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November 25, 2007

Achalasia

Achalasia is reallymore of a symptom than a disease in itself. Perhaps a physical condition is a better description. It occurs when something goes wrong with the esophagus and the various muscular actions that allow swallowing to take place. The causes can be many and varied, cancer, genetic, age, other physcial damage:

Achalasia is a rare disorder of the esophagus, the tube that carries food from the throat to the stomach. It is characterized by enlargement of the esophagus, impaired ability to push food down toward the stomach (peristalsis), and failure of the ring-shaped muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), to relax. It is the contraction and relaxation of the sphincter that moves food through the tube.

Causes can be:

Another part of the disorder is lack of nervous stimulation to the esophagus. Causes include damage to the nerves to the esophagus, parasitic infection, cancers, and hereditary factors. Achalasia is a rare disorder, may occur at any age, but is most common in middle-aged or older adults.

Treatment can be manipulation, surgery, or even Botox!

The approach to treatment is to reduce the pressure at the lower esophageal sphincter. This may be achieved by manipulating the lower esophagus sphincter with special instruments.

Therapy usually involves widening of the lower sphincter or injection with botulinum toxin (Botox) to paralyze it and prevent spasms. Medications such as long-acting nitrates or calcium channel blockers can also be used to lower the pressure at the lower esophagus sphincter.

Surgery (called an esophagomyotomy) to decrease the pressure in the lower sphincter may be needed. Your doctor can help you decide which treatment is best for your situation.

November 25, 2007 in Medicine | Permalink

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