ABOUT THE DISEASE
It is a disorder of the Esophagus, i.e the tube that carries food from the mouth to the stomach. It is primarily considered to be a disorder of motility as the smooth muscle layer of the oesophagus has impaired peristalsis and failure of the sphincter to relax causes a functional oesophageal stricture, thereby blocking the movement of food further into the stomach.
SYMPTOMS
- • The most common symptom is dysphagia – difficulty in swallowing especially solid food.
- • Regurgitation – backflow of food
- • Chest pain - more prevalent in early disease.
- • Heartburn
- • Unintentional loss of weight
- • Nocturnal cough
CAUSES
It is a rare disorder that mostly affects adults (above 50 years) due to damage to the nerves of the esophagus. No specific cause has been identified. Symptoms similar to it are seen in patients with oesophageal or stomach cancer, Chagas disease, etc.
DIAGNOSIS
- Barium swallow test
- Endoscopy
- Manometry of the eosophagus
TREATMENT METHODS
Various options can be considered to reduce the pressure at the lower esophageal sphincter:
- Injection with botulinum toxin (Botox) – however its benefit wears off within a matter of weeks or months.
- Medications, such as long-acting nitrates or calcium channel blockers.
- Heller myotomy - the operation can be performed via the laparoscope.
- Pneumatic dilatation is the preferred choice for older/ unfit patients. A balloon is inserted into the lower oesophagus via an endoscope and it is inflated to rupture the muscle of the oesophagus. If a perforation occurs, emergency surgery is needed to close it.
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