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Home :: Family Health :: Achalasia Achalasia - Achalasia symptom, treatment, causes
Achalasia is the failure of the sphincter (muscular valve) between one part of the intestine and the next to relax, with the result that the contents of the digestive tract cannot move along normally. The oesophagus (gullet) is most commonly affected, when the sphincter at its lower end fails to relax on swallowing, food cannot pass freely into the stomach. The oesophagus above this obstruction becomes dilated and the muscles in its wall lose their coordinated peristalsis (the wave-like contractions that push food onwards). Another part of the disorder is lack of nervous stimulation to the esophagus. Causes include damage to the nerves to the esophagus, parasitic infection, cancers, and hereditary factors. Achalasia may occur at any age. Causes of AchalasiaAchalasia may be caused by degeneration of or damage to the nerves that control the sphincter and peristalsis, and occasionally by the temporary loss of coordination of gut peristalsis for unknown reasons which is characterized by loss of the wave-like contraction of smooth muscles that forces food through the digestive tract. The exact cause of achalasia is unknown. It is a neurological problem of the esophagus, where the muscle at the end of the esophagus, the lower esophageal sphincter (LES), does not relax enough for food to pass properly. Hence, ingested foods get stuck in the esophagus. Achalasia is a disorder of the esophagus (the tube that carries food from the mouth to the stomach). The esophagus is less able to move food toward the stomach, and the muscle from the esophagus to the stomach does not relax as much as it needs to during swallowing. This relaxation is needed to allow food to enter the stomach.Achalasia experience a progressive difficulty in eating sold food and in drinking liquids that can take years to evolve. The upper sphincter remains closed most of the time to prevent food in the main part of the esophagus from backing up into the throat. It is important to discuss the various treatment options with your doctor before making a decision. This disorder is caused by failure of the LES to relax and failure of the esophagus to advance food into the stomach. A chest x-ray may show a widening in the middle of the chest and a fluid level in the esophagus when the child is sitting or standing. Symptom of AchalasiaThe main symptom of Achalasia are the difficulty in swallowing, a feeling of food sticking in the chest, and regurgitation of undigested food and saliva are the usual symptoms. Because of the problem swallowing food, a large proportion of patients with achalasia lose weight. Complications of achalasia include weight loss and malnutrition, and coughing, breathlessness and lung infection due to food and saliva being inhaled. The complications of achalasia include weight loss and aspiration pneumonia. There often is inflammation of the esophagus, called esophagitis, which is caused by the irritating effect of food and fluids that collect in the esophagus for prolonged periods of time. Diagnosis And Treatment of AchalasiaThe Achalasia problem can be diagnosed by means of a chest X-ray during a barium swallow, or by endoscopy (internal examination of the oesophagus via a viewing instrument). Achalasia can be treated in several different ways. The diagnosis of achalasia may be suspected by barium xray or by endoscopy. Barium studies will show a dilated esophagus down to a "bird beak" at the level of the LES. Upper endoscopy is performed to exclude cancer as a cause of blockage. Therapy is selected for each individual based on many factors, such as age, the severity of achalasia and co-existing medical problems. Muscle-relaxing drugs will allow the sphincter to open up in some cases. Treatment may otherwise entail stretching the sphincter by passing an inflatable tube or rods of increasing diameter through it, or surgery to overcome the obstruction. The dysphagia in achalasia also is different from the dysphagia of esophageal stricture (narrowing of the esophagus due to scarring) and esophageal cancer. In achalasia, dysphagia occurs with both solid and liquid food, whereas in esophageal stricture and cancer, the dysphagia typically occurs only with solid food.
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