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    Achalasia, (Swallowing Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Achalasia, (Swallowing Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Achalasia, (Swallowing Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook96 pages36 minutes

    Achalasia, (Swallowing Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    Achalasia is a swallowing disorder of motility of the lower esophageal or cardiac sphincter.
    The smooth muscle layer of the esophagus has decreased peristalsis and inability of the sphincter to relax produces a functional stricture or functional esophageal stenosis.
    The tube that brings food from the mouth to the stomach is the esophagus.
    Achalasia makes it harder for the esophagus to move food into the stomach.
    Achalasia is a serious condition that affects the esophagus.
    The lower esophageal sphincter (LES) is a valve that blocks off the esophagus from the stomach.
    If the patient has achalasia, the LES is unable to open up during swallowing, which it is supposed to do.
    This results in a backup of food within the esophagus.
    This disorder may be inherited, or it may be the effect of an autoimmune disorder, which happens when the body’s immune system wrongly attacks healthy cells in the body.
    The degeneration of nerves in the esophagus often adds to the advanced symptoms of the condition.
    The most frequent presenting symptom is dysphagia (difficulty in swallowing).
    This involves the swallowing of solids more than soft food or liquids.
    People with achalasia will often have problem swallowing or a sensation of food being stuck in their esophagus.
    This symptom can produce coughing and increases the risk of aspiration, or inhaling or choking on food.
    Regurgitation may happen in 80-90% and some patients learn to force it to alleviate pain.
    Chest pain, which may become worse after eating, or may be felt as pain in the back, neck, and arms
    The barium swallow in achalasia is typical.
    The distal esophagus has a narrow segment and the X-ray image looks like a bird's beak.
    This is different to the rat's tail appearance of carcinoma of the esophagus.
    Manometry is the gold standard test for diagnosis of achalasia and can diagnose up to 90% of patients.
    The doctor may make use of esophageal manometry to diagnose achalasia.
    The purpose of treatment is to decrease the pressure at the sphincter muscle and permit food and liquids to pass easily into the stomach.
    Most achalasia treatments affect the LES.
    Several types of treatment can either transiently decrease the symptoms or permanently change the function of the valve.
    The first line of treatment is often oral medicines.
    1. Nitrates or calcium channel blockers can help loosen the sphincter so food can pass through it more readily.
    2. The doctors might also make use of Botox to relax the sphincter.
    To treat achalasia more permanently, the doctors can either enlarge the sphincter or change it.
    1. Dilation normally requires inserting a balloon into the esophagus and inflating it.
    This expands out the sphincter and assists the esophagus to work better.
    Occasionally dilation can produces tears in the sphincter.
    If this occurs, the patient may require more surgery to repair it.
    2. Esophagomyotomy is a form of surgery that can assist the patient if the patient has achalasia.
    The doctor will use a large or small incision to reach the sphincter and carefully change it to permit better flow into the stomach.
    3. The Heller myotomy is normally considered the best treatment for those who are fit.
    Pneumatic dilatation is the favored option for older unfit patients.
    If a perforation happens, emergency surgery is required to close the perforation and do a myotomy.
    Multiple balloon dilatation with progressive balloon diameter at two months, two years and six years is more effective.
    Peroral endoscopic myotomy and endoscopic stent insertion is techniques being explored.
    Operative failure may be treated by repeat operation, dilatation or, in extreme circumstances, esophagectomy.
    TABLE OF CONTENT
    Introduction
    Chapter 1 Achalasia
    Chapter 2 Causes
    Chapter 3 Symptoms
    Chapter 4 Diagnosis
    Chapter 5 Treatment
    Chapter 6 Prognosis

    LanguageEnglish
    PublisherKenneth Kee
    Release dateMar 19, 2017
    ISBN9781370743735
    Achalasia, (Swallowing Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Achalasia, (Swallowing Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Achalasia,

      (Swallowing Disorder)

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2017 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes the Achalasia (Swallowing Disorder), Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What You Need to Treat Achalasia)

      This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical conditions.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Achalasia

      What is Achalasia?

      Achalasia is a swallowing disorder of motility of the lower esophageal or cardiac sphincter.

      The smooth muscle layer of the esophagus has decreased peristalsis and inability of the sphincter to relax produces a functional stricture or functional esophageal stenosis.

      The tube that brings food from the mouth to the stomach is the esophagus.

      Achalasia makes it harder for the esophagus to move food into the stomach.

      Achalasia is a serious condition that affects the esophagus.

      The lower esophageal sphincter (LES) is a valve that blocks off the esophagus from the stomach.

      If the patient has achalasia, the LES is unable to open up during swallowing, which it is supposed to do.

      This results in a backup of food within the esophagus.

      This disorder can be linked to injury of nerves in the esophagus.

      It can also be due to injury of the LES.

      What Causes Achalasia?

      Causes

      Most patients have no known underlying cause but a small percentage happens secondary to other disorders - e.g., esophageal cancer.

      The tone and the activity of the muscle are regulated by a balance of excitatory transmitters such as acetylcholine and substance P and inhibitory transmitters such as nitric oxide and vasoactive intestinal peptide (VIP).

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