Achalasia
Achalasia is a infrequent disorder of the esophagus, the tube that take food from the throat to the stomach. It is characterized by impaired capacity to push food down toward the stomach (peristalsis), failure of the ring-shaped muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), to relax. It is the contraction and relaxation of the sphincter that shift food through the tube.
Signs & Symptoms of achalasia :
The symptoms of achalasia normally seems gradually. Most of the people with this disorder undergo an impairment in the capacity to swallow (dysphagia) as a major and early symptom. There can also be lenient chest pain that comes and goes. Some affected individuals undergo pain that is very intense.
Reservation of saliva and ingested food in the esophagus can frequently cause regurgitation of these contents; in addition, such contents can also be move into the lungs while breathing (tracheobronchial aspiration). Other symptoms of this disorder can include a cough in the night and significant weight loss, because of difficulty in swallowing, in cases that remain untreated. Dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) are not uncommon in patients with achalasia.
The aspiration of saliva and food contents by people with achalasia can give rise to pneumonia, other pulmonary infections, or even death. The incidence of esophageal cancer is significantly grownbin patients with achalasia.
Causes of achalasia :
The proper cause of achalasia is unknown. Some clinical researchers suspect that the condition can be caused by the degeneration of a group of nerves situated in the chest (Auerbach’s plexus). It is trusted that there can be a rare, inherited form of achalasia, but this is not yet well understood at this time.
Affected Populations :
Achalasia is a infrequent disorder that normally affects adults between the ages of 25 and 60 years. Although, this disorder can take place at any age, including during childhood. Achalasia affects males and females in equal numbers except in cases that seems to reflect an inherited form. In those cases, it appears that males are twice as probably as females to be diagnosed with this disorder.
Related Disorders of achalasia :
Symptoms of the following disorders can be same to those of achalasia. Comparisons can be useful for a dissimilar diagnosis:
• Esophageal cancer -
The symptoms of esophageal cancer resemble those connected with achalasia. Esophageal cancer can start at almost any point in the tube. Small cancers can be asymptomatic or can be present without any symptoms. As the tumor grows, the first sign can be difficulty in swallowing and/or pain upon swallowing and/or feeling as if food were stuck behind the breastbone. Difficulty in swallowing can be go by indigestion, heartburn and choking. Weight loss is not unusual.
• Swallowing disorders :
Swallowing disorders come in a variation of forms. Some are the result of disturbances of the brain like Parkinson’s disease, multiple sclerosis or amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease). Others are the result of malfunctioning of parts of the throat involved in swallowing. For instance, the pharynx can malfunction after a stroke.
Diagnosis of achalasia :
X-ray test (radiology) is often useful in the diagnosis of achalasia. Radiological examination, mostly with the use of barium, can show enlargement (dilation) of the esophagus and the retention of food and secretions within the esophagus. Devices that measure fluid pressure (manometers) within the esophagus are used to confirm the diagnosis of achalasia.
Treatment of Ashalasia :
The aim of treatment is to decrease the pressure at the sphincter muscle and allow food and liquids to pass without any difficulty into the stomach. Therapy may involve:
• Injection with botulinum toxin (Botox) -
This can help in relaxing the sphincter muscles. Although, the benefit wears off within a few weeks or months.
Medicines, like long-acting nitrates or calcium channel blockers These drugs can be used to relax the lower esophagus sphincter. But there is hardly a long-term solution to treat achalasia.
• Surgery (called a myotomy)-
In this process, the lower sphincter muscle is cut.
• Widening (dilation) of the esophagus -- This is done during EGD by stretching the LES with a balloon dilator.
Your health care team can help you decide which treatment is best for you.
Prevention of Achalasia :
Many of the causes of achalasia cannot be cure. Although, treatment can help to prevent difficulties.