Achalasia Cardia is a rare condition that influences the esophagus, the tube that directly connects the mouth to the stomach. This condition makes it difficult for food and liquids to pass into the stomach because the muscles in the lower esophagus fail to rest properly. Imagine swallowing your favorite meal and feeling it get “stuck” in your chest- this is a common struggle for people with achalasia.
While it can occur at any age, achalasia is most commonly seen in adults between 25 and 60 years old. The exact cause of this medical condition remains unidentified, but it is believed to be linked to nerve damage in the esophagus. Over time, the inability to swallow properly can lead to discomfort, weight loss, and a significant impact on one’s quality of life.
This blog will explore achalasia cardia in detail, covering its symptoms, causes, diagnosis, treatment options, and tips for managing life with this condition. Whether you’re seeking information for yourself or a loved one, this guide will help you understand and navigate achalasia cardia with clarity.
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Table of Contents
Achalasia Cardia Treatment
In India, where healthcare combines advanced technology with cost-effective solutions, various treatments are available for Achalasia Cardia, each with its own advantages and associated costs.
Pneumatic Dilation
Pneumatic dilation remains one of the most common non-surgical treatments for Achalasia Cardia. This medical approach involves the insertion of a balloon into the LES, which is then inflated to enlarge the opening and facilitate easier swallowing. The cost of pneumatic dilation in India varies but generally ranges from INR 50,000 to INR 1,50,000. The procedure is less invasive and can be an effective short-term solution for many patients.
Heller Myotomy
Heller myotomy is a surgical procedure that provides a more permanent solution. It involves cutting the muscles at the LES to prevent them from closing too tightly. This surgery can be performed laparoscopically, making it less invasive with a shorter recovery time. The cost of a Heller myotomy in India can range from INR 2,00,000 to INR 5,00,000, depending on the hospital & the surgeon’s expertise.
Peroral Endoscopic Myotomy (POEM)
The Peroral Endoscopic Myotomy (POEM) is a newer and increasingly popular treatment. This innovative endoscopic procedure involves creating an incision within the inner lining of the esophagus to access and cut the LES muscles. POEM offers the benefits of no external scars and a quick recovery period. The cost for POEM in India is approximately INR 3,00,000 to INR 7,00,000.
Medication
Pharmacological management with calcium channel blockers or nitrates can temporarily reduce LES pressure and alleviate symptoms. However, these are not long-term solutions and are often used in conjunction with other treatments. The cost of medication therapy is relatively low, but the prices of drugs can vary widely.
Esophagectomy
In severe cases where the esophagus has become significantly dilated and non-responsive to other treatments, an esophagectomy may be necessary. This involves removing the affected portion of the esophagus. It is a major surgery and is less commonly performed for Achalasia Cardia. The cost of an esophagectomy in India can exceed INR 10,00,000.
Botulinum Toxin Injection
Botulinum toxin injections into the LES serve as another treatment option, especially for patients who may not be good candidates for surgery. This treatment temporarily paralyzes the muscles, easing symptoms for several months. The cost of botulinum toxin injections can range from INR 25,000 to INR 50,000 per session.
The choice of treatment for Achalasia Cardia in India depends on various factors, including the patient’s age, the severity of the condition, and any comorbidities. Patients must consult with a gastroenterologist to determine the most appropriate treatment plan. With various options available, patients can find a treatment that suits their medical and financial needs.
It’s important to note that the costs mentioned are approximate and can differ based on the location, hospital, and the patient’s specific circumstances. Patients are advised to seek clear information from healthcare providers and consider all factors before deciding.
Achalasia Cardia Causes
Achalasia Cardia occurs when the muscles in the lower part of the esophagus, which is the tube that connects your mouth to your stomach, don’t function properly. This makes it hard for food and liquid to pass into your stomach. But what exactly causes this problem? The cause of achalasia isn’t completely understood, but a few factors could contribute to its development.
