The most common symptom of achalasia is trouble swallowing foods and drinks. Other symptoms can include:
• Chest pain
• Feeling like you have a lump in your throat
• Losing weight without trying
• Nausea and vomiting undigested food
• Dysphagia (food getting stuck in esophagus)
Yes. If your doctor or nurse suspects that you have achalasia, he or she will do 1 or more of the following tests:
Doctors can treat achalasia in different ways. Treatments cannot cure achalasia, but they can improve symptoms. The different treatments include:
Medicines – Different medicines can relax the lower esophageal sphincter (LES). People can take these medicines before they eat. ( this is a temporary measure and medications can have side effects such as low blood pressure)
Making the LES wider – During an upper endoscopy, a doctor can use a thin wire to put a special balloon through a person’s mouth and down into the esophagus. The balloon is deflated until it reaches the LES. The doctor puts air into the balloon to widen the LES. Then he or she lets the air out of the balloon and removes it and the wire.
A shot of medicine (Botox) into the LES – During an upper endoscopy, a doctor can give a shot of medicine into the LES to make it relax. (temporary measure- may last 2 to 5 months)
Surgery – Laparoscopic (or Robotic) Heller Moyotomy vs Per Oral Endoscopic Myotomy ( POEM ) procedure: A doctor can cut open the LES to make it wider. This can be done by making small cuts in the belly or chest, or during an upper endoscopy without cutting through the skin at all.
Peroral endoscopic myotomy (POEM) is the endoscopic equivalent of surgical myotomy and a newer technique for the management of achalasia.
POEM utilizes the principles of submucosal endoscopy to transform the submucosal layer in the esophagus and proximal stomach into a tunnel, through which esophageal and gastric myotomy are carried out using a flexible endoscope.
POEM is performed perorally without any incisions in the chest or abdomen with minimal pain and fast recovery!
This is a new procedure and very few surgeons around the country are offering this novel treatment approach achalasia. In some studies POEM was superior to Heller myotomy (another surgical option), especially for type III achalasia.
In addition, conditions such as “Jack Hammer Esophagus” and “diffuse esophageal spasms” can be treated with POEM procedure.
With the Heller Myotomoy, this is a done laparoscopic or Robotic through small incision in the abdomen. This is a surgical procedure in which the muscles of the cardia (lower esophageal sphincter or LES) are cut, allowing food and liquids to pass to the stomach.
Yes. You will need to follow up with your doctor on a regular basis. He or she will check that your treatment is working and that it isn’t causing side effects.
Your doctor will also keep checking you for long-term problems. That’s because people with achalasia have a higher than normal chance of getting cancer or other problems of the esophagus.
To choose the treatment that’s right for you, talk with your doctor. Ask him or her about the benefits, risks, and side effects of each treatment.