What is the Treatment of Achalasia Cardia?
Undiagnosed and untreated achalasia may lead to weight loss, aspiration pneumonia, esophageal ulceration, esophagitis (inflammation of the esophagus) and even cancer.
The principle behind the treatment is reducing the pressure within the LES enabling it to relax and allow the passage of food to the stomach. Treatment options include :
- Lifestyle modifications such as eating slowly, chewing well, and avoiding food immediately before bedtime, sleeping with head raised and drinking plenty of foods helps in relieving symptoms to some extent.
- Medications such as proton pump inhibitors, calcium channel blockers and nitrates may be advised by the doctor to relieve symptoms.
- For patients who cannot risk surgery, Botulinum toxin (Botox) may be injected into the LES which paralyzes the muscles thus restricting relaxation of the LES. The effect is only temporary and lasts about 6 months. However, Botox injections cause scarring in the sphincter which may increase the difficulty of later Heller myotomy.
Achalasia Cardia Surgery
The surgeon makes tiny incisions in the abdomen and with the laparoscopic technique and divides the muscle of the LES leaving the mucosa (inner lining of the esophagus) intact. Since, Gastroesohpageal reflux disease, is a common side effect of the surgery, the surgeon performs a partial wrap of the stomach over the esophagus to protect the exposed mucosa. This procedure is also known as Esophagomyotomy.