ACHALASIA

ACHALASIA

Achalasia is a unique disorder that makes it difficult for food and drinks to go through your esophagus to your stomach. It takes place when a nerve in the throat gets injured. By then, the throat doesn’t have the capability to crush food down, and the powerful valve between the throat and stomach (lower esophageal sphincter) doesn’t fully relax— it is hard for food to go to your stomach.

There no antidote for achalasia. But symptoms can be controlled with medications.

TYPES

  • Type I with contractility in the esophageal body
  • Type II with some panesophageal pressurization
  • Type III (spastic) with distal esophageal compressions

SYMPTOMS

  • Food going back after swallowing (regurgitation)
  • Chest pain, which may increase while eating, or may be felt as pain in the back, neck, and arms
  • Difficulty swallowing liquids and solids
  • Unplanned weight loss

DIAGNOSIS

Achalasia can be misdiagnosed because it has signs like that of other stomach-related conditions. To test for achalasia, your doctor will most likely recommend:

Esophageal manometry: This test assesses the muscle contractions in your throat when you swallow, the coordination and strength of your throat muscles, and how well your lower esophageal sphincter loosens up or opens up during a swallow.

Abdominal x-rays are taken after you drink a special liquid that coats and fills the covering of your stomach. The coating enables your doctor to examine your throat, stomach, and upper gastrointestinal tract. You may similarly swallow a barium pill that can show a blockage of the throat.

Upper endoscopy: Your doctor inserts a slim, flexible tube outfitted with a light and camera (endoscope) down your throat, to investigate inside your throat and stomach. Endoscopy can be used to show a blockage of the throat if a diagnosis isn’t reached yet. Endoscopy can be used to get a sample for biopsy.

TREATMENT

Nonsurgical alternatives include:

  • Pneumatic extension
  • Botox (botulinum toxin type A)
  • Drugs

Surgical procedures include:

  • Heller myotomy
  • Fundoplication
  • Peroral endoscopic myotomy (POEM)

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