What is Achalasia?
Achalasia is an esophageal motor disorder characterized by sustained lower esophageal sphincter(LES) contraction and reduced esophageal peristalsis. This pathology eventually results in symptoms like dysphagia, regurgitation, and occasional chest pain related to food intake.
What are the causes of Achalasia?
Achalasia is thought to happen when the nerves in the esophagus become damaged and stop working properly, which is why the muscles and ring of muscle do not work.
This is an uncommon disorder of unexplained etiology, however viral, autoimmune, and neurodegenerative causes are often afflicted to its manifestation.
As per the current state of knowledge, achalasia is considered to be a chronic incurable condition. The treatment options offered here primarily aim at reducing the tone of the lower esophageal sphincter by pharmacologic, endoscopic, or surgical means.
Achalasia can be diagnosed monometrically by identifying insufficient relaxation at LES, radiographically by observing the loss of peristalsis, esophageal dilation, and minimal LES opening causing bird's beak appearance and also by seeing poor emptying of barium in a barium swallow study. It can also be diagnosed endoscopically by seeing the dilated esophagus, with retained saliva, liquid, and undigested food particle in the absence of any stricture or tumor.
Achalasia occurs equally in men and women. The peak incidence occurs between 30 and 60 years.
what is the pathology of Achalasia? The pathological consequence of the disease is the degeneration of ganglionic cells in the myenteric plexus of the esophageal body and LES. Although the cause of the degenerative process is unclear, the end result of the inflammatory process is the loss of inhibitory neurotransmitters, nitrous oxides, and vasoactive intestinal peptides and, consequently, the imbalance between the excitatory and inhibitory neurons. The result is an unopposed cholinergic activity that leads to incomplete relaxation of LES and reduced peristalsis due to loss of gradient along the esophageal body.
Ayurvedic review of AchalasiaA delayed peristalsis resulting in delayed emptying of the esophagus is understood as a vata abnormality in Ayurveda. Deglutition, movement of the food in the intestine, and defecation are considered to be a function of Vata. Any abnormality in these functions, therefore, is supposed to be originating because of derangement in vata. A spasm and subsequently derived pain is also considered an outcome of Vata derangement in Ayurveda. Ayurveda does not describe any specific disease entity resembling that of achalasia, but essentially the symptom complex is that it can easily be inferred in terms of Ayurveda.
