Achalasia is a disorder making it difficult for food and liquid to pass through the stomach. The muscular valve between the food tube and the stomach is not relaxed, resulting in food backing up into the esophagus.
It is a rare disorder and is most commonly seen among middle-aged and older adults.
With the progress of the disease, muscles of food tube also degenerate affecting the movement of the food through the tube. After a period of time the food tube stretches and dilates.
4 Making a Diagnosis
Making a diagnosis of Achalasia is done by several procedures, which include:
Video-Esophagram – in this procedure, an x-ray image of the esophagus is taken after having barium. This helps to track the movement of barium into the stomach and also dilation of esophagus, if any.
Esophageal manometry – this procedure is used to identify the abnormalities in the muscles of the esophagus. It also tracks the failure of the food valve while swallowing food.
Endoscopy – this is one of the most common methods for the diagnosis of achalasia. With this method, a small fiberoptic tube with a camera at one end is swallowed. This helps to visualize the inside of the esophagus.As the pressure in the valve at the opening to the stomach is more, the movement of the tube may be hindered.This method will also help to distinguish achalasia from other conditions like esophageal cancer and Chagas’ disease.
History of the person often reveals an inability to swallow food. In many cases, the patient compensates his/her inability to swallow food by eating slowly, and this may delay diagnosis of the condition.
Treatment for achalasia focuses on reducing the pressure at the sphincter valve of the esophagus, allowing the food to pass through easily.
Oral medications, dilation of esophageal sphincter, surgery, and Botox injections are used to treat achalasia.
Oral medications like nifedipine, isosorbide dinitrate, calcium channel blockers and verapamil, are used for short-term relief of the symptoms. These drugs help to relax the valve at the opening of esophagus.
Botox injections is a non-surgical method most commonly used in elderly patients. This helps to weaken the valve and to help improve eating. Effects of Botox wear off within few months and the patient may need to go for a repeat injection.
Forceful dilation of the lower part of the esophagus with a balloon is another treatment option for the condition. The balloon is placed near the valve with the help of x-ray and then expanded to dilate the region.
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