How is Achalasia Cardia treated?

• Medications: medications may sometimes be used to relax the lower esophageal sphincter. However, they have not shown very good or long-lasting results. Usually, they are prescribed in early stages or to people who are medically unfit to undergo any kind of procedure.

• Endoscopic balloon dilatation: Mechanical pneumatic dilatation is done to rupture the circular muscles of the lower esophageal sphincter. Fairly good results have been seen after this procedure and are said to be long lasting too. In 2% cases, esophageal perforation may occur as a complication.

• Peroral endoscopic myotomy (POEM): In this procedure, an endoscope is introduced through the mouth into the food-pipe. Internally an incision is made on the internal lining of the food-pipe until the muscle of the LES is cut. Some patients may develop acid reflux after POEM and may need a fundoplication operation if not able to control with medications.

• Laparoscopic Heller’s cardio-myotomy: This operation was originally described by Heller in 1914. Modern version of this operation involves a myotomy on the anterior aspect of the lower end of the food-pipe. It is accompanied with a partial wrap of the stomach to prevent acid reflux later on. Achalasia Cardia surgery has shown very good results in over 90% of cases over ten years follow up.