What is Achalasia?
Achalasia is defined as a rare esophageal motility disorder that involves the smooth muscle layer of the esophagus (the muscular tube that transports food from your mouth to your stomach) and lower oesophagal sphincter. In patients with achalasia, the esophagus muscles do not contract properly which prevents foods and drinks from passing into the stomach, which can get stuck and be brought back up leading to vomiting or choking.
Which age and gender are more affected by this condition?
This disorder typically affects people between the second to the fifth decade of life with a peak incidence between the ages of 30 to 60 years.
Men and women are found to be equally affected. Symptoms may also be found in children after the age of 10 years.
No particular race or ethnic group is more affected than others and familial predisposition is rarely seen.
What are the causes leading to Achalasia?
It is a rare disorder but the following factors have been found to cause it-
- Damage to the esophageal nerves.
- Cancer of the esophagus or upper stomach
- Genetic predisposition.
- Family history.
- Any autoimmune condition.
Can achalasia lead to malnutrition?
Achalasia can be a serious health issue if not treated and may lead to severe weight loss and malnutrition in later stages.
It can also cause chest pain, fatigue, and compromised immune symptoms leading to infections like pneumonia.
What are the signs and symptoms commonly seen in this condition?
People with achalasia typically experience dysphagia with other common symptoms like-
- Regurgitation of the undigested food
- Pain in the chest
- Difficulty in swallowing liquids and solids
- Heartburn
- Cough triggered when lying in a horizontal position.
- At times food and liquids are retained in the esophagus and may be inhaled through the lungs.
How to diagnose Achalasia?
Diagnosis of achalasia is multifactorial. It can be done by
- Barium swallows X-ray.
- Endoscopy with Ultrasound
- Esophageal manometry –
– Lower oesophagal sphincter (LES) fails to relax upon wet swallow (<75% relaxation)
– Pressure of LES <26 mm Hg is normal,>100 is considered achalasia, > 200 is nutcracker achalasia.
– Aperistalsis in the oesophagal body.
– Relative increase in intra-esophageal pressure as compared with intra-gastric pressure.
What other diseases look like Achalasia?
Certain diseases that might mimic symptoms of achalasia are-
- Gastroesophageal reflux disease
- A hiatus hernia
- Psychosomatic disorders
What can be the complications of achalasia?
Commonly occurring complications of this condition are-
- Aspiration pneumonia
- Esophageal Perforations
- GERD
- Oesophagal cancer
- Barrett’s esophagus
Which precautions can be helpful in Achalasia?
Some precautions that patients with achalasia can take to improve the prognosis of their condition are-
- Eat the food slowly and chew very well.
- Drink plenty of fluids when eating.
- Avoid eating solid food for three to four hours before going to bed.
- Raise the bed head or sleep with the wedge pillow to avoid flare-up of symptoms at night.
- Food that aggravates the reflux needs to be avoided.
What are the commonly indicated Homeopathic medications for Achalasia?
- Phosphorus- It is an effective homoeopathic remedy for achalasia in cases with regurgitation of food. The food comes up again in mouthfuls.
- Carbo veg- It is suitable to manage heartburn in cases of achalasia along with putrid belching and sour waterbrash.
- Asafoetida- It is usually an indicated remedy for spasmodic contraction of the esophagus and stomach with impaired peristalsis. It also works well in cases with a feeling of globus hystericus which is a sensation of a ball rising in the throat.
- Lachesis mutus- Suited for patients experiencing difficulty in swallowing along with a constant sensation of a lump in the throat with regurgitation of food.
- Robinia – Works well for treating achalasia cardia with excessive heartburn which gets worse at night on lying down and is accompanied by vomiting of intensely sour fluid.
