The Achalasia reference article from the English Wikipedia on 24-Jul-2004 (provided by Fixed Reference: snapshots of Wikipedia from wikipedia.org)

Achalasia

Rare disease>Achalasia

---

Achalasia or acalasia is a failure of a ring of muscle (as a sphincter) to relax (completely).

---

Esophageal achalasia, also called simply achalasia, is a neuromuscular disorder of the esophagus characterized by the reduced ability to move food down the esophagus (peristalsis). In addition, the inability of the cardia ( also called lower esophageal sphincter)- to relax in response to swallowing (there is increased LES pressure- spasms).

Synonyms : achalasia cardiae, cardiospasm, dyssynergia esophagus, esophageal aperistalsis.

ICD code : 530.0

Table of contents

1 signs and symptoms 2 Diagnosis 3 Complications 4 Treatment and new Expectations 5 External links

signs and symptoms

• Dysphagia
• Regurgitation of digested food
• Heartburn
• Chest pains : increases after eating and may radiate to the back, neck, and arms.
• Weight loss
• Coughing, especially at night or when lying down

Diagnosis

Due to the similarity of symptoms, achalasia can be misdiagnosed as other disorders, such as gastroesophageal reflux disease (GERD) and Chagas disease

• X-ray with a barium swallow or esophagography . Shows narrowing at the level of the gastroesophageal junction ("bird beak"), and various degrees of megaesophagus (esophageal dilation).
• Endoscopy, which provides a view from within the esophagus.
• Manometry, the key test for establishing the diagnosis. Measures the pressure induced in different parts of the esophagus and stomach during the act of swallowing.
• CT scan, which provides further visual evidence.

Complications

1. Gastroesophageal reflux disease-GERD or heartburn.
2. Barrett's esophagus or Barrett's mucosa: in 10% of patients.
3. There are two kinds of esophageal cancer: squamous cell carcinoma and adenocarcinoma. There are predisposing conditions that, if present for a long time, may lead to esophageal adenocarcinoma, like achalasia (in up to 5% of cases, Barrett's esophagus leads to esophageal adenocarcinoma).

Treatment and new Expectations

• Balloon (pneumatic) dilation. The muscle fibers will be stretched. Gastroesophageal reflux (GERD) occurs after dilatation in 25% to 35% of patients. Is a risk to later Heller myotomy.
• Medication:
  • Intra-sphincteric injection of botulinum toxin (or botox), to paralyze cardia and prevent spasms. It is transitory and symptoms will return in the majority of patients within a year.
  • Drugs that reduce LES pressure such as nifedipine and nitroglycerin may be useful.
• Heller myotomy laparoscopic surgery.
• Transplant and artificial cardia.

See also : endoscopy, esophageal motility disorder.

External links

• International Rare Disease Support Network Email List Group for Achalasia.
• Anatomy and surgeries.
• Medlineplus.
• All about achalasia.
• U.S. National Guideline about achalasia.
• Emedicine.
• Intelihealth.
• Yahoo health encyclopedia.
• Meetup for achalasia sufferers.

Health science - Medicine - Gastroenterology

Diseases of the esophagus - stomach

Halitosis - Nausea - Vomiting - GERD - Achalasia - Esophageal cancer - Esophageal varices - Peptic ulcer - Abdominal pain - Stomach cancer - functional dyspepsia

Diseases of the liver - pancreas - gallbladder - biliary tree

Hepatitis - Cirrhosis - NASH - Budd-Chiari syndrome - Hepatocellular carcinoma - Pancreatitis - Pancreatic cancer - Gallstones - Cholecystitis

Diseases of the small intestine

Peptic ulcer - Malabsorption (e.g. celiac disease, lactose intolerance, fructose malabsorption, Whipple's disease) - Lymphoma

Diseases of the colon

Diarrhea - Appendicitis - Diverticulitis - Diverticulosis - IBD (Crohn's disease and Ulcerative colitis) - Irritable bowel syndrome - Constipation - Colorectal cancer - Hirschsprung's disease - Pseudomembranous colitis

This is the "Achalasia" reference article from the English Wikipedia. All text is available under the terms of the GNU Free Documentation License. See also our Disclaimer.