Doctor insights on:
Die Esophageal Achalasia
This is a disease that destroys the nerves coordinating esophageal muscle contraction. The normal ability to push food into the stomach is lost, and the valve entering the stomach becomes tight and stiff, allowing food to collect in the esophagus and empty by gravity alone. Solids generally worse than liquids. Onset is gradual. Weight loss & malnutrition common. Treatment ...Read more
Maybe: Untreated achalasia can result in accumulation of fluid in the esophagus that can silently enter the lungs while you sleep at night. Chronic silent aspiration can cause permanent damage to the lungs, asthma, recurrent pneumonia. Any of these conditions can potentially shorten your life if not treated properly. A large aspiration event can be deadly. ...Read more
Achalasia: This is a disease that destroys the nerves coordinating esophageal muscle contraction. The normal ability to push food into the stomach is lost, and the valve entering the stomach becomes tight and stiff, allowing food to collect in the esophagus and empty by gravity alone. Solids generally worse than liquids. Onset is gradual. Weight loss & malnutrition common. Treatment directed at opening valve. ...Read more
Do you have to have difficulty swallowing if you have esophageal achalasia? What are all the symptoms?
Yes: Achalasia is a when the lower esophageal sphincter muscle incompletely relaxes and doesn't allow food or fluid to pass easily. Achalasia is characterized by difficulty swallowing, regurgitation, and sometimes chest pain. It is diagnosed with esophageal manometry or pressure study or barium swallow test. Treated with dilation, Botox injection or a heller myotomy "cutting of the muscle.". ...Read more
Hi, can GERD cause esophageal dysmotility? I don´t mean achalasia or sclerodermia. Only GERD (les 3mmhg). I have both and non specific. Thanks
They go together: Your les (lower esophageal sphincter) is hypotensive. The pressure is too low. Normally it should be above 10mmhg. Therefore acid from the stomach can freely go up to your esophagus and therefore gerd. If your physician told you that rest of manometry was unremarkable, you may still have scleroderma. Some foods and medications can decrease the les pressure. Achalasia has a high les pressure. ...Read more
I am 25y old. Can GERD cause complete aperistalsis of esophagus? It's been 3y. Not Scleroderma, Achalasia or any other diseases. My LES=5mmHg. Thanks
GERD alone unlikely: Manometric evidence of aperistalsis (not simply on barium test) unlikely from GERD alone, and can be from achalasia or esophageal scleroderma, even without skin findings of latter. You need to see Gastroenterologist or motility expert. Low LES pressure does not rule out achalasia. If you are medical personnel, I refer you to my free GI Motility on line on web via Nature Publishing on this subject ...Read more
23 years old. Have aperistalsis of esophagus-distal, middle, proximal. And gerd (0, 3 mmhg). But not achalasia and not scleroderma. What may be the cause?
Need more info: Any other related symptoms - how did you get this result in first place? It's rare to have all part of esophagus not moving in young age without underlying problem but could induce by specific drugs as well. Was this measured by functional esophagography? ...Read more
Besides achalasia, what can causes an esophagus not to contract? And can it cause chest pain under breast bone, weakness and body aches?
Achalasia: This is a disease where the nerves of the esophagus no longer function to coordinate the muscles to push down food, or send a signal to the lower valve of the esophagus at the entrance to the stomach to open an let the food in. Cause usually unknown. Most effective and most invasive treatment is surgically cutting the muscle of the valve, that can be done laparoscopically or endoscopically (poem). ...Read more
Depends: Symptom relief with pneumatic dilation or myotomy (laparoscopic or endoscopic) is usually the best, then the patient can eat. If norther of these are options, a peg could be an option, but I would imagine this scenario is uncommon. ...Read more
No: Achalasia is a problem with the nerves in the esophagus not working to coordinate the muscle. There is no known cure, but the symptoms can be relieved by treating the valve at the lower portion of the esophagus, such as Botox (not good, makes other treatments more difficult), balloon dilation (usually at least two times), laparoscopic muscle splitting (surgery) and endoscopic surgery (poem). ...Read more
See a G.I. doc: Achalasia is a disease resulting from damage to the nerves in the muscles of the lower esophagus, keeping them from being able to relax and making swallowing difficult. There is nothing you can do on your own to make this better. There are several medicinal, endoscopic, and surgical treatments available, which your G.I. doc can evaluate and go over with you. Do not delay. Good luck. ...Read more
Causes of achalasia: Achalasia often means absent peristalsis in the esophagus & incomplete relaxation of the lower esophageal sphincter (les). It may be a "primary" esophageal motility disorder, or "secondary" to cancers invading the les (pseudoachalasia), Chagas disease from reduviid bug bites, amyloidosis, sarcoidosis, eosinophilic infiltration. Similar motor abnormalities can be seen with diabetes & CIIP. ...Read more
Swallowing normally: The goal of treatment for achalasia is to improve swallowing and avoid complications such as weight loss and malnutrition. The newest, and likely most effective treatment is per oral endoscopic myotomy (poem). This is offered in springfield, ma, chicago, portland, or, san diego, and long island to name most of the centers performing this procedure. ...Read more
I was diagnosed with acid reflux for over a decade and now I have achalasia type 3.could acid reflux have caused it?
