Achalasia or achalasia cardia is a disorder that results in difficulty swallowing and the disorder is uncommon. The treatments are given to relief the candidate from the symptoms, rather than curing, as this condition cannot be cured.
A common symptom of achalasia cardia is the difficulty in swallowing. Candidates feel the sensation in the chest that the liquids and food are getting stuck. The problem becomes severe, as it invariably progresses. The condition will further result in heartburn, fullness sensation, weight loss, hiccups, sensation of lumps in the throat, sensation of fullness in the throat.
Achalasia is majorly caused from the nerve cells degeneration takes place in the food pipe, the esophagus. The reason for the degeneration is not yet known. When the nerve cells are lost, there will be two problems that result in the interference in swallowing. The first problem is the muscles that usually contract the lines the esophagus are not contracted normally. So, the food that swallowed cannot be pushed towards the stomach through the esophagus properly. The second problem is that the LES or Lower Esopageal Sphincter, which is a valve made with the muscles are not relaxed normally done with swallowing. The result will be persistent contracting LES get start dilating. The dilated esophagus starts getting accumulate large saliva and food volumes.
Diagnosis of achalasia is done through understanding the symptoms, followed by the results of certain tests conducted. There are multiple tests performed.
- Barium Swallow
The patient swallows barium white x-ray that looks like a milky liquid. If achalasia exists, a narrow region is shown at esophagus’s lower end, including dilated esophagus seen above to it.
A thin tube, which is lined with many pressure sensors, is passed through the nose or mouth to esophagus. The pressures present in the esophagus are seen on the monitor. Pressure is identified and seen with variations caused from the muscle contractions. Three abnormalities called LES relax failure, high pressures found in LES, while at rest and absence of the normal or useful contractions.
A flexible, thin and lighted tube is passed through the mouth to check the internal structure and status of LES, esophagus ad stomach.
Through the treatments cannot reverse the loss of the nerve cells, in terms of contractions, it is given to weaken the LES muscles so that it does not become barrier to pass the liquids and food through it.
The non-surgical treatments include drugs, balloon dilatation, botulinum toxin injection and per oral endoscopic myotomy.
Achalasia Cardia Laparoscopy Surgery
Achalasia patients are treated with the surgery and the surgery is called as cardiomyotomy. This treatment is done minimally invasive technique performed laparoscopically.
Patient is given general anesthesia initially. A small incision of about 1 cm is made on the upper abdomen and a tube or cannula is passed into the adomen. The video camera attached to the tube gives clear and magnified video of internal structure and organs in the esophagus. Then four more cannulas are inserted through the other incisions made about 5cm. then the muscle layer and LRD are precisely divided that prones to gastroesophageal reflux. Fundus, which is a upper stomach part is rotated so that it is fixed to the extent that a valve or fundoplication is created. It helps the stomach to prevent the return of the acid back towards the esophagus.
Patient experiences pain for 24 hours after the operation. And vomiting and nausea also may be experienced in first 12 hours. Patients are given medications to relieved from these conditions and pain. Liquids can be consumed after 8 hours. Usually, patients can be recovered to go home within 3 days after the surgery. Complete recovery may take about 15 days. Blenderized diet is to be followed for 6 weeks. Carbonated drinks are to be avoided and small frequent meals are encouraged to eat.
Cost of Laparoscopy for Achalasia Cardia
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