What is Achalasia?
Achalasia, a word of Greek origin, refers to the lack or absence of relaxation.
Achalasia is a rare disease.
The cause of the disease has not yet been found. To put it very simply, it is possible to say "there is a problem with the nerve cells in the esophagus."
The specific advancing movements of the esophagus have either disappeared or decreased. (the actions to be taken while carrying food towards the stomach)
In addition, the valve at the junction of the stomach and esophagus cannot be loosened enough.
Symptoms
- Increasing difficulty in swallowing food
- Chest pain
- Weight loss
- Swallowed food coming back to the mouth without being digested
- In the case of stress or intake of cold foods, there may be increased complaints.
View of the Esophagus on X-ray of a Patient with Achalasia
- There is a problem of inability to relax at the lower end of the esophagus, in the area where the stomach passes.
- Food can hardly pass into the stomach.
Treatment
- Medication
- Botox injection
- Balloon expansion (Pneumatic dilatation)
- Surgical treatment (Laparoscopic surgery)
Medication
- They can be used rarely because of their side effects and short-term response to treatment.
Botox Injection
Balloon Expansion (Pneumatic Dilatation)
- It is more successful than drug therapy and Botox injection.
- When applied to patients under the age of 40, the chance of recurrence of the disease is high. Because, depending on the strength of the elastic tissue, successful expansion is difficult in young people.
- Rarely, a perforation may occur in the esophagus during the procedure. Since this situation threatens life, very urgent surgical intervention may be required.
POEM
Surgical treatment
- Open surgery (classical method)
- Laparoscopic (Closed) Surgery
Laparoscopic Surgery
- The operation is performed under general anesthesia.
- The processing time is on average 60 minutes.
- There is a diet period of 2 - 3 weeks.
- The chance of success is high (95%).
- Antireflux procedure is also performed to prevent reflux development in patients.
- It is performed under general anesthesia.
- 5 intervention sites are determined on the abdominal wall.
- Camera from intervention point 1, other surgical instruments from intervention sites 2, 3, 4 and 5 are used.
- The processing time is on average 60 minutes.
- There is a diet period that lasts for 2 - 3 weeks after surgery.
As a result, one of the treatment options mentioned in the previous lines should be preferred according to the characteristics of the patient.
If no treatment is applied for a long time, lengthening of the esophagus and enlargement in its diameter occur. This situation negatively affects the success of the treatment.
