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Achalasia, or achalasia cardia is a disorder of the esophagus and the junction of esophagus with the stomach(also called gastroesophageal junction or GEJ). In this disease, the GEJ does not open adequately to allow the food to pass into the stomach.


Achalasia presents with gradually increasing reflux symptoms, vomiting, a feeling of heaviness in the chest after eating or drinking, and bad breath. People suffering from achalasia slowly adopt and start eating more of liquids to prevent food sticking in the chest and vomiting. This change in eating habits may lead to unintentional weight loss and malnutrition. 

Occasionally patients experience chest pain and are therefor evaluated by a cardiologist. A history of recurrent chest pain with normal cardiac exam and investigations should prompt you to visit a foregut clinic.

The diagnosis is usually by endoscopy or by measuring pressure in the esophagus during swallowing(manometry). If you have any or a combination of the symptoms described above, your doctor may ask you to get endoscopy with or without manometry to know the extent and type of achalasia. This is important as the treatment may need to altered based on they type of achalasia you have.

Treatment of this disease is either by endoscopy or surgery depending on the type and severity. Your doctor may dilate the GEJ  or make a cut in the muscle layer of the esophagus(POEM) endoscopically to allow food to pass through. This may require several sittings. More commonly, a single stage surgery is done to achieve the same results.

Unfortunately, there is no known effective medical treatment for achalasia. A surgery at a dedicated centre is usually effective and safe. Make sure that you get this surgery at a centre which has expertise in dealing with surgical illnesses of esophagus and stomach.

The surgery is laparoscopic or keyhole procedure.  You should be able to get out of bed 6-8 hours after surgery. The postoperative hospital stay is usually 2-3 days. Occasionally a temporary drain may be put during surgery that is frequently removed in 2-3 days. You will be put on a liquid diet for a period of one week with gradual progression to solids over the next week. 

There is significant improvement in symptoms in almost all patients and most patients have the same quality of life as the rest of the population.

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