Achalasia Cardia: Symptoms, Causes, and Treatment

Achalasia Cardia: Symptoms, Causes, and Treatment

Achalasia Cardia is a rare medical condition that affects the esophagus, the tube that connects the mouth to the stomach. When we eat, food travels down the esophagus into the stomach through a muscular valve at the bottom of the esophagus called the lower esophageal sphincter (LES). In achalasia, this sphincter doesn’t relax properly during swallowing, leading to difficulty in moving food into the stomach. The main causes are believed to involve the nerves in the esophagus not working correctly. Normally, the nerves signal the muscles in the esophagus and LES to relax and allow food to pass into the stomach. In achalasia, these nerves are damaged, causing the LES to remain tightly closed or only partially open. Achalasia Cardia can affect people of all ages, but it is more common in adults and can be treated with achalasia cardia surgery which is called Heller’s cardiomyotomy.

Symptoms of Achalasia Cardia:

The symptoms of Achalasia Cardia can vary from person to person, but some of the most common symptoms include:

1. Difficulty in swallowing: 

This is the most common symptom of Achalasia Cardia. People with this condition find it difficult to swallow food and liquid, and they may feel like the food is getting stuck in their throat.

2. Regurgitation: 

People with Achalasia Cardia may experience regurgitation, which is the backflow of food and liquid from the stomach into the esophagus. Sometimes there can be regurgitation of food particles into the wind-pipe leading to asthma like symptoms or sometimes aspiration. This can occur soon after eating or when lying down

3. Chest pain: 

Some people with Achalasia Cardia may experience chest pain or discomfort, which can be mistaken for a heart attack.

4. Weight loss: 

People with Achalasia Cardia may experience weight loss due to difficulty in swallowing and reduced food intake.

Causes of Achalasia Cardia: 

The exact cause of Achalasia Cardia is not known, but it is believed to be caused by a combination of factors, including:

1. Genetic factors: Some people may inherit a genetic predisposition to Achalasia Cardia.

2. Autoimmune disorders: It is believed that Achalasia Cardia may be caused by an autoimmune disorder in which the body’s immune system attacks the muscles of the esophagus.

3. Nerve damage: Some people may develop Achalasia Cardia due to nerve damage in the esophagus.

Diagnosis of Achalasia Cardia:

Because the symptoms of Achalasia Cardia resemble those of other digestive problems, it is possible for it to be missed or misdiagnosed. In order to check for achalasia cardiaca, we advise:

Esophageal manometry: This test gauges the force and coordination of the esophageal muscles, the rhythmic contractions of esophageal muscles during swallowing, and the degree to which the lower esophageal sphincter relaxes or opens during swallowing. When identifying the potential sort of motility issue you may have, this test is the most beneficial.

Upper digestive system Barium X-rays (esophagograms): These images are obtained following ingestion of a chalky drink (barium) that covers and fills the internal lining of the digestive tract. The esophagus, stomach, and upper intestine may all be seen as silhouettes by the doctor thanks to the coating. A barium pill may also be given to you to swallow, which can assist to reveal an esophageal blockage. An achalasia would typically appear as a bird-beak appearance.

Upper GI endoscopy: A gastroenterologist uses an endoscope, a thin, flexible tube with a light and camera, to see inside your stomach and esophagus. If the findings of a barium study or your symptoms point to the likelihood of a partial blockage of the esophagus, endoscopy can be utilized to characterize the condition. 

Treatment for Achalasia Cardia:

There is no cure for Achalasia Cardia, but there are several treatment options available that can help manage the symptoms of the condition. Some of the most common treatment options include:

1. Medications: Medications such as calcium channel blockers and nitrates can help relax the muscles of the esophagus, which can make it easier to swallow.

2. POEM: (Peroral Endoscopic Myotomy) is a minimally invasive endoscopic procedure for achalasia cardia. It involves creating a small incision in the esophagus, allowing for precise muscle cutting to relieve swallowing difficulties, offering effective and less invasive treatment for this condition.

3. Surgery: Surgery may be recommended for people with severe symptoms of Achalasia Cardia. The most common surgery for Achalasia Cardia surgery is called a Heller’s cardio-myotomy, in which the muscles of the esophagus are cut to make it easier to swallow. Achalasia Cardia surgery can be performed using minimally invasive techniques such as laparoscopy.

4. Balloon dilation: Balloon dilation involves inserting a balloon into the esophagus and then inflating it to stretch the muscles of the esophagus, which can make it easier to swallow.

Conclusion:

If you or someone you know is experiencing symptoms of Achalasia Cardia, it is important to seek medical attention. Dr. Aparna Govil Bhasker is a renowned bariatric and laparoscopic surgeon with extensive experience in Achalasia Cardia surgeries. She specializes in performing minimally invasive Achalasia Cardia surgery- Laparoscopic Heller’s Cardiomyotomy, which offers several benefits such as faster recovery time, minimal scarring, and reduced risk of complications. Contact Dr. Aparna Govil Bhasker today to schedule a consultation.