• Achalasia Cardia

    Achalasia cardia or achalasia is a rare disorder that causes difficulty in swallowing due to degeneration of the nerve cells in the esophagus. It results in accumulation of large volumes of food and saliva in the dilated esophagus. Although the condition is not curable but the aim of the treatment is to give symptomatic relief to the patient so that he can swallow.

    Symptoms of Achalasia Cardia

    • Difficulty in swallowing

    • Feeling that swallowed food or liquid is stuck in the chest

    • Regurgitation of swallowed food and liquid

    • Pain in chest

    • Heartburn

    • Feeling of fullness or a lump in the throat

    • Hiccups

    • Weight loss due to improper eating

    Diagnosis of Achalasia Cardia

    On the basis of symptoms explained by the patient, physician can make a probable diagnosis of achalasia. Following tests help the physician to confirm the diagnosis:

    • Barium swallow

    • Endoscopy

    • Manometry

    Laparoscopic Cardiomyotomy

    Achalasia Cardia can be managed by dividing the muscles of the lower esophageal sphincter and upper end of the stomach. The surgery is called cardiomyotomy and it can be performed laparoscopically.

    Laparoscopic Cardiomyotomy is performed under general anaesthesia. The surgeon makes a small incision of 1 cm in the upper abdomen. A cannula is introduced through this cannula inside the abdomen. A laparoscope is introduced through the cannula that gives a magnified view of the internal organs to the surgeon on a video monitor. Now four small incisions of 5mm each are made to enter additional cannulas that will accommodate special long instruments. Using these instruments, surgeon divides the lower esophageal sphincter and the muscle layer in the upper part of the stomach. This may cause gastro-esophageal reflux disorder. So to prevent regurgitation of stomach acid, the upper part of the stomach called fundus is rotated around and fixed in such a way that it creates a fundoplication or a valve.

    This procedure helps the patient to swallow food and liquids much better than before.

    Advantages of Laparoscopic Cardiomyotomy

    • Faster recovery

    • Only few hours or overnight hospitalization

    • Sooner return to work

    • Very less pain during and after the procedure

    • Smaller incisions without any cut on abdominal muscles

    • Negligible risks and complications

    • Less chances of wound infection

    • Faster return to normal diet

    Authored By DR.R.K.Sinha