Achalasia Flashcards
What is achalasia?
An oesophageal motor disorder of unknown aetiology, characterised by oesophageal aperistalsis and insufficient lower oesophageal sphincter (LOS) relaxation in response to swallowing.
What are the risk factors of achalasia?
Allgrove syndrome Herpes and measles viruses Autoimmune disease HLA class II antigens Consanguineous parents
What are the symptoms of achalasia?
Dysphagia Weight loss Retrosternal pressure Recurrent chest infections Sensation of lump in throat Hiccups Heartburn
What are the signs of achalasia?
Regurgitation
Slow eating
Coughing while recumbent
Postural aid rqd while swallowing
What Investigations may be used?
OGD Barium swallow/ timed barium swallow CXR CT chest Oesophageal manometry Radionucleotide Oesophageal emptying studies
What may an OGD or Barium swallow show in someone with achalasia?
OGD- Obscured mucosa by frothy saliva, sigmoid oesophagus
(Timed) Barium swallow- Loss of peristalsis, delayed oesophageal emptying and transit, dilated oesophagus which tapers towards LOS
What may you see in a CXR or CT chest in achalasia?
CXR- Absence of gastric bubble or unusual oesophagus shape
CT Chest- dilation of oesophagus, potential wall thickening
