All you need to know about achalasia

All you need to know about achalasia

Achalasia is one of the rare digestive diseases that affect the esophagus and impede the delivery of food to the stomach. It causes many symptoms, and it is treated in Turkey in several ways.

A quick overview of the esophagus

It is a muscular tube about 25 cm long that forms a passage for food and liquids to pass from the pharynx to the stomach.
When food is eaten, the esophagus works to push the food towards the stomach through peristaltic muscle contractions aimed at moving the food and accelerating its descent into the stomach.
Anatomically, the lower part of the esophagus has a lower sphincter. The function of the lower sphincter is to prevent food from being refluxed backwards from the stomach. The sphincter naturally relaxes when eating and contracts when the esophagus is empty of food or liquid.
The lower esophageal sphincter in normal conditions maintains a specific pressure, this pressure keeps the sphincter contracted in normal conditions and prevents its relaxation and regurgitation of the components of the stomach.
A number of digestive diseases are associated with the condition of the lower esophageal sphincter gastroesophageal reflux disease One of the common diseases associated with a disorder in the work of the lower esophageal sphincter.

What is achalasia?

Achalasia or achalasia or cardiospasm are all terms that refer to the same disease. Achalasia is one of the diseases that affect the motility of the esophagus and impede the process of moving food to the stomach.
Achalasia occurs when the lower esophageal sphincter fails to relax properly while eating, preventing food from reaching the stomach.
Over time, esophageal insufficiency results in a clear dilatation of the esophagus and food accumulation in it, which may cause the contents of the esophagus to return towards the mouth and a feeling of bad taste.
Echalasia is often associated with many digestive symptoms that affect the patient's life. Some patients live with these symptoms and are not diagnosed with the condition until late.
In advanced stages of the disease, paralysis of esophageal motility occurs, when this occurs, the normal function of the esophagus cannot be restored again.
In the event of delay in treatment, this sometimes leads to an increased risk of infection esophageal cancer.
This image shows a comparison between the normal state and the case of achalasia.
Diagram of achalasia of the esophagus

Achalasia symptoms

  • Common difficulty swallowing solids and liquids (most common presentation)
  • Regurgitation or reflux of undigested food
  • Frequent chest pain that is exacerbated by eating
  • frequent burping
  • Feeling heartburn
  • night cough
  • Malnutrition and being underweight (due to pain that increases while eating)
  • Aspiration pneumonia (caused by inhaling the contents of the digestive tract)

Causes of alkaliosis

Achalasia is caused in most cases by the loss of nerve cells that control the esophageal muscles with peristaltic function, as these muscles work to push food toward the stomach.

The main reason behind the loss of these neurons is not yet known, and many hypotheses have been put forward, but they are still unproven.

How is achalasia diagnosed?

Diagnosing this disease can be difficult because it is mixed with many other digestive diseases that cause similar symptoms.
A patient with achalasia symptoms is diagnosed through several methods:

Barium swallow

This method is one of the important methods in the study of esophageal diseases. The patient is given a barium-shady preparation, which is often in liquid form, and then x-rays are taken of the esophagus. In the presence of achalasia, the esophagus is dilated with a narrowing at the bottom so that The esophagus takes the form of a bird's beak.

This is a radiograph of the esophagus with the radioactive barium swallowed, and we find in this image a large expansion of the esophagus with a narrowing of its lower end, which takes the form of a bird's beak, which is a distinctive appearance of the inability to relax the esophagus (Achalgia)
Picture of a barium bite of a patient with achalasia

upper endoscopy

The doctor inserts a flexible tube equipped with a camera through the patient’s mouth or nose into the esophagus, and through it he can also reach the stomach. Through endoscopy, the doctor can see the esophagus and assess the occurrence of infections or precancerous growths Within it, this technique helps in evaluating the occurrence of complications of achalasia.
Upper GI endoscopy, which is one of the most important diagnostic and therapeutic tools used in digestive diseases
This picture shows the process of gastrointestinal endoscopy which is useful in diagnosing achalasia

Esophageal manometry

It is considered the gold standard in diagnosing achalasia. This examination measures the time and force of esophageal contractions, in addition to measuring the pressure of the lower esophageal sphincter and determining its ability to relax properly. If the lower esophageal sphincter fails to relax after eating, this indicates the infection of achalasia.
The test is performed by inserting a flexible tube containing special pressure sensors through the patient's nose to the stomach.

Treatment methods for achalasia in Turkey

Several treatment options are available, primarily to relieve the pressure of the lower esophageal sphincter so that it can relax properly and allow food to pass into the stomach.

  balloon expansion

One of the easy-to-apply treatment methods that can be performed in the outpatient clinic, a balloon is inserted through the endoscope into the center of the lower esophageal sphincter, the balloon is inflated with air, which increases the widening of the esophageal sphincter opening and facilitates the passage of food through it.

