Throughout life, a person is faced with a variety of ailments. Some of them pass independently and are seasonal in nature, while other diseases require serious treatment, and sometimes surgical intervention.
One of the common gastrointestinal pathologies is achalasia of the esophagus or, as specialists call it, achalasia of the cardia or cardiospasm. From this ailment, people aged 30 to 50 years most often suffer. Moreover, the disease equally often affects both men and women.
What is a
Esophagus achalasia is a pathology of the neuromuscular type. In the process of the disease, the esophageal peristalsis changes, and when swallowing, the reflex opening of the cardiac opening does not occur. This leads to a disruption in the passage of food into the stomach.
This disease occurs in almost 20% of all cases of gastroenterological ailments. Cardiospasm is as common a pathology as cancer of the esophagus.
Causes of the disease
Despite the fact that this pathology is quite common, it has not yet been possible to determine all the factors affecting the development of the disease. However, there are several theories that most logically explain the development of cardiospasm. Among the most frequently discussed reasons are the following.
- Viruses. According to this theory, the human sphincter is affected by a viral agent, which leads to the development of this pathology. However, to date, electron microscopy studies do not confirm this theory.
- Heredity. This theory also has not received exact confirmation. According to this hypothesis, achalasia of the esophagus develops due to abnormalities in the digestive tube.
There are also a number of non-specific factors that may be responsible for the appearance of an unpleasant ailment. It is believed that at risk are people who:
- are constantly in a strong nervous tension;
- suffer from a deficiency of B vitamins;
- violate the diet and do not think about the fact that the daily diet should be balanced;
- suffer from a hereditary predisposition.
Today, experts pay most attention to the study of the mechanisms that affect the damage to the gastrointestinal nerve cells. It is likely that this is the main cause of the disease.
Esophageal achalasia stages
Modern medical literature describes about 20 types of this disease. However, in medical practice, some of them are not found. Based on the development of pathology, 4 degrees of achalasia of the esophagus are distinguished:
- 1st stage. At this stage, functional changes in the tissues of the esophagus occur. The sphincter narrows, and the necessary expansion of the esophagus does not occur.
- 2nd stage. During this period, the sphincter is constantly experiencing cramping. This is due to moderate expansion of the esophagus.
- 3rd stage. Cicatricial changes in the sphincter begin to spread. At this time, the food and adjacent departments are expanding greatly.
- 4th stage. This degree of ailment is also called thermal. At this stage, cicatricial changes become persistent, the entire esophagus expands, and congestive ulcers form in the tissues of the esophagus.
Types of Cardiospasm
In medical practice, it is customary to distinguish only two varieties of achalasia of the esophagus:
- 1st type. In this case, there is a moderate narrowing of the lower part of the esophagus. There are also obvious changes in tissues of a dystrophic and hypertrophic nature. The esophagus expands moderately.
- 2nd type. This kind of ailment is characterized by a significant narrowing of the lower part of the esophagus. Tissues change at an atrophic level. The epithelium of the digestive canal completely changes its structure and turns into connective tissue.
In some situations, cardiospasm is considered as a secondary process caused by lesions in the neuromuscular plexus. For example, this can happen with the formation of tumors. Depending on the underlying cause, treatment for achalasia of the esophagus can vary significantly.
Standard symptoms
There is a general symptomatology that is characteristic of all stages and types of ailment: pain "behind the chest", vomiting of undigested food, unpleasant belching and weight loss. However, in order to accurately determine the presence of an ailment, it is necessary to take into account the various symptoms of achalasia of the esophagus, depending on the stage of development of the disease. In this case, self-diagnosis is not worth it. It is better to consult a specialist.
Symptoms characteristic of the first stage of the disease
If radiological examinations are done in a timely manner, then during the examination the doctor will determine a slight narrowing of the lower part of the esophagus. However, at this stage, its morphological structure does not undergo changes.
With the introduction of barium, the contrast fluid may linger in some parts of the digestive system for up to 1 hour. After this, the esophagus sometimes opens spontaneously, and the mixture passes into the stomach.
At this stage of the development of the disease, patients note:
- a feeling of "bursting" behind the sternum and heaviness (as a rule, such symptoms quickly disappear after the cardiac section of the esophagus relaxes);
- vomiting (not everyone complains about this condition);
- belching (it appears when there is a long "jam" of a food coma).
There is no weakness or other symptomatology. The general condition of patients does not change.
Symptoms of the second stage
In this case, the esophagus undergoes functional and morphological changes. On x-rays, a decrease in peristalsis is clearly visible. At the same time, a much stronger narrowing of the esophagus located near the cardiac section is noticeable.
In the second stage, the food lump can be delayed up to 3 hours. When food enters the stomach, a fairly noticeable decrease in its tone and contractions is observed. Patients complain of:
- persistent strong pain of a bursting nature;
- profuse vomiting after eating;
- severe burning behind the chest (these unpleasant sensations are due to dystrophic processes that begin to occur in the tissues);
- sharp weight loss, deterioration of the skin (this happens due to metabolic disorders).
