Achalasia
Achalasia is a motility disorder of the muscles of the oesophagus (gullet/food pipe). Achalasia is a rare disorder which makes it hard for food and liquids to pass and enter the stomach. It occurs when the nerves in the oesophagus are damaged, which may lead to the sphincter not being able to open up during swallowing.
What are the related symptoms of achalasia?
Due to the inability of the lower part of the gullet to relax, the patient will experience the following symptoms:
- Progressive difficulty in swallowing
- Regurgitation of food
- Weight loss
- Occasional chest pain
- Heartburn
- Intense pain or discomfort after eating
- Halitosis / bad breath
Achalasia diagnosis can usually be made by a barium (contrast) swallow, x-rays of the upper digestive system, or manometry (pressure testing) of the gullet.
How is achalasia treated?
There are different types of treatment options available. The main goal for achalasia treatment is to focus on relaxing or forcing open the lower oesophagal sphincter in order for food and liquids to pass through the digestive tract. Dr Cooper may prescribe conservative treatment such as oral medication, pneumatic dilatation of the lower part of the gullet and Botox injections, which all have limited success.
Dr Cooper may recommend surgery for young people because conservative treatment tends to be less effective in the group. It is widely accepted that surgical treatment offers the patient the best chance of long term cure. The procedure done to treat achalasia is called a Heller’s myotomy. During this procedure, Dr Cooper will make small incisions on your abdomen (laparoscopy) to access the oesophageal sphincter. He will then divide the thickened muscle layer of the lower part of the gullet without perforating the lining of the gullet, to allow food to pass more easily into the stomach. An anti-reflux procedure (see below) is also added. This procedure should be performed in a minimally invasive manner (laparoscopically) and can be done with minimal morbidity.