Achalasia cardia symptoms causes and treatment

Achalasia is a disorder that makes it hard for the liquid and food to pass into your stomach. Achalasia happens when nerves in the tube connecting your mouth and esophagus get damaged. This is the reason why the esophagus loses the ability to squeeze the food down and the muscular valve between the stomach and esophagus is not able to fully relax. The term achalasia means ‘failure to relax’. People suffering from achalasia have difficulty in swallowing food. If you have a similar problem, you should go for a quick diagnosis, and treatment as soon as possible as delaying the treatment can cause further damage. You should go for achalasia cardia surgery as soon as possible.

Symptoms of achalasia

The symptoms of achalasia include:

  • Difficulty in swallowing food
  • The problem in swallowing both solid and liquid food
  • Sharp chest pain usually of unclear cause
  • Discomfort in the chest from esophagus dilation

Causes of achalasia

The exact cause of achalasia is unknown. The esophagus contains both nerves and muscles. The nerves also coordinate the relaxation and the opening of sphincters. Early, in achalasia, inflammation can be seen in the muscle of the lower esophagus, mainly around the nerves. When the disease progresses, the nerves begin to degenerate because of the damage of the nerves.

Diagnosis of achalasia

Achalasia can be also overlooked because it has symptoms that are similar to other digestive disorders. The doctor will recommend these tests:

  • Upper endoscopy: Your doctors insert a thin, flexible tube equipped with a light and endoscope down your throat which will examine the inside of your esophagus. Endoscopy can also be used to define the partial blockage of the esophagus.
  • X-rays of your digestive system: X-ray scan is taken after the doctor will ask you to drink a chalky liquid which coats and fills the inside lining of your digestive tract. This coating will allow the doctor to check the silhouette of your esophagus, upper intestine, and stomach.

Treatment of achalasia

Achalasia treatment focuses on relaxing the lower esophagus sphincter so that the food and liquid can move easily via your digestive tract. Surgery might be recommended for younger people as non-surgical treatments tend to be less effective for achalasia:

  • Heller myotomy: The doctor will cut the muscle at the lower end of the esophageal sphincter to allow food to pass easily into the stomach. The procedure is done noninvasively. People who have a heller myotomy might later develop gastroesophageal reflux disease.
  • Fundoplication treatment: The surgeon will wrap the top of your stomach around the lower esophageal sphincter to tighten the muscle and prevent acid reflux. Fundoplication can be performed at the same time as heller myotomy to avoid future problems with acid reflux. Fundoplication is done with a minimally invasive procedure.
  • (POEM) Peroral endoscopic myotomy: The surgeon will use an endoscope that is inserted via your mouth & down your throat to create the incision inside the lining of your esophagus. As in Heller myotomy, the surgeon cuts the muscle at the lower end of the esophageal sphincter.

author name: Dr. Nikhil Narain

author bio: Specialist in Laser Proctology(Piles, Fissure, Fistula) and 3D Laparoscopy