Oesophageal achalasia is a motility disorder of the oesophagus as a result of disturbed peristalsis and incomplete relaxation of the LES manifested by difficulty in swallowing, regurgitation, and chest pain (O’Neill, Johnston, & Coleman 2013). In this regard, diagnostic evaluation is of great value as it is a challenge for clinicians to diagnose achalasia due to clinical manifestations being equivocal of the disease which can be attributed to other diseases, such as GERD or scleroderma (O’Neill, et al, 2013). Patients presenting with achalasia will all have a complete history taken to aid in the diagnosis (Constantini, et al, 1993) and according to Professor J. Windsor (personal communication, April 20, 2017), “it can usually take a period…
Slow or absent esophageal peristalsis may not carry the bolus through the esophagus in an efficient and complete manner, causing discomfort or pain in the chest and leaving residue on the esophageal walls that may result in infection. In some patients, the lower esophageal sphincter does not sufficiently relax to allow the food in the esophagus to flow into the stomach, resulting in achalasia. Gastroenterologists are the medical professionals who treat esophageal…
Participants Participants were prospectively recruited from the cohort of consecutive patients referred to the Combined Head and Neck Clinic (CHNC) at a large tertiary hospital in Brisbane between September 2013 and November 2014. For inclusion, all patients had to have at least one parotid gland affected by either primary, metastatic or recurrent disease, and were planned to receive either definitive XRT or surgery with postoperative XRT to a prescription dose of 60Gy or greater. Patients were…
In diagnosing Achalasia, symptoms such as regurgitation of swallowed food and liquid or feeling of an object in their throat is very common. However, the primary symptom for achalasia is problems swallowing. Many patients will unfortunately not seek help until symptoms worsen and will employ techniques such as eating slowly or lifting the neck while throwing their shoulders back to help improve swallowing solids and liquids. Once patients do decide to seek treatment for these symptoms,…
Overview: Achalasia is a rare motility disorder of the esophagus (swallowing tube) muscle, causing insufficient relaxation of the lower esophageal sphincter (a ring of muscle located between the esophagus and the lower stomach) to open and allow the food to pass into the stomach. So, people with achalasia face trouble swallowing food. Causes: The achalasia can happen for several reasons. It can be hard for your doctor to identify a specific cause. This condition may be hereditary, or it may…
Laparoscopic Nissen Fundoplication Laparoscopic Nissen fundoplication is surgery to relieve heartburn and other problems caused by gastric fluids flowing up into your esophagus. The esophagus is the tube that carries food and liquid from your throat to your stomach. Normally, the muscle that sits between your stomach and your esophagus (lower esophageal sphincter or LES) keeps stomach fluids in your stomach. In some people, the LES does not work properly, and stomach fluids flow up into the…
ACHALASIA Achalasia refers to a rare disease of the muscle of the lower esophageal body and the lower esophageal sphincter (LES) that prevents relaxation of the sphincter and inability of the muscles to contract, or absence of peristalsis, of the esophagus. LES pressure and relaxation are regulated by excitatory and inhibitory neurotransmitters however, patients with achalasia lack these nonadrenergic, noncholinergic inhibitory ganglion cells thus, causing imbalance between the excitatory and…
Patient History Mary is a 77-year-old female who was recently diagnosed with a rare esophagus, achalasia. Achalasia is a disease that prevents relaxation of the lower muscle in the esophagus. Mary was having trouble swallowing her food, having quite intense chest pain and when she was able to eat she was having trouble keeping the food down. Just a few weeks after her diagnosis, Mary was having continued issues with swallowing and shortness of breath. Upon doing an x-ray doctors found food…
asthma/chronic cough, laryngitis, nocturnal aspiration or regurgitation) - Diagnosis GERD was documented by 24hr pH monitoring (off medication) - On a PPI with GERD-related symptoms - Would like to discontinue PPI Exclusion criteria 1 Age < 18 or > 80 2. History of a severe psychiatric disorder: including suicidal ideation, or admission to a psychiatric institution. 3. Unable or unwilling to consent for an invasive procedure. 4. History of intestinal leak after surgery. 5.…
Decreased progression of Paget’s disease. Side Effects/Adverse Rxns: CNS: headache EENT: blurred vision, conjunctivitis, eye paing/inflammation CV: atrial fibrillation MS: musculoskeletal pain, femur fractures, ostenocrosis (primarily of the jaw), RESP: asthma exacerbation. Food/Med Interactions: FOOD: Food significantly decreases absorption. Caffeine (coffee, tea, cola,), mineral water, and orange juice decrease absorption DRUG: Calcium supplements, antiacids, and levothryoxine may…