1. Nerve Damage in the Esophagus
One of the leading causes of achalasia is damage to the nerves in the esophagus, especially the nerves that control the muscles responsible for swallowing. Normally, when you swallow, the muscles in your esophagus relax and push food down to the stomach. In people with achalasia, the nerves that help these muscles relax are damaged or destroyed. Without proper nerve function, the muscles don’t relax when they should, leading to difficulty swallowing.
2. Autoimmune Reactions
Researchers believe that in some cases, the body’s immune system might attack the nerve cells in the esophagus by mistake. This immune system attack is known as an autoimmune reaction. When the immune system targets the nerve cells, it disrupts the normal functioning of the esophagus, making it harder to swallow food.
3. Genetic Factors
There is some evidence that achalasia might run in families. While it is rare, some people with achalasia have close relatives who also have the condition. This suggests that there may be a genetic component, meaning certain genes might make some people more likely to develop achalasia.
4. Viral Infections
Some studies suggest that viral infections could also play a role in the development of achalasia. Viruses that affect the nerves, such as certain types of herpes virus, might be involved in damaging the nerve cells in the esophagus. However, this theory is still being researched, and more studies are needed to confirm it.
5. Other Factors
While nerve damage is the main cause, other factors may contribute to achalasia, including physical damage to the esophagus, underlying health conditions, or environmental factors. However, these causes are less clear and are still under investigation by medical researchers.
In summary, the main cause of achalasia cardia is thought to be nerve damage that affects the muscle function in the esophagus. This leads to problems with swallowing, but other factors like autoimmune reactions, genetic tendencies, and possibly viral infections may also play a role in the condition’s development. Understanding these causes can help doctors diagnose and treat achalasia more effectively.
Achalasia Cardia Types
Achalasia cardia is a condition that influences the esophagus muscles, making it hard to swallow. There are different types of achalasia, and they vary based on how the esophagus muscles behave and how the condition progresses. The three main types of achalasia are classified based on the pattern of muscle relaxation and esophageal movement. Let’s break them down simply:
1. Type 1 (Classic or “Esophageal Body” Type)
In Type 1 achalasia, the esophagus muscle (the part of the esophagus responsible for pushing food down into the stomach) cannot contract normally. The lower esophageal sphincter (LES), the muscle between the esophagus and the stomach, also fails to relax properly, causing a blockage. This means food gets stuck in the esophagus, and the body struggles to push it down to the stomach.
- Symptoms: Difficulty swallowing both liquids and solids, chest pain, regurgitation of food, weight loss.
- Cause: The nerves in the esophagus don’t function properly, and the muscles don’t get the right signals to move food down.
2. Type 2 (The “Pan-Esvophageal” Type)
In Type 2 achalasia, the problem is mainly in the lower part of the esophagus. In this type, the muscle contractions in the esophagus are weak, but there is a more noticeable issue with the lower esophageal sphincter (LES) not relaxing properly. This type often leads to much food being trapped in the lower esophagus, making it hard to pass into the stomach.
- Symptoms: The person may feel food sticking in the chest, have difficulty swallowing, regurgitate, or lose weight.
- Cause: The lower part of the esophagus struggles to move food down properly due to an issue with nerve function.
3. Type 3 (Spastic or “Distal Esophageal” Type)
Type 3 achalasia is the most severe form of the condition. It is characterized by irregular, spasming contractions in the lower esophagus, making swallowing even harder. These spasms can be painful & lead to more severe issues with swallowing. The lower esophageal sphincter (LES) fails to rest as it should, leading to a more intense block in the passage of food. This type is often associated with more frequent episodes of chest pain and discomfort.
- Symptoms: Severe chest pain, difficulty swallowing both liquids and solids, regurgitation, weight loss, and, in some cases, a feeling of food getting stuck.
- Cause: The esophageal muscles experience abnormal, forceful contractions that prevent the smooth passage of food.
Why is it important to know the type of achalasia?
