What is Achalasia?
Achalasia Cardia is a condition in which the lower end of the esophagus doesn’t relax when the food bolus reaches the lower end. This results in accumulation of food in the oesophagus.
What causes Achalasia?
Non relaxation of the lower esophageal sphincter prevents passage of food into the stomach which causes Achalasia.
What are the symptoms?
Difficulty in swallowing or feeling of lump in throat is the primary symptom.
Regurgitation of food in lying down position and later even liquids.
Loss of weight.
Repeated chest infections due aspiration of food and liquids from the esophagus to the trachea, are the few other symptoms.
How is it diagnosed?
Barium swallow is diagnostic
OGDs confirms the diagnosis and will also rule out malignancy
Esophageal manometry helps is showing the non relaxation of LES and clinching the diagnosis as well as ruling out other causes of dysphagia.
X-ray chest helps to pick up any chest infection
Routine blood tests ECG and other fitness tests as per patients age.
Treatment of Achalasia
Dilatation of narrow segment may be done in early cases however the narrowing recurs and repeated dilatations make surgery difficult.
Lap hellers Cardiomyotomy has replaced open surgery as the first alternative because of rapid recovery, very small incisions and magnification afforded by laparoscopy.
Complications of the surgery
Leakage due to accidental injury to the esophageal mucosa
Recurrence of achalasia if the surgery is incomplete.