The esophagus is the swallowing tube that connects the larynx to the stomach. Achalasia is a disease that affects the esophagus; Due to the defect in relaxation of the valve formed by the muscles called the lower esophageal sphincter on the stomach side of the esophagus, solid and liquid food cannot easily pass into the stomach and hence, difficulty in swallowing is felt.
Achalasia is caused by the deterioration or loss of nerve cells in the esophagus that control the muscles involved in swallowing food.
While there is no single method for full recovery from achalasia, quality of life can be improved by controlling symptoms with treatment.
Achalasia can develop at any age, but is most common between the ages of 30 and 60. Its incidence is equal in men and women. Although the cause has not yet been determined, studies show that genetic factors, certain diseases that the body targets itself (autoimmune diseases) and certain infections play a role in the formation of the disease.
Achalasia is a disease whose symptoms develop gradually. During the process of the disease, complaints such as:
- Difficulty swallowing solid and liquid foods
- Food comes back to your mouth
- Chest pain or burning sensation
- cough after meals
After listening to your medical history and performing a physical exam, your doctor may refer you to certain tests to support the diagnosis of achalasia, such as:
This is a direct examination of the esophagus and the valve that opens in your abdomen using a flexible device with a camera tip.
esophagogram (spelling of the barium esophagus)
This is the visualization of the movement of the esophagus when you swallow a thick contrast agent called barium.
It is a simple pressure measuring tube. It measures the amount of pressure exerted by the esophagus on liquid or solid foods. The manometry is sent to the esophagus and then to the stomach. This test can show the increased pressure in the contractions of the muscles involved.
Today, the treatment of achalasia does not allow a complete cure of the disease, but helps alleviate the symptoms and increase the patient’s quality of life.
It prevents complications that can arise in the stomach and esophagus valve. The following methods are used in the treatment of achalasia.
Pneumatic expansion: A balloon is sent into the esophagus by the doctor through an endoscope, passed through the valve between the esophagus and the stomach, and then inflated.
Botox injection: Botox is a drug that inhibits muscle contraction. Botox can be injected into the muscles of this valve to relax the opening of the valve where the esophagus and stomach meet. This procedure can also be performed during endoscopy.
The effect of Botox usually lasts between 3 months and a year, so it may be necessary to repeat the procedure when the drug loses its effect.
Surgery to widen and loosen the valve between the stomach and the esophagus is called myotomy. In myotomy, some muscles in this flap are cut. These types of surgeries usually provide long-term relief from the symptoms of achalasia.