Achalasia: Symptoms and Treatment in Dallas

Achalasia: Symptoms and Treatment in Dallas is a serious disorder that affects the esophagus and makes it difficult for food and liquid to pass through the esophagus to the stomach.

The esophagus or throat is the tube connecting your mouth to your stomach. It is the tube where food travels from your mouth into your stomach.

When the nerves in the esophagus become damaged, the esophagus becomes paralyzed and dilated over time. The esophagus eventually loses its ability to squeeze food down into your stomach. This condition is known as Achalasia.

Causes of Achalasia

Achalasia can occur for different reasons. The exact cause of achalasia is not known. It can be difficult for your doctor to know the exact cause. Doctors and researchers suspect it may be caused by the loss of nerve cells in the esophagus.

It may also be due to an autoimmune condition and can also be hereditary. Your body’s immune system may mistakenly attack healthy cells in your body. Degeneration of nerves in your esophagus may also cause achalasia.

Achalasia may also be caused by an inherited genetic disorder or rare parasitic infection. Cancer of the esophagus may also cause achalasia.

Symptoms of Achalasia

Patients with achalasia often have trouble swallowing foods or drinks. They usually feel like food is stuck in their esophagus. When this occurs, it can cause them to start coughing. It also raises their risk of aspiration, or inhaling or choking on food.

Other symptoms include:

• Regurgitating food or saliva
• Heartburn
• Belching
• Chest pain or discomfort
• Coughing at night
• Pneumonia
• Weight loss
• Vomiting
• Intense pain or discomfort after eating

Diagnosis of Achalasia

Achalasia has similar symptoms with acid reflux and other digestive disorders; hence can be quite difficult to diagnose or can be misdiagnosed.

To diagnose for achalasia, your doctor may recommend:

Esophageal manometry

This is a test that measures the rhythmic muscle contractions in your esophagus when you swallow food. It also measures the coordination and force exerted by the esophagus muscles and how well your lower esophageal sphincter relaxes or opens when you swallow food. This test helps to determine which type of motility problem you might have.

X-rays of your upper digestive system (esophagram)

During this test, you will be asked to drink a chalky liquid that coats and fills the inside lining of your digestive tract. X-rays of your upper digestive system will then be taken after drinking the chalky liquid. Your doctor will be able to see a silhouette of your esophagus, stomach and upper intestine.

Barium swallow

This is a diagnostic test whereby you will be given barium prepared in liquid form to swallow. Your doctor will then track the movement of the barium as it goes down your esophagus using X-rays.

Endoscopy

This is a diagnostic test used to view the inside of your esophagus. A thin, flexible tube equipped with a light and camera known as endoscope will be inserted down your throat so that your doctor can view and examine the inside of your esophagus and stomach. Endoscopy can be used to check the inside of your esophagus to see if there is any blockage. Your doctor can also collect a sample of tissue (biopsy) and taken to the lab for further examination.

Treatment of Achalasia

The treatment of achalasia focuses on relaxing or stretching open the lower esophageal sphincter so that food and liquid can easily move through your digestive tract.

Treatment options depend on your age, health condition and the severity of the achalasia. Treatment can either temporarily relieve your symptoms or permanently alter the function of the valve.

Treatment options include:

Pneumatic dilation

This treatment is performed to open up the esophageal sphincter. During this procedure, a balloon is inserted using an endoscope into the center of the esophageal sphincter. The balloon is then inflated to enlarge the opening of the esophageal sphincter. If the esophageal sphincter doesn’t stay open, the procedure may be repeated.

Botox (botulinum toxin type A)

This treatment involves injecting Botox (muscle relaxant) directly into the esophageal sphincter to relax the esophageal sphincter. Botox is injected into the esophageal sphincter using endoscope. An improvement after Botox injection may confirm a diagnosis of achalasia. Botox injection is generally recommended only for people who aren’t good candidates for pneumatic dilation or surgery because of their age or health conditions.

Heller myotomy

During this procedure, your surgeon cuts the muscle at the lower end of the esophageal sphincter to allow the free passage of food into your stomach. After undergoing Heller myotomy, some people may later develop gastroesophageal reflux disease (GERD).

A procedure known as fundoplication might be performed along with a Heller myotomy to avoid future complications with GERD. During a fundoplication, your surgeon wraps the top of your stomach around the lower esophagus to create an anti-reflux valve. This helps to prevent acid from coming back into your esophagus.

Peroral endoscopic myotomy (POEM)

During a POEM procedure, your surgeon inserts an endoscope through your mouth and down your throat and then creates an incision in the inside lining of your esophagus. Your surgeon then cut the muscle at the lower end of the esophageal sphincter.

POEM may also be performed in combination with or followed later by fundoplication. This helps to help prevent GERD.

Medication

Muscle relaxants such as nitroglycerin (Nitrostat) or nifedipine (Procardia) may be prescribed by your doctor. Medications are considered only if you’re not a candidate for pneumatic dilation or surgery. Medications may also be considered if Botox hasn’t helped to improve your condition. These medications may have serious side effects and may have limited effects.

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