Surgical Treatment for Achalasia of the Esophagus

Achalasia is a rare disorder that makes it difficult for food and liquid to pass into your stomach. Although the cause is not well known, it occurs due to damage to the nerves of the tube (esophagus) that connects your mouth and stomach.

Achalasia can be overlooked or misdiagnosed because it has symptoms similar to other disorders as cancer and reflux. The patient who has difficulty eating, starts to lose weight.

Diagnosing the disease can be difficult, doctor needs to listen patient’s story. Esophagus appears enlarged in endoscopic examination, especially in advanced cases. X-rays are taken after patient drinks a chalky liquid that coats and fills the inside lining of his/her digestive tract. If the painted esophageal x-ray is taken, an enlarged and thinned esophagus like a bird’s beak appears at the junction of the stomach.

Because lower esophageal sphincter pressure reaches high values, Solid and liquid nutrients cannot be easily transferred to the stomach. The diagnosis of achalasia is confirmed with high-resolution manometry.

There are three different methods of achalasia treatment. The first is pneumatic dilation. A balloon is inserted into the esophageal sphincter and inflated to enlarge the opening. This outpatient procedure may need to be repeated. The second is Botox (botulinum toxin type A). This muscle relaxant can be injected directly into the esophageal sphincter with an endoscope. The injections may also need to be repeated. The third option is laparoscopic surgery. The surgeon cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach. The surgeon can also apply a method called Fundoplication to prevent possible reflux complaints. According to studies, there is a 96 percent success rate in 5-6 years.

Laparoscopic surgery is one of the best options in treatment of Achalasia. If non-operative options have been previously applied, the patient must wait 3 months for the surgical operation.
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