Achalasia

Difficulties Swallowing?

Know more about the rare disorder, Achalasia, which causes difficulties in swallowing with our expert Gastroenterologist & Hepatologist, Dr. Gaurav Muktesh.

 Achalasia is a rare disorder that causes difficulties in swallowing. The condition happens when there is pressure on the sphincter, a muscle that aids in closing a bodily passage or opening which in this case controls the passage of food from the food pipe (esophagus) to the stomach.

As a result, the process of food travelling from the food pipe to the stomach becomes highly difficult, so complications could occur. Some of these complications include that the food pipe may get grossly dilated and the patients have trouble swallowing food as well as reflux ingested food back in the mouth and retrosternal pain.

In addition, the condition plays a big role in the patients’ quality of life, due to the difficulty in swallowing. Patients might lose excessive weight and some patients may start aspirating ingested food into the windpipe resulting in recurrent pneumonias, an infection in which the air sacs of the lungs are inflamed. Some studies suggest that patients with untreated achalasia may also have a higher risk of esophageal cancer.

Moreover, Achalasia occurs in patients due to damage to the nerves that supply the food pipe. There are various theories and studies that claim that an autoimmune process or viral infections are responsible for the loss of neurons. Autoimmune process refers to the process in which your body attacks normal cells rather than only foreign cells.

To be able to diagnose the condition, a doctor would have to assess numerous factors. A combination of clinical symptoms, endoscopy, an x-ray of chest after ingesting a liquid solution (barium swallow) and pressure monitoring of the esophagus (manometry) can help diagnose achalasia conclusively.

To treat it, there are different options available. One of them is surgical endoscopy which includes balloon dilatation of the esophageal sphincter (the lower end of the esophagus). It is a temporary solution and symptoms may come back which will require repeated dilatation. An injection of botulinum toxin at the lower esophageal sphincter is also another temporary relief option for patients with achalasia.

Surgical options include surgically cutting the muscle of the lower esophageal sphincter to allow food to easily pass to the stomach.

The latest endoscopic treatment option is peroral endoscopic myotomy (POEM), which is a highly effective one-time endoscopic incisionless treatment option for achalasia

“POEM includes the benefit of surgery without actually inducing scars externally on the body. The tight sphincter that controls the opening of the food pipe can be cut endoscopically, thereby enabling an easy passage for food to get into the stomach from the esophagus. Additionally, success rates of this procedure are more than 90%.” Dr. Gaurav Muktesh, Specialist Gastroenterology and Hepatology at Al Zahra Hospital Dubai

There are numerous benefits to the procedure. It has faster recovery rates as well as high success rates. It is also a one-time procedure and does not require any repeated sessions and the complications associated with this procedure are extremely rare. This procedure has changed the lives of thousands achalasia patients across the world, who are currently leading an entirely healthy and normal life.