Achalasia is a motility disorder of the esophagus. The neuro-muscular mechanisms which is suppose to propel food down the esophagus after the initiation of swallowing does not work and this results is a narrowing of a segment of the esophagus, with significant dilation of the esophagus above.
The weight loss with achalasia is the result of dysphagia (inability to swallow) both solids and liquids. Patient with other esophageal motility disorders have primarily solid intolerance, but with proper positioning tolerate liquids well. This is because unlike other esophageal motility disorders (where the esophagus fails to push the food down after swallowing is initiated) in achalasia, the food is carried down to a certain level, but it gets stuck, because of non relaxation of muscles that form the lower esophageal. The key would be to make the proper diagnosis by manometry, endoscopy, and radiologic studies. The treatment for achalasia is very different-than that of an esophageal motility disorders.
In Achalasia, at the treatment includes nutritional support, and laparoscopic division of the muscle fiber that are wrapped around the esophagus to allow for gravity to help with the passage of the food down to the stomach. Additionally this operation should include steps and components to prevent reflux. This video shows segments of the operation.
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