Achalasia of the cardia: important information about the disease
To date, the list is the mostcommon diseases include the pathology of the gastrointestinal tract. Nervous disorders, malnutrition, climate, various infections are the main causes leading to diseases of this type.
One of the frequent pathologies of the stomach and intestinesis achalasia of the cardia, related to neuromuscular diseases of the esophagus. With this disease, there are changes in the passage of food masses along the esophagus itself and, accordingly, from the esophagus to the stomach. This is caused by violations of the peristalsis of the esophagus and the absence of a reflex opening only of the lower esophageal sphincter. The disease occurs in people of any age, but more often in the range of twenty to fifty years, both in men and in women.
Classification of the disease
The doctors identified 4 stages of the disease characterized by various changes in the esophagus:
- Stage I is characterized by reversible temporary spasms of the cardia, not accompanied by esophageal expansion;
- Stage II is characterized by a stable expansion of the esophagus and increased motility of its walls;
- at the III stage there is a stenosis of the cardia and a constant expansion of the esophagus with a disorder of its peristalsis and tone;
- at the IV stage, the final department of the esophagus receives irreversible lesions; begins esophagitis and pereezophagitis.
Stages I and II last about a couple of months, the third stage is about ten to fifteen years, and the fourth to long decades.
Akhalasia cardia is also primary and secondary.
Causes of the disease
There are several hypotheses about the causes of the disease, however, in the medical community to the common denominator did not come. Presumptive reasons are:
- lack of vitamins of group B;
- changes and lesions in the parasympathetic nervous system;
- inflammation of the lymphatic system, lungs or mediastinum;
- stomach cancer, Chagas disease.
Achalasia of the cardia - symptoms:
- dysphagia or difficulty swallowing;
- regurgitation or movement of food masses in the opposite direction. This symptom is accompanied by vomiting;
- Pain in the chest. In the I and II stages of pain are associated with spasms, and on III - IV with esophagitis;
- weakness, weight loss, disability.
How is the disease diagnosed?
Diagnose diseases using X-ray studies, esophagogastroscopy and passage of barium.
Achalasia cardia - treatment
The main goal of treatment is to improvethe permeability of food to the esophagus and the elimination of the underlying symptoms of the disease. This is done either with the help of surgical methods, or through medications.
Inadequacy of cardia treatment implies the following:
- Sparing diet number 1 or no. 1a;
- fractional food, which implies the need to eat about five to six times a day, except for too cold or too hot dishes;
- Exclusion of alcohol and cigarettes;
- use of medications: Nitroglycerin, Isosorbide dinitrate, Nifedipine, Novocain, Atropine Sulphate, Spasmolytics, Botulinum toxin (injections) and others.
Drug treatment is not veryeffectively, as only temporarily blocks the symptoms of the disease. Surgical intervention is more effective. Basically, it is used in parallel with drug treatment. Several surgical methods are used:
- pneumatic cardiodilation (expansion of the cardia with the help of dilators). The effect of this method is high - up to 80%;
- a method of extrinsic cardiotomy according to Geller (longitudinal dissection of the muscular membrane);
- balloon dilatation (special rupture of the fibers of the lower sphincter of the esophagus).
Certainly, the treatment is prescribed only by the doctor. And it depends on the complexity and type of the disease.