ACHALASIA CARDIA
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ACHALASIA CARDIA
Achalasia cardia is a rare disorder of the esophagus characterized by impaired esophageal motility and failure of the lower esophageal sphincter (LES) to relax properly. This results in difficulty swallowing, regurgitation of food, chest pain, and weight loss. Achalasia can significantly impact a person’s quality of life and requires appropriate management to alleviate symptoms and prevent complications.
Causes and pathophysiology:
The exact cause of achalasia cardia is not fully understood, but it is believed to involve a combination of factors, including abnormalities in the nerves that control esophageal function and dysfunction of the muscles in the esophagus. This leads to impaired relaxation of the LES and a lack of coordinated muscle contractions, resulting in the characteristic symptoms of achalasia.
Symptoms:
Common symptoms of achalasia cardia include:
- Difficulty swallowing, especially with solid foods
- Regurgitation of undigested food or liquid
- Thoracic pain or discomfort, often after eating
- Heartburn or acid reflux
- Weight loss due to difficulty eating
Diagnosis:
The diagnosis of achalasia cardia typically entails a comprehensive approach, incorporating clinical assessment, imaging studies, and specialized tests.. These may include:
Barium swallow study: A fluoroscopic examination where the patient swallows barium contrast, allowing visualization of esophageal abnormalities.
Esophageal manometry: A procedure to measure the pressure and coordination of muscle contractions in the esophagus, which can help diagnose impaired LES relaxation and esophageal motility.
Endoscopy: A procedure to examine the esophagus and stomach using a flexible tube with a camera.
Treatment:
Treatment for achalasia cardia aims to alleviate symptoms, improve esophageal function, and prevent complications. Options may include:
Medications: Medications such as calcium channel blockers or nitrates may help relax the LES and improve swallowing.
Botulinum toxin injection: Injecting botulinum toxin directly into the LES can temporarily paralyze the muscle and improve symptoms.
Balloon dilation (pneumatic dilatation): A procedure where a balloon is inflated inside the LES to stretch and widen the passage.
Surgical myotomy: A surgical procedure to cut the muscles of the LES, allowing for easier passage of food into the stomach.
Peroral endoscopic myotomy (POEM): A minimally invasive procedure where the muscles of the LES are cut using an endoscope passed through the mouth.
Conclusion:
Achalasia cardia is a chronic condition that requires ongoing management to control symptoms and improve quality of life. With proper diagnosis and treatment, many individuals with achalasia can experience significant relief of symptoms and lead normal, active lives. It is important for individuals experiencing symptoms of achalasia to seek evaluation and treatment from a healthcare provider experienced in managing esophageal disorders.