The esophagus is the muscular tube. It extends from the neck to the abdomen and connects the throat to the stomach. Achalasia is a type of esophageal motility disorder. It is the inability of the esophagus to move food into the stomach
. There is no cure for achalasia. But you can recieve minimally invasive therapy or surgery to control the symptoms.
- Hard or unable to swallow
- Pressure in the chest after eating
- Backing up of undigested food and fluid sometimes hours after eating
- Coughing or choking on food
- Bad breath
- Esophageal manometry
This test measures the timing and strength of esophageal contractions and muscular valve relaxations.
- X-rays of your upper digestive system
X-rays are taken after you barium preparation( (liquid or other form)
- Upper endoscopy
Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach.
The cause of the achalasia is still unkown
. Some researchers think it may be linked to virus. Recent studies indicates that achalasia may be caused by an immune disorder. But the exact cause is still undisclosed.
Specific treatment depends on your age and the severity of the condition.
- Pneumatic dilation.
A balloon is inserted into the esophageal sphincter and inflated to enlarge the opening. This procedure may need to be repeated if the esophageal sphincter doesn't stay open.
- Botox (botulinum toxin type A).
Botox is generally recommended only for people who cannot receive pneumatic dilation or surgery due to age or overall health. The doctor will inject it directly into the esophageal sphincter with an endoscope. You may need to repeat the injections, and this may make it more difficult to perform surgery later if needed.
Your doctor might suggest muscle relaxants such as nitroglycerin (Nitrostat) or nifedipine (Procardia) before eating. These medications have limited treatment effect and severe side effects. So you should conside this option only if the other two are both unaccessible.
Surgery may be recommended for younger people
because nonsurgical treatment tends to be less effective in this group. Surgical options include:
- Heller myotomy
The surgeon cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach. People who have a Heller myotomy may later develop gastroesophageal reflux disease (GERD).
The surgeon wraps the top of your stomach around the lower esophageal sphincter, to tighten the muscle and prevent acid reflux. In order to avoid future problems with acid reflux, you might have fundoplication at the same time as Heller myotomy. Fundoplication is usually done with a minimally invasive procedure.
- Peroral endoscopic myotomy (POEM)
The surgeon inserts an endoscope through your mouth and down your throat. Then, as in a Heller myotomy, the surgeon cuts the muscle at the lower end of the esophageal sphincter. POEM doesn't need an anti-reflux procedure.
Keywords: achalasia; esophageal motility disorder; symptoms; diagnosis; causes; treatments