Achalasia Cardia is an esophageal mortality disorder in which the lower esophageal sphincter does not relax properly and it prevents the passing of food specifically liquid from the esophagus into the stomach.
In this condition, the smooth muscles of the lower esophageal sphincter do not relax properly. Distal inhibitory nerve fibers of smooth muscles lose their function.
The cause is unknown but some studies say it could be viral infections or autoimmune disorders.
Signs & symptoms:
- Difficulty swallowing (dysphasia) feels like food or drink is stuck in your throat.
- Regurgitation (food and liquid backflow into the mouth after being swallowed.
- Chest pain and chest heaviness (heartburn)
- Aspiratory pneumonia
- Weight loss
- Coughing at night
- Belching
Diagnosis:
- Esophageal Manometry – to measure pressure throughout the esophagus as you swallow, it can detect the location and severity of muscle contractions that affect swallowing ability.
- 24-hour pH monitoring – to measure continued 24-hour pH (acid) monitoring of the lower esophageal region.
- Upper Endoscopy – to examine the esophagus and stomach using an endoscope – a thin tube with a camera inserted through the mouth.
- Radiography – is an imaging modality test that uses barium meal swallow and does an x-ray to see an x-ray image of the upper gastrointestinal tract (GI), it shows a narrowing of the lower esophagus which is known as a bird beak sign.
Treatment:
Medication – some drugs like Nitrates and calcium channel blockers can temporarily help to improve your symptoms, but medications are not more effective in treating achalasia.
Injection of Botulinum toxin through an endoscope into the lower esophageal sphincter shows a good effect on some achalasia patients.
Surgical management- fundoplication – is a surgical procedure in which myotomy of the lower sphincter is done to decrease pressure.
Balloon dilations of the lower esophageal sphincter for passing bullous.
Avoiding too hot or cold food, and coffee.