Achalasia is a rare condition that affects the oesophagus that connects the throat to the stomach. The nerves in the oesophagus no longer signals it to push food down into the stomach, and the valve at the end of the oesophagus (lower oesophageal sphincter) no longer opens during swallowing. As a result, ingested food cannot enter the stomach and collects in the oesophagus. It is a progressive disease that worsens over time and results in a higher risk of oesophageal cancer.
The majority of achalasia cases are idiopathic (i.e. unknown cause). No one truly knows why the nerve cells in the oesophagus are affected, although it has been linked to virus infections or autoimmune disease (where the nerves are “attacked” by your own immune system).
The food that remains in the oesophagus can undergo fermentation and come back up into the mouth, resulting in a bitter taste. This is often mistaken for gastroesophageal reflux disease (GERD) but unlike GERD, the undigested food comes from the oesophagus and not from the stomach. The main symptoms are:
Three tests are performed to diagnose achalasia. They are:
If left untreated, achalasia can result in severe weight loss due to malnutrition, and even recurrent lung infections due to aspiration of food. The main treatment options are:
Second line treatment options may be recommended under certain circumstances (i.e. when the patient is not fit for general anaesthesia). These treatments include:
The type of treatment offered will depend on the type of achalasia. Our team of doctors will discuss for your treatment options in further detail with you.
Patient will need routine blood investigations, chest X-ray and ECG before evaluate by anaesthetist because the procedure is done under general anaesthesia.
The laparoscopic Heller myotomy can perform with same day admission and 1-2 days hospitalisation. For the first 2 weeks, you can either take full liquid or soft diet after consulting your surgeon.