Achalasia

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Achalasia is a condition in which the esophagus ( esophageal ) lost the ability to push food from the mouth to the stomach . The disease is relatively rare , can be inherited , and can strike people of all ages . However, most patients with achalasia , middle-aged or an autoimmune disorder .

Normally , the lower esophageal sphincter ( LES ) will be loosened so that the food can enter the stomach . However , in patients with achalasia , the LES does not slack off properly . So the food is piled on the lower part of the esophagus or food more often ride back . LES itself is a circular muscle at the bottom of the esophagus that opens automatically when the food or drink down to the stomach . And closed by itself to prevent acid and food in the stomach does not rise back up into the esophagus .
Damage and loss of nerves in the walls of the throat is the main cause of achalasia. However, the cause of broken or loss of neurons is still unknown. Autoimmune disorders, such as Sjogren's syndrome, lupus, or uveitis, can also be connected with the advent of achalasia.

There are several complications that can be experienced by patients with achalasia, namely:

• Regurgitation. Acid reflux back into the esophagus or food.
• Pneumonia, due to the entry of food into the lungs.
• Oesophageal perforation. Tearing of the esophagus wall.
• Cancer of the esophagus. Blockage of the esophagus by food in large quantities that can not get into the stomach, then esofasgus cancer risk also increases.

symptoms of achalasia
A symptom is something that is felt and told by the patient. The main symptoms are generally perceived by patients with achalasia are:

• Dysphagia, is a condition in which patients with achalasia difficulty, even pain when swallowing food or drink.
• Chest pain, which usually worsens after eating.
• Pain in the gut.
• Vomit dripping from its mouth.
• Body weight down for no apparent reason.

The diagnosis of achalasia
Diagnosis is a step the doctor to identify the disease or condition that explains the symptoms and signs experienced by the patient. Some of the things that usually do physicians to diagnose achalasia are:

• Imaging X-rays and barium. Patients will be asked to swallow a liquid containing barium chemicals, so that the esophagus can be seen when the picture is taken with X-rays. Normally the diameter of the esophagus looks quite wide and barium looks smoothly into the stomach. But not so in patients with achalasia.
• Endoscopy. Flexible instrument with a camera on the end to be inserted into the bottom of the esophagus so that the doctor can examine the walls of the esophagus and stomach.
• Manometry. A small plastic tube will be inserted into the esophagus through the mouth or nose, and will record the activity and strength of muscle contraction and check the function of the esophagus. In achalasia would seem the loss of contraction and higher pressure at the end of the esophagus.

Treatment of achalasia
The goal of treatment for patients with achalasia is to open the LES muscle, so that food and drink can enter the stomach. Several types of treatment for patients with achalasia are:

• Widening of the esophagus, particularly in parts of the narrowing with the help of a balloon. This action was preceded by general anesthesia and must be repeated several times again after more than a year.
• Drugs. LES muscle can slack while by taking drugs. Doctors usually prescribe drugs such as nitrate or nifedipine.
• Surgery. The esophagus will be accessible through the abdomen or chest, then muscle fibers that tighten the LES will be separated. Generally, the effectiveness of therapy in this way is permanent.
• Injection of Botox (Botulinum toxin). The doctor will inject Botox into the muscle of the LES, because Botox can cause muscle fibers to relax. Usually only effective for a few months.

To reduce discomfort after undergoing esophageal dilation or surgical measures, there are some things you can do:

• Drink plenty of fluids during meals.
• Always eat with the upright sitting position.
• Do not rush and chew food well before swallowing.
• Use several pillows to refute the head, to prevent stomach acid up into the esophagus and cause pain in the gut.

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