Achalasia Cardia

Clinical Features:

• Inability to swallow (dysphagia), which may feel like food or drink is stuck in your throat.
• Regurgitating food or saliva.
• Heartburn.
• Belching.
• Chest pain that comes and goes.
• Coughing at night.
• Pneumonia (from aspiration of food into the lungs)
• Weight loss.

Investigation :

1)Esophageal manometry.

2)Barrium meal - distal esophagus narrowing ([post id="245" title="X-ray-finding"]

3)X-ray chest -airfluid level esophagus, absence of fundic gas.

4)Endoscopy of upper GIT 

5)24-pH monitoring 

Rx:

1. Relief GI spasm :

2. Tab.Butapan(Hyoscine butyl bromide)(10mg)

1+1+1+1.....(খাবার ৩০ মিনিট আগে)......  continue

3.  Tab.Nifin(Nifedipine)(10mg)

1+1+1.........1 month 

🎴Surgical treatment :

• Heller's Cardiomyotom

Advice: 

• Avoid NSAID 
  
• Avoid Alcohol, spicy food 
  
• Avoid lying down for 2-3 hours after taking food.
  
• Oesophageal dilatation using pneumatic bag under fluoroscopic guidance.
• Oesophago-cardio-myotomy may be required in afew cases.