Difficulty in Swallowing: Can it be Achalasia Cardia?

 Difficulty in Swallowing: Can it be Achalasia Cardia?

The term “Achalasia Cardia” is derived from greek word meaning “failure or lack of relaxation”.

This is the most common motility (movement) disorder of the esophagus (food pipe).In this condition the muscles in the lower end of the food pipe ( called lower oesophageal sphincter) fail to relax and there is loss of peristalsis ( forward movement of ingested liquids or solids ) of the food pipe. This results in progressive dilatation of the esophagus with impaired emptying of ingested food. The primary cause for this is due to destruction of some nerve cells in the muscle layer of the esophagus.

Achalasia cardia is a pre-cancerous condition. If not treated it can lead to cancer of the esophagus which is one of the most dreaded cancers we encounter in our practice. Patients suffering from this condition usually present with difficulty with swallowing (initially for liquids), regurgitation and weight loss. They may also present with heart burn,chest pain and dry cough.Most of the times these symptoms are attributed to Gastro Esophageal Reflux Disease (GERD) and are treated.

The correct diagnosis of this condition is very important, because if misdiagnosed,it can lead to cancer of the esophagus in the future. Diagnosis is achieved by means of patient’s symptoms, Barium swallow,endoscopy and oesophageal manometry. Esophageal Manometry is the gold standard test for the diagnosis of this rare condition.

This condition is treated by medicines, botox injections, forcefull endoscopic dilatation which are proved to provide only temporary relief of symptoms.The best and long lasting treatment of this precancerous condition is by surgery.

We, at A.V.Hospital offer laparoscopic surgery for the permanent cure for this condition,in which tiny ( ½ cm-1 cm) cuts are made over the abdomen. During laparoscopy,the muscle fibres of the esophagus and upper part of the stomach is cut, allowing the mucosa ( innermost layer of food pipe/esophagus) to pop out. This results in relief of difficulty in swallowing which the patient use to experience earlier. The patient has to stay just 2 days in the hospital and can be back to routine activities in a weeks time.

A.V.Hospital has all the state of the art equipment and gadgets like Ultrasonic scalpel, vessel sealing system, High Definition Video-laparoscopic system and a whole range of laparoscopic instrumentation which ensures the best surgical outcome.

Blog by Dr. Ganesh Shenoy

Consultant (Minimal Invasive Surgery Department)

AV Hospital, Basavanagudi

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