Which treatment successfully cures achalasia cardia?
Posted by Dr. Chirag Thakkar on August 20th, 2019
What is achalasia cardia?
Achalasia cardia, also called ‘cardio spasm’ is a rare disease which affects the passage of nutritive foods down the food pipe. It affects the nerves of the oesophagus (food pipe), making it difficult for it to function normally. The food pipe has muscles that automatically contract and relax, while ingesting food and drink. Achalasia cardia makes this movement slower and defective, resulting in an impaired functioning of the oesophagus.
Diagnosing achalasia cardia
The scientific method of diagnosing achalasia lies in finding a flaw in the LES (lower oesophageal sphincter). The LES connects the stomach with the food pipe, and aids in the passage of food towards the stomach. A person affected with cardio spasm, would exhibit a difficulty in swallowing food, as the LES would fail to function properly. This would lead to food backing up along the oesophagus resulting in chest pain, and a feeling of nausea.
Causes of the disease
- Immunity disorders: Achalasia cardia can be caused due to autoimmune diseases that affect the inherent ability of the body to keep healthy cells safe. An immunity disorder causes the destruction of healthy cells automatically, resulting in other diseases.
- Heredity: Achalasia cardia could also arise due to a family history, or hereditary reason.
- Cancer: Oesophageal cancer could also lead to cardio spasm. Cancer also causes a degeneration of cells by the abnormal multiplication of cells in a particular area of the body.
- Chagas’ disease: A rare tropical disease- caused by the parasites spread by the triatomine bug; the Chagas’ disease can also lead to achalasia cardia.
Treatment of achalasia cardia
As explained earlier, most cases of achalasia cardia involve the malfunctioning of the LES. Once diagnosed, there are various methods of treating achalasia cardia. It is however best to make sure that the patient is indeed affected by cardio spasm. This is because the symptoms of the disease could also be due to other intestinal problems like acid reflux and celiac disease.
- Modification of the oesophageal sphincter: The first method of treating cardio spasms is to alter the shape of the oesophageal sphincter to enable a smoother passage of food and drink for the patient. It is usually either dilated or inflated, depending on each patient’s condition. Sometimes, this procedure can result in tearing of the sphincter, which requires further surgeries to repair the damage.
- Using Botox: Botox is used to reduce the effects of ageing such as wrinkles and fine lines. It is also used to treat muscle disorders and bladder or bowel problems. For achalasia cardia, Botox is injected into the oesophageal sphincter to help relax it, for the movement of food and drink in a normal way.
- Esophagomyotomy: In this surgical procedure, an incision is made in the sphincter, for a better flow for the patient. It is a popular way of treating achalasia cardia, however in some cases the treatment can go wrong and lead to GERD. Gastroesophageal reflux disease (GERD) leads to the backing up of stomach acids into the food pipe. This can also lead to heartburn.
- Oral medicines: Another method of treating cardio spasm is by the usage of calcium and/ or nitrate blockers to relax the food pipe. Once it is relaxed, food and drink passes easily towards the stomach. Some of the drugs used are: isosorbide dinitrate, verapamil and nifedipine.
- Less invasive Surgery: A last resort attempt to treat achalasia cardia is surgery (myotomy), when the other options like dilations or incisions do not work effectively or the results do not last long. Surgery is effective about more than 90% of the time. If unsuccessful, it could degenerate into other diseases like respiratory problems, or acid reflux. This would require further separate treatment.
- Dietary changes: While there is no specific diet that achalasia patients must follow, following a diet with light foods that pass easily through the food pipe would help in faster recovery. Liquids and food supplements are often recommended as a way of treating early stages of achalasia cardia.
- Pneumatic dilation: In this procedure, a balloon is entered at the LES, and then inflated slightly to enable easy passage through the oesophagus to the stomach. The muscles around the LES get inflated so that the ill effects of achalasia can be reversed for the patient. This is a temporary fix, and patients may have to undergo multiple dilations in case the cardio spasm flares up again.
There are various ways of curing achalasia cardia. Though it is a relatively rare disease, effects can be very harmful for patients. Cardio spasms, if not treated at the correct time could lead to more serious diseases like oesophageal cancer, acidic reflux and respiratory problems. As the food pipe is adjoining to the wind pipe and lungs, the bad impact could be felt in terms of breathing trouble and in rare cases- heart disease.