Achalasia is a disease of unknown cause, which develops as a result of the destruction of nerve cells, which causes the muscles in the esophagus to function abnormally. In the disease, there are no regular muscle contractions in the esophagus, which are normally necessary for pushing the food into the stomach, thickening of the muscles, abnormal pressure increase in the esophagus and esophagus-stomach junction, and relaxation disorder. Associate Professor of Gastroenterology. Dr. Erdem Akbal points out that the ingested food has difficulty in being pushed towards the stomach, deteriorates in its passage to the stomach and begins to accumulate in the esophagus.
How does achalasia develop?
Although the disease is a slowly progressive disease, the rate of progression of the disease may vary from person to person. It is a disease that can be seen in all age groups, although it is more common in young adults and middle-aged groups.
What are the symptoms of achalasia?
Difficulty in swallowing after eating is the most important finding. There may be a feeling of getting stuck and blocked by food in the chest, a feeling of discomfort in the chest, food coming back from the mouth, lung infections, bad breath and chest pain as a result of escaping into the lungs. Since the complaints are similar to reflux disease, sometimes there may be delays in the diagnosis. The majority of achalasia patients are patients who have been treated for reflux for many years. Therefore, in addition to other findings, achalasia should be considered in patients who do not respond to reflux treatment.
Can achalasia be treated endoscopically?
The most advanced endoscopic treatment methods in the world are now successfully applied in our country. In our center, endoscopic applications are performed without the need for surgery in achalasia using advanced endoscopic systems. Endoscopic method known as Peroral Endoscopic Myotomy (POEM) is applied in achalasia disease.
What is the POEM method in the treatment of achalasia?
It is the most effective method used in the treatment of achalasia today. With the POEM method, which was first developed by the Japanese and applied in only a few centers in the world, the problematic muscles in the esophagus are cut by entering through the mouth as if normal endoscopy is performed. The muscles in the esophagus affected by achalasia are intervened endoscopically, allowing the patient to eat again.
Since the procedure is performed endoscopically, there is no incision in the body and discharge is provided in a short time. 1 day after the POEM procedure, which lasts approximately 1-1.5 hours, the patients start to eat and are discharged on the 2nd day.
Can POEM be applied in patients who have undergone balloon-botox/surgery before?
POEM method is also used in newly diagnosed patients who have not received any treatment before, as well as in patients who were previously ballooned due to achalasia, received botox treatment or underwent surgery but whose complaints did not regress/relapse.