Achalasia cardia is a swallowing disorder where the lower esophageal sphincter (LES), designed to keep the stomach contents from entering the throat, remains closed, preventing people from swallowing. Patients usually experience the onset of this condition gradually, finding that they have increasing trouble swallowing accompanied by discomfort while eating. Medical imaging studies can be used to get a picture of the esophagus for use in a diagnosis, and there are a number of treatment options for achalasia cardia available.
In patients with this condition, there is often a history of irritation to the LES. Over time, it tends to stay clamped shut instead of opening with the swallow reflex. This causes the base of the esophagus to distend and fill with food and fluid. The tissue around the sphincter can thicken and develop fibrous scarring. In a scan, the swollen and distorted shape of the esophagus will be clearly visible, especially if a barium swallow is used to highlight the patient's internal structures.
Conservative treatment for achalasia cardia can include the administration of medications to encourage the sphincter to relax, and in some cases, injections of Botox can help loosen the sphincter so the patient can swallow normally. Surgeries, including stent surgeries to hold the esophagus open, are another treatment option for achalasia cardia if the patient does not respond to other measures. A specialist is usually called in for surgery to make sure it is done properly.
Dietary modifications may be used for patients in the early stages of treatment to provide nutrition and to give the esophagus time to recover. Eating soft foods and drinking fluids can be recommended, including consuming nutrition drinks to get an appropriate balance of vitamins and minerals. As the patient starts to improve, more solids can be introduced to promote gastrointestinal motility, as liquid diets are not recommended for long-term use. If a patient does not tolerate the introduction of solids during achalasia cardia treatment, more diagnostic testing may be recommended to check for other problems with the patient's health.
People who start to experience difficulty swallowing can see an ear, nose, and throat physician, a gastroenterology specialist, or a speech-language pathologist for a diagnostic evaluation. Early treatment is recommended, as the longer a swallowing disorder is left untreated, the more serious the potential complications for the patient. Patients may have more treatment options if they catch the condition early, and will recover more quickly from surgery and other treatments when they haven't been struggling with ill health for an extended period of time.