Achalasia Flashcards
Define Achalasia.
It is a neuromuscular condition characterized by oesophageal aperistalsis and impaired relaxation of the lower oesophageal sphincter.
What other condition can mimic the symptoms of achalasia.
Chagas’ disease. (Trypanosoma Cruz infection in South America).
What age group does achalasia tend to affect.
Typically affects those aged 25-60 years.
What is the incidence of achalasia.
1:100,000.
It affects men and women equally.
What is a prominent feature in the PMH of a patient with suspected achalasia.
Long history of intermittent dysphagia, for both solids and liquids.
What are the symptoms of achalasia. (4)
Dysphagia.
Regurgitation of food(particularly at night).
Spontaneous chest pain.
There may be some weight loss.
What is the cause of the chest pain in achalasia.
Due to oesophageal spasms.
What is a complication of achalasia, and why.
Regurgitation of food from the dilated oesophagus can lead to aspiration pneumonia.
What is the differential diagnosis for patients presenting with achalasia. (4)
Genetic syndromes.
Infectious diseases.
Neoplasms.
Chronic inflammatory conditions.
What are the signs of achalasia. (3)
There are no physical signs, confirmation of diagnosis is by:
Barium swallow: shows tapering of the lower oesophagus (bird’s beak), with proximal dilation.
Oesophageal nanometre: reveals incomplete relaxation of the lower oesophageal sphincter.
OGD: to exclude malignancy.
What is a potential complication for patients with achalasia.
There is a slight increase in the incidence of squamous carcinoma of the oesophagus. (7% after 25 years - in both treated and untreated patients)
