What is achalasia?
The esophagus is a muscular tube about 30 cm long. When we swallow food, it travels into the esophagus. The muscles in the esophagus wall to transport the food toward the stomach. This is an active process in which the muscles contract in the esophageal wall. These contractions are called "peristaltic movements". The lower portion of the esophagus acts as a sphincter (sphincter). This ensures that gastric contents can not easily flow back into the esophagus.
Achalasia is a rare disease of the esophagus. Literally meaning achalasia 'inability to relax. " About 1-2 in 200,000 people have achalasia. The exact cause of achalasia is usually unknown, there are some rare diseases are known in which achalasia in families, such as the Allgrove or 'Triple-A' syndrome.
In people with achalasia, the nerve supply of the esophagus is reduced in the lower part thereof. The movements of the muscles in the esophagus that portion of the esophageal wall are also reduced. Because the nerve supply is reduced in the lower part of the esophagus, "spans" the lower part of the esophagus continuous touch. This has the result that the sphincter between the esophagus and the stomach can not be well more relaxed to allow food to pass. The food which is not good through the esophagus can go lingers above the sphincter. As a result, secure the bottom of the esophagus from. Esophageal sphincter becomes also by the continuous contraction thickened and relaxes more and more difficult. This has the result that food will pass even less easy, and there is still more food can accumulate at the bottom of the esophagus. Untreated achalasia can ultimately lead to a dilated esophagus.
Achalasia of the esophagus is a rare chronic disease in which the nerve supply of the esophagus is damaged. As a result, the smooth muscle tissue in the esophagus remains tightened constant. This leads to the sphincter between the esophagus and stomach can be difficult to food by normal peristalsis and there is no longer takes place when swallowing. The cause of this disease is unknown.
Achalasia symptoms
The food will thus remain standing in the esophagus and can be difficult to pass through the stomach. This can give symptoms of food that lingers behind the breastbone, giving up undigested food (which at night can lead to coughing), pain behind the breastbone cramps and weight loss.
Diagnostics
The definitive diagnosis is made with a pressure measurement of the esophagus (esophageal). This pressure measurement shows absent peristalsis and impaired function of the lower esophageal sphincter. An X-ray video of the esophagus during drinking of contrast shows the disturbed passage. Often, the esophagus is also stretched by the food debris.
Achalasia treatmentF
Treatment is focused on reducing symptoms. Because achalasia is a rare disease, patients are usually treated in some hospitals with experience in this field. Due to the stretching of the lower esophageal sphincter with a balloon, the food can be easier bags. Also, a botox-injection into the muscle tissue around the esophagus, at the height of the sphincter muscle, can lead to good results. However, this result is temporary, and the treatment must be repeated so repeatedly. The time that Botox is effective varies greatly from patient but averages between four months and a half years. Therefore, this treatment in general is not regarded as a permanent solution. Another treatment is the surgical cutting of the esophageal muscles via an operation (Heller myotomy). This now goes through keyhole surgery. Typically, also performs an anti-reflux procedure in this operation in order to prevent the backflow of stomach acid into the esophagus (reflux). Here the upper part of the stomach as a cuff on the esophagus-stomach fixed transition. It is even disagree on what treatment, stretching or surgery, earns the first preference. Many patients require multiple treatments because symptoms return over time. Recently it is also possible to perform the complete endoscopic myotomy.