Achalasia Definition, Reason, Symptom, Treatment, Prevention
Definition
Achalasia is a digestive system disorder that makes it difficult for food or drink to reach the stomach. Food from the mouth will pass through the esophageal tube (esophagus) and the lower esophageal sphincter before being stored and digested in the stomach.
The esophagus is in charge of carrying food by the process of peristalsis. In patients with achalasia, peristalsis may be impaired or the lower esophageal ring may not open during swallowing. So that food collects in the esophagus.
This disorder usually occurs in middle age. But it can also happen to children. Achalasia is more common in autoimmune disorders.
Reason
Achalasia can occur for a variety of reasons and it is difficult to pinpoint the main reason. This disorder can be caused by heredity or an autoimmune condition. Autoimmunity itself is a condition in which the immune system attacks healthy cells in the body because they perceive them as ‘enemies’.
One of the causes of achalasia is nerve damage to the esophagus. As a result, the lower esophageal ring, which is muscle tissue, does not respond to swallowing. Achalasia can also be caused by damage to the lower esophageal ring.
Diagnosis
Doctors will initially suspect achalasia from symptoms of difficulty swallowing either food or drink. Usually, the symptoms will get worse over time. Investigations such as esophageal manometry can assist in the process of determining the diagnosis.
The examination will be done by placing a tube in the esophagus while swallowing. The tube records the activity of the esophageal ring muscle. In addition, other examinations such as X-rays and endoscopy can also be done to assess the esophagus. X-ray examination can be done with the help of swallowing barium liquid so that barium flow can be seen through the esophagus.
On examination, you can see the appearance of a bird’s beak. Endoscopic examination is done by inserting a tube with a camera at the end to look for problems in the esophagus.
Symptoms
Symptoms of achalasia that usually appear include:
- dysphagia (difficulty swallowing or feeling a lump in the esophagus)
- regurgitation or stomach acid
- cough
- choking often
- chest pain or discomfort
- heartburn
- weight loss
- severe pain or discomfort after eating
There are several diseases that can mimic the symptoms of achalasia. For example GERD (gastroesophageal reflux disease), esophageal cancer or parasitic infection Chagas disease. However, Chagas infections are more common in South America.
Treatment
Treatment of achalasia involves the lower ring of the esophagus. There are several treatment options that can temporarily relieve symptoms or permanently treat lower esophageal ring function. Treatment may include surgical procedures or medication alone.
The first option is pneumatic therapy, which expands the lower ring of the esophagus by inserting a balloon and inflating it. This procedure can help improve esophageal function. However, it is possible that this dilation procedure could injure the ring and require additional surgical procedures to repair it.
Another procedure is esophagomyotomy, which is making an incision or wound to access the LES. After the procedure usually the patient will have better movement of food to the stomach. However, side effects can also occur such as GERD.
Another therapy can be done using botulinum toxin (botox) to relax the esophageal muscle ring. Botox fluid is given using an endoscope. Other medications such as nitrates and calcium channel blockers can be used to help the esophageal ring relax so that food can pass easily.
Treatment can also be done not only with one treatment option but with a combination of the above therapies.
Prevention
The condition of achalasia is difficult to prevent because the underlying cause is often difficult to determine. If you have experienced symptoms of achalasia, you should immediately consult a doctor so that treatment can be carried out immediately. Achalasia (esophageal) – signs and symptoms, pathophysiology, investigations and treatment With Armando Hasudungan