Achalasia is an esophageal motility disorder which involves the smooth muscle layer of the oesophagus and lower oesophagal sphincter.
3 features that characterize this disorder are:
•Incomplete lower oesophagal sphincter relaxation
•Increase in lower oesophagal sphincter tone
•lack in the peristaltic movement of the oesophagus due to the inability of smooth muscles in the wall of the oesophagus to move food down the oesophagus.Do Age & Sex have any role in Achalasia?
This is a rare disease and it occurs at any age. It most commonly occurs in middle-aged or older adults. In some people, this disease is an inherited.
This disease can affect an individual of any race.
There is a muscular ring at the junction of oesophagus and stomach. This muscular ring relaxes during swallowing. In individuals suffering from achalasia, this muscular ring does not relax as well. The main cause for this muscular ring disorder is damage to the nerves of the oesophagus. In cases of cancer of the esophagus or upper stomach and a parasitic infection causing changes, the patient has symptoms like those of this esophageal motility disorder.
• Dysphagia, difficulty in swallowing.
• There is the regurgitation of the undigested food.
• Pain in the chest behind the sternum which is increased after eating.
• Patient has difficulty in swallowing liquids and solids.
• Complaints of heartburn.
• There is coughing when individuals lie in a horizontal position.
• Sometimes food and liquids are retained in the oesophagus and may be inhaled into the lungs.
There are three major investigating methods for diagnosis:
• Barium swallows X-ray.
• Oesophageal manometry.
• Endoscopy of the oesophagus, stomach and duodenum.
• Endoscopy with Ultrasound.
• In cases of cancer of oesophagus or stomach, biopsy tissue is taken from oesophagus during the endoscopy process.
Prognosis of this disorder is good in some cases but if not treated carefully then lead to complications. Surgeries are very rarely successful in cases of achalasia.
• Gastroesophageal reflux disease.
• A hiatus hernia.
• Psychosomatic disorders.
• Breathing of food contents into the lungs can cause pneumonia.
• Perforations in the oesophagus.
• Reflux of food and acid from the stomach back into the oesophagus.
The main step is to reduce the pressure at the lower oesophagal sphincter. Therapies involved
• Medications include long-acting nitrates or calcium channel blockers are used to relax the lower oesophagus sphincter.
• Surgery known as esophagostomy is done to decrease the pressure in the lower sphincter.
• Widening of the oesophagus at the location of the narrowing and that is done by esophagogastroduodenoscopy.
• Patients suffering from achalasia need to eat slowly.
• The patient should chew food very well.
• The patient should eat plenty of water with meals.
• Avoid eating near bedtime.
• Raise the head of the bed or sleeping with the wedge pillow promotes emptying of the oesophagus by gravity.
• Food that aggravates the reflux need to be avoided and that are ketchup, citrus, chocolate, alcohol, and caffeine.
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