Achalasia cardia (from the Latin and — No, chalasia) — A chronic neuromuscular disease in which there is no disclosure of the reflex cardia (Holes on the border of the stomach and esophagus) during swallowing. As a result of impaired motility and tone of the esophagus and the passage of food through it. First described the disease T.Willisv 1672, but until now the reason for its occurrence is unknown.
The main symptoms are a violation of swallowing food (dysphagia), esophageal regurgitation and vomiting, and pain behind the breastbone. Dysphagia occurs sporadically in the beginning of the stress or a hasty meal, and then becomes constant and prevents the passage of the esophagus is not only solid food, but also liquid (broth, juice, water). Inability to swallow food leads to esophageal vomiting — the reverse flow of food into the throat and mouth when torso and in the supine position, especially at night while sleeping. This is dangerous because of the risk of getting the contents of the esophagus in the airways, which may cause coughing, asthma, aspiration pneumonia. Chest pain occurs when the esophagus or overflow due to hypermotility (enhancing peristalsis) of the thoracic esophagus. Often against the background of the disease there is a decrease in body weight, with considerable.
The most common complication of achalasia is stagnant esophagitis (inflammation of the esophagus), which can lead to cancer of the esophagus. Also extended esophagus can compress the return and vagal nerves, right bronchus, superior vena cava. Achalasia can trigger chronic non-specific lung disease due to aspiration of food into the airway, lead to the formation of diverticula of the esophagus and hiatal hernia.
Diagnose disease possible on the basis of fluoroscopic (survey picture of the chest and a more informative X-ray with contrast barium sulfate suspension of the esophagus) or endoscopic examination. Great value for the diagnosis of achalasia has ezofagomanometriya. As an additional method used pharmacological trials with intravenous injection of carbachol or acetylcholine.
Treatment and prevention
Treatment of the disease is carried drugs normalize the motility of the esophagus. For the prevention and treatment of inflammation of the esophagus (esophagitis), we recommend frequent (4-5 times a day) diet, moderate light diet (avoid spicy, fried, too hot or cold food, excluding alcohol), receiving envelop, binders. Patients should avoid excessive physical and psychological stress. Also performed intensive stretching the cardia (dilation) with a special balloon. The effect of dilatation usually lasts for 8-12 years or more, a re-emergence of symptoms procedure is repeated. Patients with achalasia cardia, including after dilatation should consist followed up by a gastroenterologist.