At this point, most of us are familiar with GERD, a condition in which acid splashes back up from the stomach into the esophagus, resulting in frequent reflux. GERD is caused by a weakened lower esophageal sphincter, the valve between your stomach and esophagus. When the valve isn’t tight enough, it allows acid and food to travel back up.
Most surgeries used to combat GERD involve tightening the LES, but it’s all about finding the right balance. Tighten it too much, and you’ll find yourself dealing with the disorder on the other end of the spectrum: achalasia.
Achalasia is definitely the lesser known of the two disorders, but it can be just as frustrating (if not more so) to live with as GERD is for patients who suffer from it. Achalasia is an esophageal disorder that prevents the esophagus from emptying properly. In patients with Achalasia, certain nerve fibers in the esophagus are destroyed. This results in two issues: the esophagus loses its ability to push, and the valve at the lower end of the esophagus (otherwise known as the lower esophageal sphincter) does not relax properly.
Achalasia is, in many ways, the opposite condition of GERD. While patients with GERD suffer from a weakened lower esophageal sphincter, patients with Achalasia have an overly tight lower esophageal sphincter. Like GERD, Achalasia can occur at any age, but is more prominent in middle-aged and elderly individuals. It affects men and women equally, and has not yet been linked to any specific causes.
People who suffer from Achalasia may experience any number of symptoms, but some of the most common achalasia symptoms include:
· Dysphagia (difficulty swallowing)
· Chest pain
Unfortunately for patients with Achalasia, there is no permanent cure for the disorder. There are several treatment options available to help minimize the effects of Achalasia for various amounts of time, but no intervention will be able to completely cure the disorder.
The most effective treatment option for lasting long-term relief of Achalasia symptoms is the Heller myotomy, a laparoscopic procedure that involves cutting the muscle of the LES to relieve dysphagia and allow food to pass through. During the procedure, the LES is then partially rebuilt to prevent reflux from occurring post-surgery.
It’s a fairly un-invasive procedure, and most patients notice improvement in their ability to swallow almost immediately. As we mentioned before, it’s not a permanent cure for Achalasia, but it does allow patients to live their lives relatively symptom-free for a very long time. If you have questions about the Heller myotomy, or if you’re wondering what other treatment options might be right for you, don’t hesitate to sit down with one of our surgeons. We’ve been performing the Heller myotomy on patients for years, and we’d be more than willing to answer any questions you might have.