Achalasia Definition, Reason, Symptom, Treatment, Prevention

Achalasia Definition, Reason, Symptom, Treatment, Prevention

Achalasia Definition

Achalasia is a rare medical condition that makes it difficult for food and liquids to enter the stomach.

Achalasia occurs when the innervation of the tube that connects the mouth and stomach, namely the esophagus, is damaged. As a result, the esophagus loses its ability to push food down, and the muscular valve that lines the esophagus and stomach, the lower esophageal sphincter, does not relax completely and makes it difficult for food to enter the stomach.

Achalasia Reason

Achalasia can occur as a result of many things. Sometimes, it is difficult for health professionals to determine the specific underlying cause.

This condition can be inherited, or it can also occur as a result of an autoimmune disease. In these conditions, the immune system can attack healthy cells in the body. Degeneration of the innervation of the esophagus often contributes to the development of advanced signs and symptoms of achalasia.

Achalasia Symptoms

People with achalasia often have difficulty swallowing or feel that the food they eat is stuck in the esophagus. This condition is known as dysphagia.

These symptoms can cause excessive coughing and increase the risk of aspiration, which is inhaled food into the respiratory tract with the potential to cause choking.

Some other signs and symptoms of achalasia are:

  • Pain or discomfort in the chest
  • Unintentional weight loss
  • Heartburn
  • Excessive pain or discomfort after eating

In addition, people with achalasia can also experience regurgitation or backflow of stomach acid into the esophagus. However, it can also be a sign and symptom of other gastrointestinal conditions, such as acid reflux.

Achalasia Diagnosis

The diagnosis of achalasia can be determined from a detailed medical interview, direct physical examination, and certain investigations. Sometimes, achalasia can have signs and symptoms that are quite similar to other gastrointestinal diseases.

Therefore, to confirm the presence of achalasia, the doctor may recommend several types of investigations, such as:

  • Esophageal manometry. This test measures the rhythmic muscle contractions of the esophagus when a person swallows, the coordination and pressure exerted on the esophageal muscles, and the ability of the lower esophageal sphincter to relax when a person swallows.
  • X-ray examination of the upper gastrointestinal tract. Imaging examination using X-rays can be done after the patient consumes a milky white liquid which helps the doctor to visualize images of the esophagus, stomach, and small intestine.

Patients can also be asked to take pills that contain barium to help see if there is a blockage in the esophagus.

  • Upper gastrointestinal endoscopy. This examination uses a thin, flexible tube accompanied by a light and camera, which is then inserted into the throat to evaluate the condition of the esophagus and stomach.

An endoscopy can be performed to determine the presence of partial obstruction of the esophagus if the signs and symptoms indicate the possibility of this happening. Endoscopy may also be performed to take tissue samples by way of a biopsy to assess for complications from gastric acid reflux.

Achalasia Handling

Treatment of achalasia is focused on promoting relaxation or opening of the lower esophageal sphincter so that food and fluids can pass through the digestive tract more easily. The choice of the treatment itself depends on various factors, including age and the severity of the condition experienced.

Several types of treatment groups that can be carried out are:

  • Non-surgical treatment. One non-surgical treatment option may be pneumatic dilation, which involves the use of a balloon that is inserted into the lower esophageal sphincter and inflated to enlarge the gap between the esophagus and stomach. Sometimes, this procedure may require repetition if the sphincter does not open permanently.

In addition, botulinum toxin type A can be given, which is a treatment to support muscle relaxation. This treatment can be injected into the lower esophageal sphincter with the help of an endoscope. The injection may require repetition.

Treatment with botulinum toxin is generally recommended only for patients who are not good candidates for pneumatic dilatation or surgery due to age or general health.

The third non-surgical treatment is muscle relaxation medication which is taken before meals. Because oral medications generally have a limited therapeutic effect and certain side effects, they should only be considered if the patient is not a candidate for pneumatic dilation or surgery and administration of botulinum toxin has shown no benefit.

  • Surgical treatment. Surgery may be considered in patients with a younger age group. There are several types of surgical techniques that can be performed, depending on various indications.

Achalasia Prevention

Because the exact cause of achalasia is not known, there is no proven way to prevent this condition completely. In Armando Hasudungan Video Achalasia (esophageal) – signs and symptoms, pathophysiology, investigations and treatment.

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