Achalasia is a rare disease which makes it difficult for food and liquid to reach the intestine. This occurs when the nerves connecting the tubes of the mouth and oesophagus become damaged, similar to structural defects in the abdomen in HIrschsprung's disease, which result in the oesophagus losing the ability to let food down. Also Read: Hirschsprung Disease: Causes, Symptoms and Treatment
Achalasia is characterised by the impaired ability of muscular valve, the ring-shaped muscle at the bottom of the oesophagus and the lower oesophageal sphincter to dilate. The peristalsis movement is the contraction and relaxation of the sphincter muscle that assists in the smooth passage of food through the food pipe. The term achalasia means “failure to relax “and it is also known as cardiospasm, dyssynergia oesophagus, oesophagal aperistalsis i.e. gastrointestinal motility issues and megaesophagus. Also Read: Lifestyle Changes Can Prevent Gastrointestinal Motility Disorder
There’s no complete cure for achalasia, however, the symptoms can be managed with minimally invasive therapy or surgery.
The cause of achalasia is not very clear. Studies shows that the disorder may be caused by the worsening of a cluster of nerves located in the chest (Auer Bach’s plexus), hereditary or autoimmune abnormality of the immune system causes the body to damage the oesophagus.
Signs And Symptoms:
Difficulty swallowing food and liquid, like in dysphagia
Regurgitation of food mostly happens at night making the food to aspirate into the lungs, a more severe problem.
Uneasiness in the chest due to oesophageal dilation or retention of food.
Weight loss, due to reduced food intake.
Diagnosis:
Achalasia can sometimes be misdiagnosed as the symptoms are quite similar to other digestive system disorders. Generally, doctors recommend the below tests to confirm the diagnosis which includes:
Oesophageal Manometry
This test monitors the muscle contractions in the oesophagus when you swallow, the coordination and pressure exerted by the sphincter muscles and how well it relaxes or opens during a swallow.
X-rays
X-rays help the doctors to screen the functioning of upper digestive tract. X-rays are taken after giving the patient a chalky liquid which coats and fills the lining of the intestinal tract. The coating permits the doctor to find the outline of your oesophagus, stomach and upper intestine. A barium pill is also given which assists to show any blockage in the oesophagus.
Endoscopy
The doctor inserts a thin flexible tube instrument attached with a light and camera down the throat to observe the lining of the oesophagus and stomach. Endoscopy helps to find out any blockage and tissue sample is sent for biopsy for further diagnosis.
Treatment:
Generally, the treatment plan of achalasia is aimed at relaxing the opening of sphincter muscles which allows the food and liquid to easily pass through the stomach. The precise treatment plan is determined based on the age of the patient and the seriousness of the disorder.
Nonsurgical treatment options include:
Pneumatic dilation is a procedure where a balloon is inserted through the oesophageal sphincter and inflated to enlarge the opening. This procedure in most of the cases is repeated within six months as the muscle does not remain open. This improves digestive ability and gut health to some extent in affected persons.
