Achalasia (Esophagus Disorder) - Maximed Turkey

Achalasia (Esophagus Disorder) 

Achalasia is a disorder of the esophagus in which the lower esophageal sphincter (LES) does not relax and allows for food to pass into the stomach.

The LES has a large number of nerve endings that when stimulated cause an involuntary rhythmic contraction, or peristalsis, that propels food into the stomach. In individuals with achalasia, this muscular contraction does not occur and so food cannot be pushed through.

Symptoms of Achalasia:

1. Difficulty swallowing or feeling like you have an obstruction in your throat

2. Weight loss without trying

3. Heartburn

4. Feeling as if food is not being moved down the throat as it should

5. Pain in the esophagus caused by a mass or a gallstone

6. Difficulty chewing

7. Lying on your left side or sitting for a long period can cause pain in the esophagus

8. Chest pain, fainting, or shortness of breath

9. Persistent cough after eating, especially after eating fatty foods or greasy foods such as French fries or hamburgers (also known as "burger's cough")

Achalasia Diagnosis

Once a physician can rule out any other disorders that may be causing similar symptoms, they may make a diagnosis of achalasia. An endoscope may be used to examine the esophagus for characteristic changes.

X-rays are also done of the chest through the mouth area, this is called an upper GI series, where the food contents of the esophagus are measured. If there are abnormalities, then another more detailed x-ray of the esophagus performed using barium is performed.

Barium is a chalky substance that can be seen on an x-ray and outlines structures in the body so that they can be visualized on film. A normal individual's barium swallows into the stomach after about 30 minutes. A person with achalasia will have the barium still present in their esophagus at 2 hours (see Achalasia).

Achalasia is one of several conditions known as spasmodic dysphonia, which is characterized by involuntary muscle spasms of the muscles involved in one or more stages of esophageal motor function, resulting in voice quality changes. The other conditions include physiologic dysphonia (normal voice), functional dysphonia (abnormal voice due to psychological factors), and myogenic dysphonia (abnormal voice caused by one or more pathologic conditions of the larynx).

Treatment for Achalasia

Treating achalasia focuses on procedures that enable the esophageal sphincter to relax and allow food to pass through, offering patients relief from symptoms that make eating difficult. Your doctors may recommend dilation, surgery, or an injection, depending on your symptoms and diagnosis.

1. Dietary Changes

Patients with achalasia are often advised to eat frequent, smaller meals rather than three large ones. Increasing the intake of dietary fiber or chewing gum between meals may be recommended because it can help stimulate smooth peristalsis of the esophagus, and it may decrease symptoms of heartburn.

2. Muscle-relaxant Medications

Muscle relaxants such as Dicyclomine (Bentyl), Hyoscyamine (Levsin), and Metoclopramide (Reglan) can help reduce symptoms such as chest pain and difficulty swallowing. However, over time these medications may cause serious side effects such as confusion, irregular heartbeat, or bone loss.

3. Pharmacologic Treatment

Chronic use of morphine (Narcotan), Oxycodone (Percocet, Percodan), or Oxymorphone (Opana) can lead to constipation. The medication Alprazolam (Xanax, generic) can help with the symptoms of achalasia and is not a narcotic. But it only alleviates symptoms for a limited period and can have side effects such as drowsiness, confusion, and slurred speech.

Frequently Asked Questions on Achalasia

What is the early symptom of it?

The first symptom of achalasia is a feeling as though something is stuck at the base of your throat. You may have trouble swallowing, or food may feel as if it's getting stuck.