Achalasia cardia is a rare disease in which there is difficulty in swallowing both liquids and solids and the swallowed food is prevented from passing from the esophagus to the stomach.
Cause of this disease:
This occurs due to nerve damage in the esophagus, resulting in the esophagus becoming damaged, dilated, its ability to contract and expand is lost, and at the same time the LOS (gateway at the lower part of the esophagus) is narrowed and the food cannot reach the stomach.
In this, food accumulates in the esophagus, sometimes coming up into the mouth and feeling bitter in the mouth.
Some people mistake it for GERD.
In achalasia, swallowed food comes up from the esophagus, whereas in GERD it comes from the stomach.
There is no complete cure for achalasia. Once the esophagus is damaged, the muscle can no longer function properly. However, the symptoms can usually be controlled with the help of medication, endoscopic intervention, and surgery.
Signs and symptoms of achalasia:
The signs and symptoms of this disease appear gradually and over time, permanent disability occurs —
1) Inability to swallow food as if food or drink is stuck in the throat;
2) Regurgitation of food or saliva;
3) Heartburn;
4) Belching;
5) Chest pain that comes and goes;
6) Dry cough at night;
7) Pneumonia (food regurgitates into the lungs and causes infection)
8) Frequent vomiting;
9) Weight loss.
Causes of achalasia:
The exact cause has not yet been determined.
Researchers believe that the main cause is nerve damage in the esophagus. Some have attributed it to viral infections and autoimmunity. Others have also attributed it to hereditary birth defects or some other unknown viral infection.
Diagnosis of achalasia:
This disease is often not detected or misdiagnosed in routine examinations because its signs and symptoms are similar to those of other diseases.
The following tests are used to diagnose this disease—
1) Esophageal manometry:
This test measures whether the esophageal muscle's ability to contract and expand rhythmically to move food from the throat to the stomach is intact;
2) Barium swallow X-ray:
After the patient is given a chalky white drink, the contraction and expansion of the esophagus and the opening or narrowing of the LOS or gateway in the lower part of the esophagus are seen.
3) Endoscopy:
This test shows the dilation of the esophagus, the food accumulated in the esophagus, and the tightness of the LOS or gateway in the lower part.
Treatment of achalasia:
The main goal of this treatment is to widen the narrowed LOS or gateway in the lower part of the esophagus so that food and drinks can easily pass from the esophagus to the stomach without obstruction.
The appropriate treatment depends on the patient's age, physical health condition and the severity of the disease.
1) Treatment through medication:
Calcium channel blockers or
Nitroglycerin-like medications;
2) Treatment through endoscopy:
Botulinum toxin is applied through endoscopy;
The narrowed LOS is widened by inflating a balloon through endoscopy;
POEM (Peroral Endoscpic Myotomy) is a small surgery through endoscopy to widen the LOS;
3) Surgical treatment:
Laparoscopic surgery is performed by Heller Myotomy or
Fundoplication.
Above all, through lifestyle changes —
Take time, slowly, and develop the habit of chewing and swallowing food well;
Drink plenty of water with meals;
Make it a habit to go to bed at least 3 hours after eating;
Keep the head of the bed elevated or use two pillows instead of one.
To prevent acid reflux from the stomach after balloon dilation or surgery, the following foods should be avoided —
Sour fruits, tomato ketchup, chocolate, alcohol, coffee, etc.;
If you can take PPI drugs along with it, you can get the desired results.