Achalasia Cardia 
Achalasia Cardia 
  Swallowing Problem Esophageal Manometry POEM

Achalasia Cardia:  Esophageal or Food Pipe Disorder

Today we’ll talk about Achalasia Cardia which is a disorder of esophageal or food pipe.

There is a valve between the food pipe and the stomach called the Lower Esophageal sphincter or LES.

The valve stops the acid in the stomach to come up or come out.

Whenever we drink or eat something the valve has to always open so that the food or water goes easily inside the stomach.

The valve becomes tight in patients having Achalasia Cardia.

I am Shashi Prabha, I came from Gorakhpur. I have pain in my stomach and I face difficulty in having food. The comes up in the neck and in the nose. I have consulted Dr. Vikas Singla.

When such patients come to us, firstly, we do an endoscopy to check if there is any tumor in the food pipe or a narrowing of the food pipe.

If we find that the endoscopy is normal, we suspect it may be a case of Achalasia Cardia.

Then we conduct a special test called Esophageal Manometry.

Esophageal Manometry is an important test to detect Achalasia Cardia.

The patients who find difficulty in eating food, firstly, we conduct an Endoscopy and if the patient finds it normal then we advise them to do Esophageal Manometry.

You can see that there is one catheter attached to the machine.

This catheter is put in the nose of the patient, it enters the food pipe through the neck. You can see a computer screen. When the catheter is inside, we feed the patient with water.

You can see some graphical changes on the computer screen after the water is given.

We assess the disease by reading & observing these graphical changes.

A catheter is already inserted in the food pipe of this patient.

We shall start the procedure.

We inform the patient that he/she will be fed about 5ml of water.

Once the patient swallows the water, we analyze the graphical changes on the screen.

So, we are now beginning the procedure. You can see as the water is swallowed in the food pipe, the graphical changes can be seen taking place on the computer screen.

The endoscopy of the patient, Shashi Ji named earlier, was normal.

We conducted Esophageal Manometry & through this test, we established that she suffering from the disease, Achalasia Cardia.

We discussed various treatment options.

To treat Achalasia Cardia, the available options are
Balloon dilatation (poem surgery)
and
Lap Heller Myotomy.

In the case of Balloon Dilatation, we insert a balloon in the food pipe and it is blown to expand. Sometimes, we may have repeatedly do the Balloon Dilatation. There is also a danger that the food pipe may burst during Balloon Dilatation.

The new treatment for Achalasia Cardia is POEM (Per oral endoscopic myotomy).

Using this technique, we cut tight valve fiber of food pipe slowly and this is a safe technique.

its efficacy is more than 95%.

Shashi Ji was treated using the POEM technique.

We started giving her a liquid diet the next day after the treatment and started a solid diet after two days only.

Shashi: I got my treatment from the hospital. Before the treatment, I could not eat anything. I am able to eat now.
Husband of Mrs. Shashi: I brought her to the hospital. She got the treatment from Dr. Vikas Singla. She was admitted for 3 days.

Now she is fine and is able to eat without any issues. She was given a liquid diet, then semi-solid and now she is on a solid diet.

Husband of Mrs. Shashi: Dr. Singla & his team is very good. I appeal to everyone who is affected by this disease, they should come to Dr. Singla & get their treatment done. The treatment done is very good. All the facilities are available.

When Shashi Ji came to us for the follow-up, she was very happy. She did not have any issues with swallowing food or drinking water.

If anyone is having difficulty swallowing food, they may have Achalasia Cardia. They should get the diagnosis done & if they are affected with Achalasia Cardia, we can easily treat them.

If you have any doubt, please write to us or you can meet us.

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