Understanding the specific type of achalasia a person has helps doctors choose the right treatment approach. For example, in Type 1, the focus might be on relaxing the esophagus muscles, while in Type 3, addressing the spasms with medication or other treatments might be prioritized.
Achalasia Cardia Meaning
Achalasia Cardia is a condition that affects the esophagus, the muscular tube that carries food & liquids from your mouth to your stomach. In people with achalasia, the muscles in the lower part of the esophagus don’t work properly. Normally, when you swallow, the esophagus muscles push food down toward the stomach, and a muscle at the lower end of the esophagus rests to let foodstuffs pass into the stomach.
In achalasia, the muscle at the lower end of the esophagus does not relax, and the muscles of the esophagus don’t contract correctly to push food down. This results in difficulty swallowing, and food can get “stuck” in the chest. Over time, the esophagus can become enlarged because food backs up inside it.
Achalasia Cardia Diagnosis
Diagnosing achalasia usually requires several tests, as the symptoms are similar to other digestive disorders. Here’s how doctors typically diagnose it:
- Barium Swallow (X-ray): The patient swallows a special liquid that shows up on an X-ray. This helps doctors see how well food moves down the esophagus. The X-ray might show a characteristic “bird-beak” appearance of the lower esophagus in achalasia, indicating a narrowed area.
- Endoscopy: In this test, a thin, adaptable tube with a camera is put through the mouth to look inside the esophagus. This can help rule out other conditions, like tumors, that might be causing similar symptoms.
- Esophageal Manometry is one of the most important tests for diagnosing achalasia. It measures the pressure inside the esophagus & the function of the lower esophageal sphincter. The pressure is usually higher than average in people with achalasia, and the lower esophageal sphincter fails to relax properly.
- CT Scan or MRI: In some cases, doctors might use imaging techniques to get a more detailed view of the esophagus and check for any other issues.
Achalasia Cardia Signs & Symptoms
The symptoms of achalasia can develop gradually, & they often worsen over time. Common signs and symptoms include:
- Difficulty Swallowing (Dysphagia): This is the most familiar symptom. People with achalasia often find it hard to swallow both solid food and liquids. It may feel like food is getting stuck in the chest or throat.
- Regurgitation: This happens when undigested food or liquids come back up into the mouth. It can be uncomfortable and lead to choking, especially when lying down.
- Chest Pain: Some people experience discomfort or pain in the chest, which might feel like heartburn or pressure. The pain can happen after eating and may be mistaken for heart problems.
- Weight Loss: Because swallowing is difficult, people with achalasia may be unable to eat enough, leading to unintended weight loss.
- Heartburn: Although not as common, some people with achalasia may experience heartburn or a burning sensation in the chest due to food backing up in the esophagus.
- Coughing or Aspiration: If food or liquid enters the windpipe instead of the stomach, it can cause coughing or aspiration pneumonia, where food or liquids go into the lungs, potentially causing infection.
These symptoms can be mild at first but may worsen over time, making it essential to consult a doctor if you experience any of them.
Conclusion
In conclusion, achalasia cardia is a challenging condition that affects the ability to swallow properly, causing discomfort & a significant impact on daily life. Early diagnosis & treatment are crucial to managing symptoms and improving quality of life. While the exact cause remains unclear, several treatment options are available that can help ease symptoms and improve esophageal function. If you or someone you know is experiencing symptoms of achalasia, it is important to seek medical advice for an accurate diagnosis & appropriate care.
The treatment of achalasia cardia can be expensive, especially in India, where medical costs for surgeries, procedures, and long-term care may be high. A fundraising platform can be a lifesaver for individuals who cannot cover these costs on their own. By creating a fundraising campaign, families and patients can reach out to their communities for support, raising money through donations to help cover medical expenses. These crowdfunding platforms allow you to share your story, connect with potential donors, and receive financial assistance from people who want to help. This can make a huge difference in addressing the cost of treatment & improving the patient’s quality of life.