Not likely.: Achalasia is a disease of the nerves of the esophagus, which would be unlikely to be affected by reflux in the lumen of the esophagus. It would be interesting to verify the results of your manometry. This is an unusual turn of events. You might consider verifying it with a second opinion from a different gastroenterologist, particularly before any achalasia procedure is planned. Good luck. ...Read more
In the past 3 months I have had the symptoms of Achalasia about 6 times. NMot being able to swallow is not consistent. Can it be something else? Thx
Variable symptoms: Achalasia may have variable symptoms, especially early on in its course. The esophagus does not empty its content into the stomach readily. Symptoms can include intermittent difficulty with swallowing, heartburn, regurgitation, reflux, vomiting, choking, coughing, and even chest pain, often with different degrees of severity. There could be other conditions, especially if symptoms are different. ...Read more
Achalasia vs. GERD: In achalasia, the muscles of the esophagus don't push food down and the lower esophageal sphincter (les) doesn't open to allow food to enter to stomach. Treatment is with endoscopic dilation or surgical cutting of the les. Gerd occurs when the les is abnormal (weak) and allows stomach juices to wash up into the esophagus. Treatment is with antacid medications or surgical reinforcement of the les. ...Read more
Sphincter difference: Gastroesophageal reflux is gastric contents going up into esophagus because of lack of normal tone of distal esophageal sphincter or muscle which closes esophagus. Achalasia represents too much tone and spasm of sphincter causing obstruction to ingested materials and prolonged retention in esophagus. ...Read more
Achalasia: This is a narrowing of the esophagus which can be very painful. Sometimes it can be treated by dilating the esophagus to reduce the pain and narrowing. You should see a gastroenterologist for further treatment. ...Read more
endoscopy is performed to exclude a malignancy of the esophagus. X-rays often demonstrate a narrowing or birds beak of the distal esophagus. Manometry is diagnostic.
Laparoscopic surgery with a heller myotomy is highly effective treatment. ...Read more
Communicate: Feelings often don't make sense. Achalasia is a life-threatening illness and is not a reason to be angry. There must be something else going on. If you need to write us, it's time to sit down together with someone the two of you trust -- pastor, physician, friend, whoever is right -- and get the channels of communication open again. ...Read more
Yes.: I have a patient that suffers from barrett's esophagus, achalasia and such severe gerd that he has had two operations bringing the stomach up into the chest cavity and forming a new ring lower down in the stomach. Despite this and medications, he continues to suffer episodes of regurg, vomiting, aspiration. Now he is getting Botox injections into lower esophagus to paralyze nerves. Next? Who knows. ...Read more
Adjunct only: Achalasia is life-threatening short-term. If you've been offered definitive treatment, take it. Don't waste time or focus on herbal / pop / health-food-store alternatives. If you have an evidence-based holist in your area, you may get some recommendations for discomfort after treatment. ...Read more
Many treatments: Sometimes certain medications can improve early achalasia, lower esophageal sphincter treated directly by forceful dilation with patient swallowing tube with a balloon. Balloon is placed across the lower sphincter with help of x-rays, and balloon is blown up suddenly for dilation. Sphincter can be cut surgically, called esophagomyotomy. Another treatment is Botox placement in muscle by scope. ...Read more
Achalasia~: ~called esophageal dysmotility syndrome today with better effect. If the whole esophagsus involved its very serious because you need motility to swallow (and a tube for feeding!) If patchy, less severe and swallow technique can be taught. But if you have real dysmotility, you're on the SHORT-run to the doc for sure. Thanks ...Read more