In normal swallowing, the rhythmic stenosis (contraction) of the esophagus walls suppresses the food down the esophagus. In a rare disorder known as achalasia, nerves that control the muscles in the lower part of esophagus become “defective”, causing the contraction to become irregular and uncoordinated. The cause is uknown and the consequence is the distortion and swelling of the lower part of esophagus.
The main symptoms of this disease are difficult swallowing and pain, and usually the pain in the chest. Since food is accumulated in the esophagus, it is possible to have an unpleasant taste in the mouth as well as bad breath. Vomiting in the mouth may occasionally occur. At first, the patient will have hard time swallowing liquid, but later on will experience difficulties with solid food.
As the disease is progressing the food may stay in esophagus, so there is always the possibility that the patient could inject the food particles while sleeping. Food particles can cause infections of the chest cavity, e.g. pneumonia. Due to eating difficulties, the patient usually loses weight and shows other signs of malnutrition.
What to do?
If you suspect that you have an achalasia, contact a doctor who will examine you and probably refer to X-rays with barium. Diagnosis can be confirmed by visual examination of the esophagus – endoscopy. In order to alleviate the pain, your doctor may prescribe a spasmodic.
Achalasia can also be treated with special procedure – inserting a thin rubber bag into the esophagus; the bag is filled with water to widen the muscles in the lower prt of the esophagus. This facilitates the passage of food into the stomach, though not permanently, so it has to be repeated every few weeks. The only permanent therapy for this disease is a surgical procedure, an operation called cardiomyotomy, in which a part of the muscle at the entrance to the stomach is cut to extend the passage for food. This operation is successful in about 80% of cases.