Achalasia: The Main Examinations and Treatments

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Achalasia is a disease that can affect people of all ages, but tends to manifest more between the ages of 20 and 40, and progresses gradually over time.

Follow the main information about this condition, such as causes, symptoms, diagnostic tests, and treatments. Also, see how to access health and wellness materials on the internet.

What is achalasia?

Achalasia occurs in the esophagus due to the lack of peristaltic movements – responsible for moving food through the narrowing of the esophageal sphincter to the stomach. In achalasia, there is also difficulty in relaxing this sphincter.

The disease causes significant difficulty swallowing and weight loss (due to insufficient nutrient intake).

What are the main causes and symptoms?

The exact cause of achalasia is still unknown. In this case, scientists believe it may be caused by the immune system itself, which ends up destroying the nerves in the wall of the esophagus. In Brazil, a common cause of achalasia is Chagas disease, which can lead to megaesophagus. This condition can occur over the years, where the esophagus begins to dilate due to the difficulty of food passage through the sphincter.

As a consequence, both the movements responsible for transporting food and the relaxation of the esophageal sphincter muscle do not occur adequately. As a result, both solid and liquid foods are prevented from reaching the stomach.

Symptoms

The main symptoms of achalasia are:

• Difficulty swallowing (dysphagia);
• Chest pain and discomfort;
• Reflux and regurgitation (especially when lying down);
• Weight loss.

What tests are used for the diagnosis of achalasia?

For the diagnosis of achalasia, the following tests are used:

Endoscopy: allows the doctor to analyze the mucous membranes of the stomach, esophagus, and the initial part of the intestine.

Esophageal manometry: helps to examine the peristaltic functions of the esophagus and the degree of relaxation of the esophageal sphincter.

Esophagram: the test that evaluates the passage of food through the esophageal tube and checks the degree of dilation of the organ. It is done through X-ray, after the ingestion of a contrast food.

Read more about: Esophageal dilation

What are the possible treatments?

There are four main treatments that can help patients with achalasia. They are:

Dietary care

Even before having the diagnosis confirmed, the patient with difficulty swallowing (dysphagia) can adopt some dietary habits:

• Chew food thoroughly;
• Have meals in a calm manner, ingesting both solid and liquid foods (to help the food go down);
• Prefer easily digestible foods;
• Avoid lying down immediately after meals;
• Take medications with plenty of water to help the peristaltic movements of the esophagus.

Endoscopic treatment

Through endoscopy, it is possible:

• To apply botox injections to the esophageal sphincter to relieve symptoms, being a palliative measure that can last from 6 months to 1 year.
• To perform pneumatic dilation, which uses a dilating balloon to break the muscle of the lower esophageal sphincter and provide relief to the patient.
• In some cases, myotomy can be performed through endoscopy, with the resection of the muscle of the lower esophageal sphincter, to decrease its pressure.

Surgical procedure

In surgery, part of the lower esophageal sphincter is sectioned so that it no longer obstructs the passage of food. In more severe cases of megaesophagus, the esophagus is removed.

Important: after the surgical procedure, it is necessary to follow up and use medications to prevent reflux.

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Through EndoBlog, you can access, completely free of charge, materials about achalasia and other conditions that affect the digestive system. The site also strives to inform about good health habits and how the human body should function. Follow to access the articles firsthand, elastic band ligation of esophageal varices and much more

Also read: Endoscopic treatment of stomach varices | Upper Digestive Endoscopy | Intragastric balloon