How are stages 3 and 4 manifested?
At this stage, changes affect almost the entire human body. Even if the patient undergoes an X-ray examination on an empty stomach, doctors reveal the remains of food that was eaten a very long time on the image. You will even see drunk water.
At stages 3-4, the entire esophagus tube expands. Similar symptoms are also found in the stomach itself. On the tissues of the esophagus noticeable ulcers appear. Food masses cannot fully move; even their absorption does not occur.
Since this is the final stage of the disease, patients suffer it very hard. Patients complain of:
- persistent pain in the area behind the chest;
- the impossibility of eating food (all the food that a person eats, immediately goes outside with vomiting).
Also at this stage there is a very sharp weight loss. This is due to serious metabolic disturbances.
How does the disease occur in children
Despite the fact that people over the age of 30 are most susceptible to this disease, esophageal achalasia is also found in children after five years. In infants and babies up to four years of age, such problems are practically not diagnosed. However, if this still happens, then doctors find that the cardia is unable to open up correctly. In this case, the baby has frequent burping and coughing. This seriously complicates the process of eating. Since it is very important for children to eat fully so that all body systems develop correctly and function without failures, this phenomenon requires urgent measures.
If we are talking about children, then drug therapy cannot be carried out. Therefore, when children reveal achalasia of the cardia of the esophagus, surgery becomes the only possible option to get rid of the disease. However, surgical expansion of organs does not give a long-term result.
Possible complications after cardiospasm
Even provided that timely treatment of achalasia of the esophagus has been performed, there is a great risk that the body systems will not be able to work in normal mode. Most often, among complications, doctors record:
- the development of cancer in the esophagus;
- exfoliation of tissues of certain organs;
- development of pathological processes in the human lungs;
- the appearance of neoplasms in the cervical spine;
- significant expansion of the veins in the esophagus;
- pneumopericardium.
If the disease lasts too long, then there is a risk of too much expansion of the esophagus. This leads to serious thinning of its walls and the complications described above. 85% of patients have severe weight loss. In some, submucosal exfoliation occurs, fistulas appear.
Diagnostics
When contacting a doctor, a specialist first of all finds out from a patient all the features of unpleasant symptoms and carefully studies the history of his illness. In the second, esophagus achalasia is diagnosed using specialized equipment. The most accurate results are shown by x-ray examination. Thanks to him, the doctor very quickly detects expansion of the esophagus and other signs of pathology.
In the third turn, in order to clarify the stage of development of the disease, esophagoscopy is performed. In some situations, the specialist wants to exclude the possibility of developing esophageal cancer. For this, an endoscopic biopsy is prescribed. To assess the contractile function and tone of the esophagus, it is necessary to perform esophageal manometry, which will also clarify the pressure inside the esophagus and changes in peristalsis.
Achalasia of the cardia of the esophagus: medication
It is worth noting that this ailment lends itself very poorly to the drug type of therapy. Medicines are prescribed by the doctor only if it is necessary to reduce pain in the patient or if it is about the very first stage of the disease.
Patients are recommended to adhere to a sparing diet. Of the drugs prescribed sedatives, vitamin complexes and other tablets and weak-acting medicines. Even if the treatment of achalasia of the cardia of the esophagus with medication gives a visible effect, it will not be long.
Surgical intervention
If the patient's condition worsens, and drug treatment does not give results, then more serious measures must be taken to combat the disease. Bilateral cardiomyotomy is an operation for achalasia of the esophagus, which is considered the most effective method of combating pathology.
In the process of surgical intervention, the layers of the departments of the diseased organ are neatly dissected. If the disease has not reached a serious stage, then a simpler procedure is possible - unilateral cardiomyotomy.
Treatment with folk remedies
In this case, herbal medicines and other recipes can only be considered as adjuvant therapy. Natural remedies help restore immunity, have general strengthening properties and support in the postoperative period.
The most effective are infusions made on the basis of lemongrass and ginseng. It is also recommended to take tincture of marshmallow, aloe and pink rhodiola.
You should definitely pay attention to the recipes of traditional medicine, which can relieve unpleasant symptoms. For example, if there is heartburn, you can try to cook oregano or buy calamus root (everything is brewed according to the pharmacy instructions).
Diet food
In order for any therapeutic measures to give a visible result, you must always monitor your diet. As a rule, a specialized diet is a doctor. However, regardless of the particular case, it is necessary to abandon the fried and greasy. You need to eat food in very small portions, but often. After each meal, it is important to drink plenty of water.
Also, experts recommend starting to play sports, but without strong physical exertion. However, before starting training, you must definitely check with your doctor the admissibility of such events. If the patient has other ailments, then do not risk it.