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| Name | Achalasia Cardia I Hellers Myotomy |
| Video Uploader | Video From Dr Chintan B Patel - Best Bariatric / Laparoscopic & General Surgeon in Surat, Gujarat, India |
| Upload Date | This Video Uploaded At 16-07-2024 11:15:31 |
| Video Discription | Achalasia cardia, often simply referred to as achalasia, is a rare disorder of the esophagus, the tube that carries food from the mouth to the stomach. It occurs when the lower esophageal sphincter (LES), the ring of muscle that acts as a valve between the esophagus and stomach, fails to relax properly. This leads to difficulty in swallowing, regurgitation of food, and sometimes chest pain. Here’s a detailed overview: Causes and Pathophysiology • Neurological Dysfunction: Achalasia is primarily caused by the degeneration of nerve cells in the esophagus, particularly the ganglion cells in the myenteric plexus. This affects the muscles in the esophagus and the LES, preventing normal peristalsis and relaxation of the LES. • Autoimmune Factors: There is evidence suggesting that an autoimmune response might play a role in the development of achalasia, where the body’s immune system mistakenly attacks the nerve cells in the esophagus. Symptoms • Dysphagia: Difficulty in swallowing both liquids and solids is the most common symptom. Patients often feel that food is stuck in their chest. • Regurgitation: Undigested food and saliva may come back up into the mouth, which can lead to aspiration and respiratory complications. • Chest Pain: Some patients experience chest pain, which can be severe and mimic heart pain (angina). • Weight Loss: Due to difficulty in eating, patients often lose weight. • Heartburn: While less common, some patients might experience heartburn. Diagnosis • Barium Swallow (Esophagram): An X-ray study where the patient swallows a barium solution. It can show a dilated esophagus and a narrowed LES, often described as a “bird’s beak” appearance. • Manometry: This test measures the rhythmic muscle contractions of the esophagus when swallowing. It is the most definitive test for diagnosing achalasia, showing a lack of peristalsis and failure of LES relaxation. • Endoscopy: A flexible tube with a camera is used to visually inspect the esophagus and LES, ruling out other conditions like tumors. Treatment 1. Pneumatic Dilation: • A balloon is inserted into the LES and inflated to stretch and weaken the muscle, allowing food to pass more easily into the stomach. 2. Surgical Myotomy (Heller Myotomy): • The muscles of the LES are cut to allow food to pass into the stomach. This can be performed laparoscopically or robotically for minimal invasiveness. 3. Peroral Endoscopic Myotomy (POEM): • A newer, less invasive endoscopic procedure where an incision is made in the inner lining of the esophagus to access and cut the LES muscle. 4. Medications: • Medications such as nitrates or calcium channel blockers can be used to relax the LES, though they are generally less effective than other treatments. 5. Botox Injections: • Botulinum toxin is injected into the LES to temporarily paralyze and relax the muscle. This is usually reserved for patients who are not candidates for other treatments. Long-term Management • Regular Follow-up: Patients require ongoing monitoring to manage symptoms and detect any complications early. • Dietary Adjustments: Eating smaller, more frequent meals and avoiding foods that are hard to swallow can help manage symptoms. • Managing Complications: Aspiration and significant weight loss may need additional interventions, such as dietary supplements or feeding tubes in severe cases. Conclusion Achalasia cardia is a chronic condition that requires careful diagnosis and management. While there is no cure, various treatment options can significantly improve symptoms and quality of life. Early detection and appropriate intervention are key to managing this disorder effectively. |
| Category | Science & Technology |
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