Symptoms of achalasia of the cardia and is treated as such a disease
Achalasia cardia is also referred to as cardiotonic extension of the esophagus, megaezofagus, venospasm. Kardiya is the lower esophageal sphincter (circular muscle). It separates the esophagus and stomach. When achalasia cardia is the lack of a reflex extension of the cardia during swallowing, impaired peristalsis, decreased tonus of the thoracic esophagus.
This disease was first described in the 17th century. Modern medical data do not have accurate information on the prevalence of achalasia cardia among the people. As they come from attendance of patients, their lower and upper bounds differ considerably. It is believed that women become ill with achalasia of the cardia more frequently than men.
Causes of achalasia
Until today, the cause of achalasia cardia of the day not found. Today many of the concepts of the origin of such diseases cause only of interest to historians of medicine.
It is believed that the main reason for the defeat of esophagus is the pathological state of the autonomic nervous system. It arises as a result of its innate features. It is also known the development of achalasia cardia under the influence of an infectious process in the esophagus.
Since the defeat of the autonomic nervous system disturbed motility of the esophagus, the cardiac sphincter is not fully closed when swallowing. Disturbed and peristalsis in the esophagus. Fully disclosure of the cardiac sphincter takes place only under the pressure of food that had accumulated in the esophagus.
The stage of the disease
Achalasia cardia is of four stages:
- At first, early stage is temporary and reversible spasm of the cardia. Esophagus not expanded.
- In the second stage, the stable expansion of the esophagus. Observed enhanced motility of its walls.
- Occur further scarring and stenosis of the esophagus. He has a steady and marked expansion. Tone and peristalsis of this organ is broken as well as his function.
- Achalasia cardia the fourth stage is characterized by irreversible lesions of the body. Develops esophagitis (i.e., inflammation of the lining of the esophagus), inflammation of the surrounding tissues.
Signs of disease
The disease has symptoms, and its clinical picture is quite complex.
So, patients with symptoms of difficulty swallowing (dysphagia). Difficulty swallowing occurs suddenly, against the background of complete well-being (in one third of patients). In other patients dysphagia appears gradually. Acute onset of this phenomenon is associated with emotional stress. And in this respect it is a kind of vicious circle – against the background of stressswallowing difficult, and this, in turn, even more traumatic. Treatment of patients with achalasia cardia long is wrong: instead of treating the esophagus, they treat stress.
Eating home-cooked meals for some time, weaken the symptoms of achalasia. The disease tends to worsen in response to eating certain categories of food. In some patients it may be fruits, and other foods and spices. Patients with achalasia cardia are looking for ways to promote food through the esophagus: drink water, hold your breath, swallow the air, etc. is such that the liquid food can flow better than solid, and sometimes Vice versa.
Symptoms of regurgitation, i.e., backward movement of food, are not less characteristic for the disease. Occurs regurgitation. In the mouth can get different amounts of food. This is especially noticeable with a full stomach or when the body is tilted forward. In some cases, reverse the movement of food occurs only a few hours after a meal.
Regurgitation often takes place at night. Food gets into the respiratory tract – there is a night vomiting and night cough. Achalasia of the cardia third and fourth stage is characterized by regurgitation mouth full.
Pain in achalasia
In addition, the patient whose cardiac achalasia pains. They may occur during swallowing and eating. Patients feel pain behind the breastbone. In case of anxiety, psychoemotional loads of pain are particularly strong. The duration of pain from a few minutes to several hours. Their frequency also varies. They are taking antispasmodics, but can pass by themselves.
All these symptoms are achalasia cardia combined with weight loss, increasing weakness, gradual loss of ability to work. The disease occurs in waves, with periods of exacerbation and remission; it may be complicated by bleeding, perforation of the esophagus, cancer.
How to diagnose the disease
In the diagnosis of achalasia cardia is important a thorough history. To confirm the diagnosis and stage of the disease the instrumental examination of the esophagus.
The patient with achalasia cardia mandatory appoint radiography. It clearly shows that cardiac sphincter closes incompletely. A symptom of the disease is the expansion of the esophagus.
The diagnosis of achalasia cardia is confirmed by endoscopy. The endoscope allows the doctor to examine in detail the mucosa.
To choose a way to more effectively treat the disease, the doctor also conducts a pressure gauge. This measures pressure in the esophagus. So it is possible to obtain data on the state of the smooth muscles of the body.
How to treat the disease
Treatment of achalasia cardia is directed toto remove the blockage of the sphincter. This can be achieved by conservative and surgical.
Surgical treatment of achalasia cardia has the following advantages:
- High efficiency.
- The possibility of a detailed examination of the mucosa of the esophagus for the presence of malignant tumors. This survey reduces the risk of long-term complications.
- Good tolerance of this type of treatment of the sick.
However, to treat achalasia cardia can and conservative method. First, quite successfully used balloon cardiodilatin. This treatment gives good results. Thus there is an artificial extension of the orifice of the stomach. To do this, use the special tools – cardiodilatin. With the help of the balloon in the esophagus is achieved optimal blood pressure, contributing to the closure of the sphincter.
Medication used in the early stages of achalasia. Patients assigned to nitroglycerin (under the tongue). Nitroglycerin taken before or during meals. This facilitates swallowing and allows to stop the pain. Is also and treatment myotropic antispasmodic. Among them – But-shpa, Papaverine, Halidorum. They should be taken three or four times a day. In cases of severe swallowing disorders, these medications are administered intramuscularly.
As achalasia is accompanied by pain, before eating, can be administered benzocaine. Good results are sedative – motherwort, Valerian, tincture of a peony. For overall strengthening of the body are appointed vitamins. In severe cases, the treatment of achalasia cardia is carried out by intravenous administration of glucose, electrolytes.
Used and popular treatment of achalasia. To improve the tone of the sphincter of the use of tincture of aralia, schisandra, ginseng. The symptoms of inflammation are reduced by the cones of the alder, infusion of marshmallow root, a decoction of oregano. These same tools have a pronounced tonic effect. Shown and enveloping, astringents.
Prevention of the disease
Achalasia cardia can occur at any age. To prevent its development, you need to:
- to deal with psycho-emotional disorders;
- to ensure that the diet was enough vitamins;
- not to eat, irritant;
- eat slowly, chewing food thoroughly;
- to abandon the habit of lying down after a meal;
- to prevent overeating;
- to get rid of bad habits – alcohol and Smoking;
- to ensure that the food was regular.
In any case, if you have any symptoms of cardiac achalasia must be treated by a physician and not tryto self-medicate.