Is it hard to swallow? Is it stuck in your throat? This could be Achalasia!

When you eat, do you ever feel like the water you drink doesn't go down your throat? It feels like something is stuck in your throat... Maybe the food is coming back up into your throat. This is not just anything, it can be a symptom of a condition called Achalasia . Although many people think this is normal, it is very important to be aware of this. So let's talk about it today.

Simply put, what is Achalasia?

Think about it, when we eat, the food needs to go from our mouth to our stomach, right? This journey takes place along a tube called the esophagus. For this process to happen properly, two things need to happen.

1. The esophagus needs to contract and push the food down, like squeezing a tube of toothpaste.

2. A small valve (muscle flap) at the end of the esophagus, where food enters the stomach, needs to be opened.

Now, if you have achalasia, both of these processes don't work properly. The esophagus can't push food down, and that valve doesn't open properly. What happens then? The food gets stuck in the lower part of the esophagus. It's like a clogged drain in a sink. Eventually, this stuck food starts to come back up into the throat.

This is a very rare condition . It affects about one in a million people. But it doesn't come on suddenly, it develops gradually over years. Some people live for years without experiencing symptoms. Although it can't be cured completely, with the right treatment, you can live a normal life.

What are the causes of Achalasia?

The exact cause of this hasn't been discovered yet, but there are a few things that doctors think are possible.

• Genetic causes: This means it can be inherited.
• Autoimmune problems: This is when the immune system, which protects our body, attacks our own nerve cells.
• A viral infection: Some viral infections are thought to damage the nerves in the esophagus.
• Neurodegenerative: The gradual destruction of the nerves that control the muscles of the esophagus.

This condition can affect anyone. It affects both men and women equally. But it is most common in people between the ages of 25 and 60. It can also affect children. It is also seen in people with Down syndrome.

Are there types of Achalasia?

Yes, Achalasia is divided into three main types. Depending on which type you have, symptoms and treatments may vary.

What are the main symptoms of this?

The main and most common symptom of achalasia is difficulty swallowing liquids and solids . Food can become stuck in the throat, causing the esophagus to become distended or enlarged.

In addition, these features can also be seen:

• Chest pain after eating.
• Food coming back up into the throat.
• Heartburn and indigestion.
• Weight loss without reason.
• Cough at night.
• Vomiting.
• Food or liquids entering the lungs can cause pneumonia.
• Choking.
• Hiccups or difficulty passing stools.

How do you find this, Doctor?

Because the symptoms of achalasia are very similar to other gastrointestinal conditions, such as GERD (Gastroesophageal Reflux Disease), your doctor may treat that first. However, if these do not improve, these tests may be done to check for achalasia.

• Manometry: This is the best test to confirm the condition. Here, a thin tube is inserted through your nose into your stomach and the doctor measures the strength of the muscles in your esophagus and the function of the valve at the bottom when you swallow a liquid.
• Upper Endoscopy: A tube with a camera, called an endoscope, is inserted through your mouth and the inside of your esophagus and stomach is examined. It is used to check for abnormalities and narrowing, and a biopsy may be taken if necessary.
• Barium Swallow: This is also called an Esophagogram. Here, you are given a special liquid called barium to drink and an X-ray is taken. This liquid makes the esophagus clearly visible on the X-ray. This makes it easier to see if there are any narrowings in it.
• pH Testing: This measures the acidity in your esophagus. This can help determine if you have other conditions, such as GERD.

What are the treatments?

The main goal of treatment is to loosen and widen the tight muscles in the lower part of the esophagus, allowing food and liquids to pass more easily into the stomach. Your doctor will decide the best treatment for you based on your age, symptoms, and other health conditions.

Surgery

The most effective treatment for achalasia is surgery. Most people experience long-term recovery after surgery.

• Heller Myotomy: This is the most common surgery. It is often done laparoscopically, which means it is done through a few small incisions in the abdomen and with the help of a camera. Here, the doctor cuts and loosens the tight muscle layer at the bottom of the esophagus.
• Peroral Endoscopic Myotomy (POEM): This is a new surgical procedure. No incisions are made on the outside. The endoscope is inserted through the mouth, a small incision is made in the lining of the esophagus, and the tight muscle is cut through.

Both of these surgeries are successful, but some people may experience acid reflux afterward.

Non-surgical treatments

Not everyone needs surgery. These methods can help, but they are not as permanent a solution as surgery. You may need to do it several times.

• Botox injections: During an endoscopy, a Botox (botulinum toxin) injection is given to the tight muscles. This temporarily relaxes the muscles.
• Pneumatic Dilation: Using an endoscope, a balloon is inserted into the narrowed area of ​​the esophagus and inflated to stretch and widen the muscles.
• Medications: Medications like nitrates and calcium channel blockers can help relax tight muscles. However, these can cause side effects, so they should be used only as directed by your doctor.

These things can help when living with Achalasia

There is no specific diet for this condition. But you will understand what foods go down easily and what is difficult. It is also a good idea to write about it in a book. It is very important to be careful about how and when you eat.

• Chew food well and eat in small pieces .
• Eat while sitting up straight . This will help the food go down more easily with the help of gravity.
• Don't eat solid food close to bedtime .
• Very hot or very cold foods and drinks can cause muscle spasms in some people.
• Drink a little more water while eating.
• Some people say that drinking carbonated drinks helps push food down.

If your condition is severe, it may be a good idea to switch to a liquid diet for a while. But if you do, talk to your doctor to make sure you're getting the nutrition you need. If you're losing a lot of weight, tell your doctor, too, as it could be a sign of malnutrition.