What is Achalasia?
Achalasia is a condition that affects swallowing due to improper functioning of the esophagus. It can cause symptoms such as regurgitation (food coming back up into the mouth), chest pain, and weight loss. The condition occurs because the lower esophageal sphincter (the valve controlling food passage into the stomach) does not relax properly, and the coordinated muscle contractions (peristalsis) that move food down the esophagus do not work well.
Cause of Achalasia:
The exact cause of achalasia is unknown, and it is not considered a hereditary condition.
Benefits of Surgery:
Surgery, such as Heller’s cardiomyotomy, is recommended to help improve swallowing. The procedure aims to make it easier for food to pass into the stomach, and its benefits often last a lifetime.
Alternatives to Surgery for Achalasia
Achalasia is not life-threatening, and there are several non-surgical options for temporary symptom relief:
- Dietary Changes
– Eating in an upright position and drinking plenty of fluids with meals can help.
– Switching to more liquid-based foods may provide short-term relief.
- Medication
– Some medications can stimulate the esophageal muscles, but they are only effective in the early stages and offer limited symptom improvement.
- Botox Injections
– Botox can be injected into the lower esophageal sphincter using an endoscope to temporarily relax the valve.
– This provides symptom relief for up to three months but carries risks with long-term use and is not effective for everyone.
- Balloon Dilatation
– A balloon is inflated in the lower esophageal sphincter to widen it, making swallowing easier.
– This is the most successful non-surgical treatment, with benefits lasting up to three years. However, there is a small but serious risk of esophageal tearing.
Surgical Alternatives
- Surgery remains the most reliable long-term treatment.
- A newer minimally invasive procedure, Peroral Endoscopic Myotomy (POEM), is available in some centers. It involves cutting the lower esophageal sphincter muscle using an endoscope inserted through the throat.