Achalasia Research UK has been created to explore, fund, and ultimately, conduct further research into this condition.

WELCOME

TO ACHALASIA RESEARCH UK

The aim of this independent charity is to provide all people, regardless of age, colour, sex, race, creed or financial status, absolutely all the information available on Achalasia, its causes, and possible treatments, so that they can make more informed personal choices and thus increase their individual odds of beating this condition.

With no vested interests, except getting further investigation into the causes of Achalasia and to fund further research into effective treatment for this condition, Achalasia Research UK will seek and examine complimentary therapies or natural alternatives and also look for ways to improve upon the current orthodox medical treatments available.

Over the past few years I have visited many forums and read many articles on this subject, visited websites that examine and discuss Achalasia, and have read testimonies of those who manage their condition or who have had successful or unsuccessful medical treatment.

The thing that I have noticed most is that for all the treatment and investigation written by professionals, though worded slightly differently from one medical website/journal to the next, pretty much all say the same thing and it seems like nothing new has been found in the past 10 years or more.

With that in mind I thought it was about time that we had a voice and push research into this condition because I, like many others, are not happy with the few treatments available and the lack of information.

SO WHAT IS ACHALASIA?

Achalasia affects the lower end of the gullet or oesophagus deep inside the chest, where it empties into the stomach. Normally a ring of muscle, known as the cardiac sphincter, controls this area. Most of the time this keeps the opening to the stomach shut tight so that acidic stomach contents cannot reflux back up into the gullet and damage it.














But during swallowing the muscular sphincter relaxes to allow food to pass down into the stomach. In achalasia the muscular ring does not relax properly, so that the end of the gullet becomes blocked and food cannot enter the stomach. Achalasia is often associated with chest pain during eating, weight loss, and regurgitation of food.

Achalasia is rare - it affects about 6000 people in the UK (statistics provided by the NHS Choice UK). It is caused by damage or dysfunction of the nerves that control the muscular sphincter. Patients typically first note increasing difficulty swallowing. Most people are diagnosed between the ages of 25 and 60 years. It is usually a chronic condition that worsens over time and does not resolve.

Several different treatments are available. Each treatment has advantages and disadvantages. It is important to discuss the various treatment options with your doctor before making a decision.

The specific cause of achalasia is unknown. However, patients with achalasia have two problems in the oesophagus (the tube which carries food from the mouth to the stomach).

•The first is that the lower two-thirds of the oesophagus does not propel food toward the stomach properly.

•The second problem is in the lower oesophageal sphincter (LES), a circular band of muscle that lies at the junction of the oesophagus and the stomach. The LES normally helps prevent food from flowing backwards, from the stomach into the oesophagus. The LES should relax in response to swallowing to allow food to enter the stomach. In patients with achalasia, the LES fails to relax, creating a barrier that prevents food and liquids from passing into the stomach. One theory about achalasia is that the nerve cells responsible for relaxation are destroyed by an unknown cause.

Damage to the LES and oesophagus causes large volumes of food and saliva to accumulate in the oesophagus. Patients can initially compensate for this but eventually the barrier progresses to the point where food and saliva cannot reliably enter the stomach, and, as a result, build up in the oesophagus.

NHS

POEM

THERAPIES

This is a basic guide as to what the NHS in the UK provides and offers to patients who suffer from achalasia.

The peroral endoscopic myotomy (POEM) was first introduced in Japan by Haruhiro Inoue to address the suboptimal results with endoscopic balloon dilation and surgical myotomy.

Here you will find articles and excerpts of information from around the world about alternative treatments gathered from other online resources.


NHS CHOICES - ACHALASIA

POEM

OTHER TREATMENTS

ACHALASIA SYMPTOMS AND DIAGNOSIS

The symptoms have a slow onset and progress gradually; many people delay seeking medical attention until symptoms are advanced. The major symptom is difficulty swallowing (liquids or solids). Other symptoms include chest pain, regurgitation of swallowed food and liquid, heartburn, difficulty burping, a sensation of fullness or a lump in the throat, hiccups, and weight loss.

Achalasia is usually suspected based upon the presence of the symptoms described above, but tests are needed to confirm the diagnosis. In addition, it is important to rule out other conditions with similar symptoms, such as gastroesophageal reflux disease, pseudoachalasia (a rare condition in which certain tumours can mimic the features of achalasia), and an infection called Chagas' disease, which is seen almost exclusively in Central and South America.

Chest x-rays — A simple chest x-ray may reveal distortion of the oesophagus and absence of air in the stomach, two abnormalities that suggest achalasia.

Barium swallow test — The barium swallow test is the primary screening test for achalasia. The test involves swallowing a chalky-tasting, thick mixture of barium while x-rays are taken. The barium shows the outline of the oesophagus and LES.

Barium swallows are usually performed under fluoroscopy, a continuous low-grade x-ray, which is helpful for studying the motion in the oesophagus. In achalasia, barium swallows usually reveals an absence of contractions in the oesophagus after swallowing. Sometimes this test reveals spastic contractions of the oesophagus in response to swallowing; this variation of achalasia is known as vigorous achalasia.

After the barium swallow, patients should drink extra fluid. Stools may be light in colour for a few days after testing as a result of the barium.

Manometry — Manometry refers to the measurement of pressure within the oesophagus and the LES. Pressures are measured by advancing a thin tube through the mouth or nose into the oesophagus. The test is done after patients have had nothing to eat or drink for eight hours, while patients are awake. Patients will be asked to swallow while the tube is in place.

Manometry is always used to confirm achalasia. The test typically reveals three abnormalities in people with achalasia: high pressure in the LES at rest, failure of the LES to relax after swallowing, and an absence of useful (peristaltic) contractions in the lower oesophagus. The last two features are the most important and are required to make the diagnosis.

Endoscopy — Endoscopy allows for direct visualization of the inside of the oesophagus, LES, and stomach using a thin, lighted, flexible tube. Endoscopy is done while a patient is sedated. This test is usually recommended for people with suspected achalasia and is especially useful for detecting other conditions that mimic achalasia.



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ACHALASIA DICTIONARYCOMMUNITY

IMPORTANT MEDICAL INFORMATION - PLEASE READ

All the content within this website is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other healthcare professional. We are not responsible or liable for any diagnosis made by a user based on the content of this website. We are also not liable for the contents of any external web sites listed, nor do we endorse any commercial products, services mentioned, or advised on, on any of these sites.

At Achalasia Research UK we provide information that is already in the public domain. It is not our intention to provide advice. It is up to our site visitors to decide themselves if any of the matters, to which any article refers to, might be suitable for them.

Always consult your own GP (Doctor/Consultant/Healthcare Professional) if you're in any way concerned about your health.

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