What is achalasia?
Achalasia is a condition that affects the oesophagus. If you are suffering from achalasia, your lower oesophageal sphincter (LES) fails to open during swallowing. This can lead to a backup of food within your oesophagus.
There are several different causes of achalasia, and it can often be difficult for your doctor to identify a specific cause. Some causes of achalasia are:
- Autoimmune condition – this causes your body to mistakenly attack healthy cells in the body, which can lead to the degeneration of nerves in the oesophagus, contributing to achalasia.
- Hereditary – achalasia is a condition that can be hereditary in families.
Other conditions can cause symptoms that are similar to achalasia, such as oesophageal cancer, so it is important if you are experiencing any of the following symptoms you should seek medical attention.
- Reflux sensation (heartburn)
- Intense pain or discomfort after eating
- Weight loss
- Pain or discomfort in the chest (similar to heartburn)
If you are experiencing any of these symptoms you should seek medical attention from your doctor.
- Oesophageal manometry
- Barium Swallow
Achalasia Treatment & Surgery
Non-Surgical Achalasia Treatment
There are several different non-surgical achalasia treatments available, however they are generally only offered in the circumstance that a patient isn’t a suitable candidate for surgery. They include:
- Medication – muscle relaxants are an option, but have limited treatment effect and potentially severe side effects.
- Botox – botox is a muscle relaxant that is injected directly into the LES. Botox isn’t a permanent, long-term solution so multiple injections may need to be repeated, meaning this treatment is often only used for patients who aren’t candidates for surgery.
- Pneumatic Dilation – this is an outpatient procedure that uses a balloon. The balloon is inserted into the centre of the LES and then inflated to enlarge the opening. This treatment may need to be repeated and again usually means this treatment is often only used for patients who aren’t candidates for surgery.
Surgery is the most effective treatment for achalasia, for suitable patients. The standard surgery for achalasia is Heller Mytomy. Find out more about achalasia surgery below.
During a Heller Myotomy, A/Prof Pilgrim will cut the muscle at the LES, which will allow food and liquid to pass more easily into the stomach. The Heller Myotomy procedure can be performed with minimally invasive surgery (robotically or laparoscopically), requiring smaller incisions, resulting in fewer potential complications and faster recovery times for the patient.
Patients who undergo a Heller Myotomy procedure may later develop gastroesophageal reflux disease (GORD) and therefore Fundoplication is usually combined with the Heller Myotomy procedure to help prevent GORD.