Achalasia | White Plains Hospital

Achalasia

There are certain diseases of the esophagus that are not cancers but do require surgical attention. These diseases include achalasia, gastroesophageal reflux disease (GERD) and esophageal leiomyoma.

Facts

  • Chronic disease usually affected patients from their mid 20’s until their early 60’s.
  • Caused by a loss of the nerve cells that line the esophagus.
  • As a result, the esophagus does not propel swallowed food from the mouth to the stomach.
  • A band of muscle, known as the lower esophageal sphincter (LES), is located at the bottom of the esophagus where the esophagus enters the stomach.
  • The LES does not function properly and does not relax to allow food to enter the stomach.
  • This abnormality of the LES prevents food from going from the esophagus to the stomach which can lead to enlargement of the esophagus.

Symptoms

  • Difficulty swallowing, frequently both to solids and liquids.
  • A sensation of food being stuck in the chest.
  • The need to drink a lot of water to help get food down.
  • Symptoms tend to start slowly and get worse over time.
  • Recurrent episodes of pneumonias because undigested food backs up and goes into the lungs.

Diagnostic Tests

Treatment Options

  • Medications: There are medications that are taken by mouth or injected into the sphincter can be a temporary fix to the problem.
  • Pneumatic Dilation: During an esophageal endoscopy, the sphincter is stretched so food can pass into the stomach.
  • Laparoscopic Heller Myotomy: The LES muscle is surgically divided to relieve the excessive tension. This procedure has been done since the late 1920’s. With state of the art equipment, we can perform this minimally-invasive surgery with cameras and fine instruments utilizing five 1-inch incisions. Patients generally go home within 24-36 hours of surgery.

Surgery is recommended for those patients who are good surgical candidates. Pneumatic dilation is recommended for those patients who cannot undergo surgery. Our multidisciplinary team will confer on which procedure is best for you.

At White Plains Hospital we have a fully staffed Thoracic Surgery Service that includes board-certified thoracic surgeons, anesthesiologists, gastroenterologists, pulmonologists, and critical care intensivists. In addition, we have a staff of highly trained nurses, respiratory therapists, nutritionists, physical therapists, case managers and social workers that work in-sync with your surgeon to provide great care for you when you are recovering from your surgery.