This procedure relieves symptoms of the disease in about 50 to 90% patients, we may need to repeat the balloon dilation procedure if symptoms return, according to Study One third of patients treated with balloon dilation need re-expansion every five years.

The esophageal sphincter dilatation surgery used to treat achalasia in Turkey
This image shows the dilatation of the esophageal sphincter used to treat achalasia in Turkey

botulinum injection (Botox)

Botox acts as a muscle relaxant to help relax the lower esophageal sphincter. Botox is injected directly into the lower esophageal sphincter through an endoscopically guided needle.
The patient may need to re-inject Botox a large number of times (once every six months). The repeated injections of Botox make the surgery difficult to perform, so it is recommended to perform a Botox injection in patients who are not candidates for surgery or balloon dilatation.

Surgical treatment of alkalisia in Turkey

The surgical procedures that are performed to manage achalasia are:
Heller process
The surgeon biopsy part of the lower esophageal sphincter through the endoscope, which relieves sphincter pressure and allows food to pass more easily into the stomach.
One of the complications associated with the Heller operation is the occurrence of disease gastroesophageal reflux disease The lower esophageal sphincter relaxes excessively, allowing food to flow backwards.
To avoid gastroesophageal reflux disease, the surgeon performs a laparoscopic fold of the stomach fundus around the lower esophageal sphincter (Nissen operation) in conjunction with the Heller operation.
Oral endoscopic muscle biopsy
In this method, the surgeon inserts the endoscope through the mouth, and then an initial incision is made in the layers of the esophageal wall in order to reach the muscle layer.
The layers of the esophageal wall are then sutured where the incision was made.

drug therapy

 The doctor prescribes some muscle relaxants such as nitroglycerin or calcium channel blockers such as nifedipine, and the effect of these drugs is often weak and their side effects are many, so drug treatment is the last option for patients who are not candidates to undergo other Ekalizia treatments.

Why should I choose treatment in Turkey?

Recently, Turkey has become one of the leading countries in the field of medical tourism in the world.
The reason for this is due to the presence of advanced medical centers that provide appropriate treatment by the most skilled doctors and the latest medical devices at a low cost.
Regarding what has been said, the medical center of Bimaristan Medical is your first choice For treatment in Turkey.
We guide you to the best expert specialists in all departments.
We facilitate the language of communication between you and everyone through specialized Arab doctors who will help you communicate with your doctor.
We help you secure the right treatment and high-end service in the most modern hospitals and medical centers in Turkey.
We provide our services extensively and precisely.
We accompany you step by step towards recovery.
Free consultations around the clock.
do not hesitate Contact usBimaristan, your family center in Turkey.

These sources were used:

  1. Healthdirect
  2. penn medicine
  3. NHS

common questions

There are some foods and herbs that help relieve dysphagia, but they are not an effective way to treat the disease, but rather a way to control symptoms.

Achalasia patients are exuded by combining water with meals to facilitate its passage to the stomach. Soups, juices, and protein shakes are also useful when the patient suffers from poor appetite and severe problems with swallowing.

It is a rare disorder that affects the digestive system and causes a defect in the process of food transfer to the stomach. The pathogenic mechanism is the failure of the lower esophageal sphincter muscle to relax when eating, which prevents the passage of food into the stomach. The esophagus loses its ability to peristalsis with the passage of time and becomes paralyzed, which affects the swallowing process. The most common symptom seen in people with achalasia is dysphagia for food and drink.
  • Dysphagia of food and drink (a very common symptom in patients with achalasia)
  • Reflux or reflux of esophageal contents (undigested food)
  • smelly breath
  • Feeling of heartburn (also called heartburn)
  • Chest pain that usually increases when eating
  • Weight loss
Food ingestion disorders in people with alkalizia occur because the lower esophageal sphincter cannot relax properly. Over time, swallowing disorders may cause esophagitis and loss of the ability to peristaltic movement of the esophagus. In addition, a serious complication of acalzia is aspiration pneumonia following resorption of the contents of the digestive system. .

There are many types of treatment methods available to manage this disease, one of the methods used to treat alkalisia is balloon expansion, which is usually the first treatment option that is used when the disease is diagnosed, and it is also possible to perform surgical intervention and perform a process aimed at treating this disease and relieving its symptoms called Heller process Botox can also be injected down the esophagus into the loop of the lower esophageal sphincter, a type of disease management method.

The causes of achalasia are still not clearly understood, some believe that the cause is due to damage to the nerves of the esophageal plexus responsible for controlling esophageal motility, while others believe that the cause of the disorders is due to an immune factor so that special antibodies were found in the blood of some patients.

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