Achalasia, a Guide to the Diagnostic Testing and Treatment Options

Achalasia disorder affects less than 200,000 Americans annually. As aresult, achalasia is classified as a rare esophageal disorder and is often misdiagnosed. With advances in technology and the availability of surgery, patients suffering from this painful condition may find relief when properly diagnosed, treated and have an understanding of the side effects and contraindications to the testing associated with diagnosing the achalasia disorder.

In recent years, achalasia has been treated through a surgical procedure, esophagomyotomy. This surgical approach, itself, attributes its success to the ability to decrease pressure in the lower sphincter of the esophagus. In patients with achalasia, food is unable to pass through to the stomach due to a deficiency or defect in the valve which separates the stomach and esophagus whereby the valve does not relax properly to allow food to pass into the stomach for digestion. The condition is also compounded by a further complication in which the nerve endings, within the esophagus, lie dormant or are understimulated. Research has shown achalasia may be a co-morbidity with other conditions such as cancer, parasite infection, general stomach smooth muscle deterioration or even a genetic disorder. Although not a guaranteed cure for achalasia, the esophagomyotomy does offer the patient a more improved life by reducing inflammation, coughing, symptoms of heartburn relating to smooth muscle pain, correcting nutritional deficiencies involving weight loss, anemia and relieving symptoms and co-morbid disorders such as regurgitation of food.

Diagnosing achalasia involves an esphogeal manometry diagnostic test however most physicians will begin with an upper a GI study to rule out underlying causes for the patient’s symptoms. When esphogeal manometry is ordered, the physician will probe the esophagus using a catheter, to measure esophagus pressures and contractions. The test will examine the action of the lower esophagus sphincter which is the main culprit responsible for the deficiency found in achalasia patients. The test can be performed on individuals of any age, including newborn children.

As with any diagnostic procedure, the esophageal manometry is not a procedure without complications. However the complications are rare and may not outweigh the benefits of completing the study. While performing the procedure, your physician will monitor for such complications as excessive saliva as this may increase the likelihood of aspiration which will potentially lead to a disorder of the lungs including aspiration pneumonia.

Should the esophageal manometry text prove positive your physician will, at this point, recommend the surgical procedure, esophagomyotomy.

As stated, the esophageal manometry testing provides some risks to the patient however, the risks do not outweigh the benefits of the procedure and he potential for relieving symptoms. When considering a diagnostic procedure, consult your physician regarding the side effects and, although not guaranteed to result in a true diagnosis of achalasia, the esophageal manometry has been proven to be the best technology available for diagnosis and, potentially, discussing resolution of achalasia symptoms.

For more information regarding achalasia procedures, research and symptoms visit www.fda.gov or www.ssat.com