty during swallowing
  • Your symptoms remain the same even with necessary treatment

Achalasia follow-up

As there is no specific treatment for achalasia, the goals of the treatment include recognition and the treatment of symptoms. Regular follow-up is a compulsion which can help prevent the development of complications such as enlargement of esophagus and cancer.

If you have any trouble swallowing the food, then your doctor might suspect Achalasia and order for certain Achalasia cardia radiology procedures that include:

Barium swallow : Barium swallow technique is the most common screening test for Achalasia. You will be asked to drink a thick mixture of barium, and then the x-rays are taken. In the presence of Achalasia, your LES is seen narrowed, with a dilated esophagus above the narrowed area.

Chest X-ray: Chest x-ray just reveals any dilation in the esophagus and the absence of air in the stomach. Your doctor would not rely on the findings of chest x-ray, and a further testing is required.

Endoscopy A thin flexible tube which has a fiber-optic video camera is passed down your throat, into your esophagus and stomach. This test is performed to rule out the presence of esophageal cancer.

Esophageal ManometryThis test is used for measuring the function of the LES and the muscles of the esophagus. It helps your doctor to find out any abnormalities in the movement of food into your stomach.

There are different types of achalasia cardia treatments. They are:

Drug therapy

The first line of treatment always includes medication. Your doctor would prescribe you various medicines such as calcium-channel blockers and nitrates that help to relax the lower esophageal sphincter.

Dilation

Dilation is nothing but stretching the lower esophageal sphincter with the help of a surgical balloon. To ensure the perfect positioning of the balloon, a gastroscope is used during the procedure.

Surgery

A keyhole surgery is carried out to divide the fibers in the muscles. This procedure alleviates the most troublesome symptoms such as difficulty in swallowing.

Botulinum toxin

This toxin is safe and effective in treating Achalasia. It is injected into the lower esophageal sphincter (LES) which weakens the muscles and acts as a muscle relaxant. This is considered as one of the safest treatment options.

Tips that help in coping with Achalasia:

  • Eat your meals on time
  • Eat foods that are and fresh
  • Avoid drinking before going to bed
  • Avoid having drinks that are too cold
  • Lift up your chest and take a deep breath
  • Eat small quantities of food and chew well