Achalasia Cardia

Achalasia cardia is also simply known as “Achalasia.” It is a rare swallowing disorder in which food cannot pass from the oesophagus to the stomach. Oesophagus, or the food pipe, is the swallowing tube in our body that connects the mouth and the stomach. The oesophagus normally contracts and relaxes, squeezing the food down into the stomach. However, in achalasia cardia, the food pipe dilates and loses its ability to push the food into the stomach. As a result, the food may get trapped in the oesophagus, get fermented or rush back into the mouth.

The condition is very rare yet one of the most common causes of motor-related swallowing difficulty affecting around 16 per 10,00,000 people worldwide.

Symptoms of Achalasia Cardia

Symptoms of Achalasia Cardia may develop slowly over time. The most common symptom that patients experience initially is difficulty in swallowing food or liquid. Other common symptoms include:

1. Chest pain that occurs on and off
2. Coughing at night
3. Difficulty belching
4. Dry mouth and eyes
5. Heartburn.
6. Hiccups
7. Malnutrition due to the inability to swallow food
8. Pneumonia
9. Regurgitation of undigested food.
10. Vomiting
11. Weight loss

Causes of Achalasia Cardia

Achalasia Cardia occurs when the nerves in the oesophagus get damaged, causing paralysis of the food pipe. As a result of the paralysis, the food pipe remains dilated and, over time, loses its ability to squeeze food down to the stomach.

The cause behind the nerve damage is not yet understood well. However, researchers believe that this could occur as an autoimmune response to a viral infection. The immune system attacks the nerve cells in the muscle layers of the walls of your oesophagus, and at the LES (lower oesophageal sphincter (LES) is a ring of muscle that relaxes to allow the food to move from the food pipe to the stomach). Once the nerve cells get damaged, the muscle cannot relax, and the food cannot pass to the stomach. This could occur due to genetics, autoimmune disease, or viral infections.

Risk Factors of Achalasia Cardia

Although there is no specific cause known for causing achalasia, research suggests certain risk factors may increase the risk of the condition. When it comes to race or gender, achalasia cardia seems to affect all races and genders equally. Also, it mostly affects adults between the ages of 25 and 60. Common risk factors that can be associated with the condition include the following:

1. Genetics: Identical twins or a family history of genetic disorders like Down syndrome and Parkinson’s disease may be a factor.
2. Autoimmune disorders: Some autoimmune disorders, such as Chagas disease, have been linked to achalasia.
3. Viral infections: In rare cases, viral infections, such as herpes or human papillomavirus (HPV), may trigger the development of achalasia.
4. Environmental factors: Exposure to certain environmental toxins or chemicals, such as heavy metals, may increase the risk of achalasia.
5. Obesity: There is some evidence to suggest that obesity may be a risk factor for achalasia cardia, although more research is needed to fully understand this association.
6. Other diseases like anorexia, lymphoma, neurodegenerative disorders, spinal cord injuries, and stomach cancers may also be possible links to developing the condition.

Preventing Achalasia Cardia

Unfortunately, there is no way to predict or prevent the occurrence of Achaalisa Cardia in someone. If someone has Achalasia Cardia, they must understand that they could not have done anything to possibly prevent the condition.

Complications Associated with Achalasia Cardia

If left untreated, Achalasia Cardia can cause the following complications, some of which can be life-threatening:

1. Aspiration Pneumonia.
2. Dental issues
3. Oesophageal cancer
4. Oesophageal dilation
5. Lung infections or other breathing issues

Precise Diagnosis of Achalasia Cardia at Apollo Hospitals, Karnataka

Achalasia Cardia is a rare progressive condition. It develops slowly over time. It is, therefore, not easy to diagnose it. If a patient is facing trouble swallowing food or liquids or has some other indicative symptoms of Achalasia Cardia, our doctors will perform a complete physical exam and take a thorough medical history of the patient. They may then perform the following tests to confirm the diagnosis.

1. Barium swallow
2. Esophagram or X-ray of the upper digestive system
3. Upper endoscopy
4. Manometry
5. 24-hour pH monitoring

Our doctors may even run some blood tests or additional tests to eliminate the possibility of other conditions.

Treating Achalasia Cardia at Apollo Hospitals, Karnataka

If someone has been diagnosed with Achalasia Cardia, they must understand that there is no known cure for the condition yet. They may need lifelong treatment to manage the symptoms and live a normal life. Based on the condition of the patient, there are some procedures available that our doctors will perform to relieve the symptoms and prevent further complications due to the disease. These procedures include the following:

Medications: Medications may be used to help relax the muscles in the oesophagus and make swallowing easier. Injections may also be given to help relax the muscles and improve swallowing function. This treatment is usually only effective for a few months and may need to be repeated.

Pneumatic dilation: This is a procedure that involves using a balloon to stretch the lower oesophagal sphincter and improve swallowing function. This treatment is effective in about 70-80% of cases and may need to be repeated.

Surgery: Surgery may be necessary in more severe cases of achalasia.

• The most common surgical procedure is a laparoscopic Heller myotomy, which involves cutting the muscle fibres of the lower oesophagal sphincter to relieve the obstruction. This surgery is effective in the majority of cases and can lead to significant improvement in symptoms.
• Another surgical procedure may be Peroral Endoscopic Myotomy (POEM) is another minimally invasive procedure which may be done as an alternative to laparoscopic Heller myotomy. This procedure involves cutting the muscles on the side of the oesophagus, the LES and the upper part of the stomach to loosen them and allow the oesophagus to empty like it normally should.

The treatment for achalasia cardia depends on the severity of the symptoms and the stage of the condition. The goal of treatment is to relieve the symptoms, improve swallowing function, and prevent complications. The doctors will also suggest some lifestyle modifications, precautions and coping strategies to help achalasia patients lead normal lives.

Doctors at Apollo Hospitals, Karnataka, are experienced in diagnosing and treating rare disorders like Achalasia Cardia. Early diagnosis and treatment can help to prevent complications and improve outcomes for individuals with achalasia. Therefore, it is important that you seek medical treatment at a place where doctors can diagnose such rare conditions effectively.

Apollo Hospitals, Karnataka, has the medical competence and infrastructure to perform all the necessary tests required to diagnose the disorder and carry out treatment procedures for the condition efficiently.