Symptoms and Prevent Achalasia

Achalasia, literally ‘failure to relax’, is characterized by uncoordinated, non-progressive contraction within the esophageal body. There is derangement of the neuromuscular mechanism responsible for the normal working of the cardiac sphincter which fails to relax when food reaches it. Achalasia presents with Dysphagia as the primary symptom. As the disease progresses the esophagus dilates proximal to the obstructing LOS, and can harbor large volumes of food, which may be regurgitated or even aspirated if it doesn’t pass distally. Patients often lose weight as the symptoms progress. Dysphagia in Achalasia is variable and can occur to solids and liquids. Patients may be able to assist esophageal emptying by employing manoeuvres such as straightening up or lifting their arms.
Treatment of achalasia is aimed at decreasing the resting pressure in the lower esophageal sphincter to a level at which the sphincter no longer impedes the passage of ingested material. This can be accomplished by mechanical disruption of the muscle fibers of the LES (eg, pneumatic dilation or surgical myotomy) or by biochemical reduction in LES pressure (eg, injection of botulinum toxin, oral nitrates, or calcium channel blockers)



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