Achalasia Definition
Achalasia is a condition of the loss of the ability of the esophagus for pushing food or drink from the mouth to the stomach. The disease is classified as a rare disease and can attack people of various ages, both men and women.
The Cause Of Akalasia
Achalasia occurs when the nerves on the walls of the esophagus connects the mouth with the hull damaged and cease to function normally. Generally, the muscles of the lower part of the esophagus (LES) will open automatically so that the food can go into the stomach.
But in people with Achalasia, LES does not open and close normally, so the food is piled up at the bottom of the esophagus or the ride back to the base of the esophagus.
The main cause of destruction of the LES is not yet known for sure. However, there are several factors that are thought to potentially increase the risk of the occurrence of akalasia, among other things:
-Disorders of the immune system. Achalasia suspected caused the error of the immune system that attacks the nerve cells of the esophagus, so the nerves of the esophagus has decreased function.
-Hereditary factors. Achalasia is allegedly derived from older people who experience Achalasia.
-Virus infection. For example the herpes virus.
Symptoms Of Achalasia
Achalasia symptoms appear gradually. Over time, the function of the esophagus will be increasingly weak and appear some symptoms as follows:
-Dysphagia, Achalasia sufferers of the condition when the difficulty, even in pain, when swallowing food or drink.
-Heartburn, is a sense of heat or sharp pain in the solar plexus due to stomach acid up into the esophagus.
-Regurgitation, a condition when the food or drink back up into the throat.
-Chest pain.
-Vomiting flowing or dripping from the mouth.
-Weight loss.
If Achalasia symptoms continue to be left without treatment, then it will increase the risk of cancer of the esophagus.
The Diagnosis Of Achalasia
Achalasia have symptoms that are similar to the symptoms of other digestive disorders. As a first step, the doctor will examine the medical history and symptoms that patients experience. Then, the doctor will perform a physical examination to see the function mainly swallowing sufferers.To ensure the diagnosis, the doctor will likely perform a follow-up examination, among others:-Esofagografi. One type of Imaging tests to get the detail pictures of the esophagus. Patients will be asked to swallow the liquid dye (contrast) substances containing barium, allowing the esophagus can be clearly visible when the x-rays. Normally, the diameter of the esophagus looks pretty wide and barium looks smooth entering the stomach. However, it is not the case in people with Achalasia.-Manometri. Small and flexible plastic tube will be inserted through the nose into the esophagus. This tool will record activity and strength of muscle contraction, and examine the pressure which appeared in LES.-Endoscopy. A flexible instrument accompanied the camera at the end will be inserted into the lower part of the esophagus so that the doctor can check the condition of the walls of the esophagus and stomach.
Treatment Of Achalasia
Treatment of Achalasia is aimed to reduce the perceived symptoms the patient muscle, opens the LES so that food and drink can log in easily to the stomach, and prevent the occurrence of complications. There are several types of handling against Achalasia sufferers, among others:
-Dilation of the esophagus. This procedure is performed by inserting a balloon into the narrowed the esophagus with the help of the endoscope. The balloon is then developed to enlarge the opening of the LES, so food can get into the stomach. These actions need to be done repeatedly to get the best results.
-Injection of botox (botulinum toxin). This type of treatment is done for patients with health conditions are generally less well, so it is not possible to perform dilation of esophagus action. The doctor will inject the botoxsecara directly to LES through endoscopy, so LES will loosen and open. The influence of injecting botox is only temporary, can last for several months and sometimes a few years.
-Operation. Surgical procedure to open LES known with myotomy. There are several types of surgery myotomy for Achalasia handles, among other things:
-Heller myotomy. This procedure is done by cutting the muscle using laparoscopic technique or LES operation with minimal incisions, making food easier entry into the stomach.
-Peroral endoscopic myotomy (POEM). This procedure is performed using an endoscope that is inserted through the mouth into the esophagus to cut the LES.
-Fundoplication. The surgeon will wrap the upper part of the stomach (below from LES) to tighten the muscles of the stomach and prevents the rising of stomach acid. This surgical procedure is usually done in conjunction with the Heller myotomy through laparoscopic technique.
In addition, administering medications can also be made of the patient's doctor if the condition does not allow for the widening of the esophagus through the procedure or surgery, and when injecting botox also didn't help. Medications that can be given to relaxes LES, such as nitroglycerin or nifedipine, which consumed before eating.
Complication Of Achalasia
There are some complications that can be experienced by sufferers of Achalasia, among others:
-Aspiration Pneumonia, occurs when food or liquid gets into the lungs and cause infections.
-Perforation of the esophagus, a condition that is tearing of the walls of the esophagus or esophageal. Perforation of the esophagus can cause life-threatening infection of the patient.
-Cancer of the esophagus. Achalasia esophageal cancer raises risk.
Prevention Of Achalasia
Achalasia is prevented, but the harder to sufferers can prevent the onset of complications, among others with:
-Reproduce the drink while eating.
-Chew food well before being swallowed up.
-Undergo a diet with small portions and more often.
-Avoid eating before bed time, give at least 3 hours before going to bed.
-Avoid sleeping with position flat. Use pillows to support the head, this is done to prevent stomach acid rise into the esophagus.
-Stop smoking.
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