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Achalasia

Achalasia is a motility disorder that affects the esophagus. This causes difficulty in swallowing, regurgitating food and pain. Let us learn more about achalasia and its characteristics.

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Definition

Achalasia is a rare disorder that affects the esophagus. The esophagus is a long muscular tube that pushes food down to the stomach from the throat.

In this condition, the smooth muscle fibers fail to relax causing the sphincter to remain closed and not open when it has to. Thus, the food is not allowed to move into the stomach. The food is often vomited out as a result.

Under normal conditions, the ring of muscles at the opening from the esophagus to the stomach is tightly shut. This prevents acid from moving up into the esophagus from the stomach (acid reflux). When the muscles relax, the food swallowed passes into the stomach. However, in case of achalasia, this does not happen and the food blocks the esophagus.

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Symptoms of achalasia

The symptoms of achalasia are slow to appear. The initial and the one of the major symptoms of achalasia is dysphagia, that is, inability to swallow.

One may often complain of chest pains that comes and goes. In some people, a spasm like pain is experienced that is very intense.

It may even lead to regurgitation of undigested and bitter-tasting food. Heartburn is also commonly experienced. However, most of the time, the condition is confused with other gastrological conditions such as acid reflux.

Achalasia can lead to coughing fits or vomit to dribble from the mouth at night. When the vomit trickles into the windpipe, it may lead to repeated chest infections and pneumonia.

The affected person starts losing weight and becomes weak.

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Causes of achalasia

The main cause of achalasia is damage to or loss of nerves in the gullet wall. The reason for this remains unexplained, but many experts think a viral infection is suspected to cause the damage to the nerves.

Autoimmune diseases such as Sjogren’s syndrome, lupus or uveitis can also cause damage to the nerves leading to achalasia.

Diagnosis of achalasia

Achalasia is diagnosed only with proper diagnostic tests. There are three diagnostic tests that help confirm and evaluate achalasia.

1.A barium swallow is a test where the patient is asked to drink a solution containing barium and its movement is observed through X-ray.

2.Endoscopy is done with the help of a long narrow tube that is passed through the esophagus and sends images onto a computer screen for evaluation.

3.Manometry is a test the help measure the time and strength of esophageal contractions as well as the lower esophageal valve relaxation.

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Treatment of achalasia

The treatment aims to open the lower esophageal sphincter muscle to allow passage of food into the stomach. Achalasia cannot be cured, however, treatments can help relieve the symptoms to some extent.

Medications such as nifedipine or nitrates can help provide a brief period of relaxation to the esophageal muscles. However, these medications are not effective in all patients.

Some patients are suggested dilation under general anesthesia.  The balloon is used to stretch the muscle fibers of the sphincter muscle at the lower end of the gullet. This helps improve swallowing, but the dilation procedure may have to be repeated several times after a year or more.

Botulinum toxin is another method that helps relax the muscle fibers. However, its effects last for only a few years and one may have to repeat the treatment.

Surgery under general anesthetic helps divide lower esophageal sphincter muscles that do not relax. Thus, giving a more permanent solution to the problem.

Aftercare of achalasia

After treatment, one should take some care to reduce the symptoms.

This includes:

  • Chew slowly and carefully
  • Eat food slowly
  • Drink a lot of fluids or water along with your meals
  • Eat food sitting upright
  • When sleeping keep several pillows under the head so that you sleep a bit upright. This will prevent acid reflux and avoid heartburn

Achalasia can be managed with proper treatment. If you continue to suffer from swallowing difficulties, heartburn, chest pain or acid reflux after treatment, speak to your healthcare provider immediately.

Written by: healthplus24.com team

Date last updated: August 17, 2015