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Treating Achalasia

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Achalasia is a disorder of the esophagus, the passageway for food to travel from the mouth to the stomach. Where the esophagus and stomach meet, a muscle called the lower esophageal sphincter (LES) has the responsibility of keeping food, liquid, and stomach acid from the stomach out of the esophageal tube. When swallowing food the LES opens to allow food to be pushed down by nerve signals in a process called peristalsis. These functions do not occur properly in those with Achalasia and can, as a result, suffer from symptoms such as coughing, chest pain (after or during meals) and regurgitation of food, heartburn, or unintentional weight loss.

The Mayo Clinic, ranked #1 in digestive disorders by "U.S. News & World Report" in their Best Hospitals rankings, details numerous ways that Achalasia can be treated. While there is no cure for the rare disorder there are different options one can take to manage the condition.

A list of treatments provided by The Mayo Clinic website are:

1. Oral Medication;
2. Botox Injections;
3. Pneumatic (Balloon) Dilation; and
4. Surgery.

Oral medication is recommended for those only in the early stages of the disorder and Botox injections for those who are at a high risk for complications during surgery. Surgery is designed to repair the lower esophageal sphincter giving it the capabilities to perform its natural function properly. Botulinum Toxin, or Botox, is injected into the LES weakening the muscle and allowing for food to pass properly through the esophageal tube.

A unique procedure is that of the Pneumatic Dialtion. A balloon is inserted into the esophagus to stretch the LES, a function that usually occurs during peristalsis. “This procedure is successful 50 to 80 percent of the time and does not require hospitalization. If balloon dilatation is successful, its benefits are usually permanent. However, a small number of people may need repeat treatment if the esophageal sphincter contracts.” The danger of the pneumatic dilation procedure is the ripping of the esophagus during treatment. If this occurs, an immediate surgery to repair the tear should take place.

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Hi Anonymous,
I regret no one got back with you on this. How has your condition been since posting this? Have you been treated for achalasia, or another condition? Please give us an update. We are not doctors here, but are happy to try and help you any way we can by doing research. Have you found any resources that sound more like what you have experienced? Have your sons seen a doctor regarding this condition you all share? What did they say?
Please follow up with us. Thank you for your comment.

October 21, 2010 - 8:29am
EmpowHER Guest

I read an online article you had written, and I would like to get some feedback from you, if you would please just read and see if you have any interest. I have just been diagnosed with Achalasia after repeated episodes of severe chest pain due to swallowing. It doesn’t FEEL LIKE difficulty swallowing, it feels more like an elephant stepping on my chest and it happens AS A RESULT OF swallowing. It never really FEELS stuck, it just hurts. I first recognized this happening at about age 20 or so, but it wasn’t until age 40 or 42 that I actually had a black out as a result of this pain. I was at the dinner table, felt the pain after swallowing, and literally blacked out. I awoke to a sensation that my body was in a sort of ‘seizure.’ My extremities were shaking or seizing, my head was bobbing, and I could sort of ‘sense’ this was happening. I regained consciousness, and within two minutes felt absolutely fine. I finished eating, and had no other difficulties.
I know that most people would have immediately gone to the emergency room, etc., but I am one of those folks who believes that some things just happen, and there is no need to panic and run off to get seen about and charged for nothing. Anyway, I still had the pain off and on for another year or two. Then I had another one, and another one and another one, in very short proximity to each other. I had one with my father sitting there with me, and he was mortified. He insisted that I go to the doctor. I did, and my GP said he thought it was “esophageal syncope” but sent me to a heart specialist to have everything checked out. I did every test known to man including wearing a monitor for 30 days to try to ‘capture’ one of these spells. This was in vain. I returned the instrument, told the doctor that nothing had happened, so he agreed with my GP, and they said that nothing, really, could be done about it, but to chew my food well, drink lots of water, and be careful about driving and having one.
This continued for 15 years. I am now almost 59 years old, and I continue to have this painful GRABBING of my esophagus and shaking it severely quite often. 18 months ago I had one while driving, but my doctor insisted it was something else. I had every test known to man, and he said that he thought I had some sort of hypo – something or other that basically meant I fell asleep very quickly without warning, and that caused my ‘black out’ before I literally rammed into the car in front of me while completely blacked out.
A month ago, I had my second accident the same way. I was stuck in afternoon rush hour traffic, took a bite of my lunch leftovers, and it hit immediately – a bad one, as I call it, where I immediately with little to no warning, blacked out. I awoke to the seizing and felt my car ramming into the car in front of me, veering off to the side and then hitting a concrete wall, which ultimately threw the car upside down in a slow-motion roll-over. I awoke to being upside down, having hit a car and caused the folks just sitting in the traffic to jump out of their cars and wonder what in the world just happened.
This time, a GI specialist saw me and began running tests. He said he never heard of ‘esophageal spasms with syncope’ and instead ran an endoscopy and esophageal manometry tests. He says I have this achalasia; however, everything I am reading says nothing of the blackouts and the seizing. Is there something you think I should talk with my doctor about – something that would point him in the right direction. I may have this achalasia; however, I think I have something else going on as well, but no one wants to look at this holistically and see what the real picture is.
I wish there was a “Dr. House” or a diagnostician out there somewhere who may take great interest in these symptoms and my condition. Can point me in the right direction. I do not have these every time I swallow something. At the worst it's only about 10 -15 times per week atthe high end of having this pain. I have never thrown up or refluxed anything, and it doesn’t feel like 'difficulty swallowing' or difficulty actually getting it down. It just hurts like hell and causes me to blackout maybe once in 100 times, which is maybe 10-20 times a year. Can you help me? (By the way, I have two sons, 32 and 23 and they both have the same symptoms but have yet to have any blackouts. My first was at age 40-42.)

May 19, 2010 - 6:58am
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