Achalasia Cardia in New Delhi India,
Achalasia Cardia is the failure of LES (lower oesophageal sphincter)to relax for food to pass down to stomach leading to difficulty in swallowing food.
The main cause of achalasia cardia is the degeneration of the nerve cells in the oesophagus (the food pipe). The exact reason why thus happens is not known. The loss of nerve cells in the oesophagus causes two major problems that interfere with swallowing. Firstly, the muscles that line the oesophagus do not contract normally so that swallowed food is not pushed forward through the oesophagus and into the stomach properly. Secondly, the lower oesophageal sphincter (LES), a valve made of muscles, does not relax with swallowing as it does in normal people. As a result, the oesophagus above the persistently contracted LES starts to dilate, and large volumes of food and saliva can accumulate in the dilated oesophagus.
The symptoms of Achalasia Cardia include:
The diagnosis can be made based on symptoms and following tests are done to confirm the diagnosis.
Treatments of Achalasia Cardia include :
The aim of the treatment is to reduce the pressure within the lower oesophageal sphincter (LES) to allow easier passage of food from the oesophagus into the stomach. The muscle of the LES is divided leaving the mucosa (inner lining of the oesophagus) intact.
Achalasia Cardia is the failure of the LES – lower oesophageal sphincter to relax and let the food pass down to the stomach which leads to difficulty in swallowing food
The exact cause is not known, however there is degeneration o f the nerves to oesophageal muscles.
The complications of achalasia include weight loss and aspiration pneumonia. There often is inflammation of the oesophagus, called oesophagitis, which is caused by the irritating effect of food and fluids that collect in the oesophagus for prolonged periods of time. There may be oesophageal ulcerations as well. There is an increased occurrence of cancer of the oesophagus in patients with achalasia
Patients with achalasia present with difficulty in swallowing, regurgitation and chest pain. It can be diagnosed by upper gastrointestinal endoscopy, barium swallow or manometry.
The amount of pain is different for each person. The pain can be controlled with the help of pain control medications. You will be able to walk and go to the bathroom yourself.
Generally, you can be discharged 2 days following surgery.
In general, plan to take about one week off from work.
Mostly the procedure is covered under most medical insurance plans. Please confirm in your policy documents.
Laparoscopic Fundoplication is a keyhole procedure performed for patients with severe gastro-oesophageal acid reflux, Barrett’s oesophagus and symptomatic hiatus hernias that do not respond to medication. It is done to prevent acid from the stomach travelling the wrong way back into the oesophagus. The operation is predominantly laparoscopic although very occasionally, conversion to open surgery may be necessary.
The procedure involves narrowing the defect through which the oesophagus passes into the stomach (called the hiatus) as well as wrapping the upper part of the stomach around the lower oesophagus (the wrap) to recreate the valve at the lower end of the oesophagus. The upper stomach wrap may be complete or partial depending on different circumstances. The operation takes about 1.5 to 2hours and is carried out under general anaesthesia.
Overnight hospital stay is to be expected, although some patients can go home on the same day. There are restrictions to food intake for the first few weeks after the operation. Soft Diet and pureed food is advised for 6 weeks following the operation. Bread, meat and fruits with seeds are likely to cause most trouble and are to be avoided. Dietary advice will be provided at discharge from the hospital.
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