Rare disorder in food pipe can mimic heart attacks Dr Vikas Singla

New Delhi: Esophageal Manometery is a test to diagnose one of the rarest motility disorders in the esophagus when its functioning is impaired. The rare condition known as Achalasia, involves complaints of difficulty in swallowing, sensation of food or water getting stuck in the chest, chest pain (which can be sometimes mistaken for heart attack), regurgitation of food and weight loss.

Diagnosis of achalasia begins with a careful medical history focusing on the timing of symptoms and eliminating other medical conditions that may cause similar symptoms. Endoscopy, which is used to look directly into the esophagus can be normal in achalasia. However, endoscopy can detect tumors of the esophagus which can mimic achalasia.

“A ring of muscle called the lower esophageal sphincter encircles the lower esophagus just above the stomach. This sphincter muscle when contracts, closes the esophagus. When the sphincter is closed, the contents of the stomach cannot flow back into the esophagus. Backward flow of stomach contents (reflux) can irritate and inflame the esophagus, causing symptoms such as heartburn. The act of swallowing causes a wave of esophageal contraction called peristalsis, which pushes the food along the esophagus down into the stomach. Normally, during peristalsis, esophageal sphincter relaxes to allow the food into the stomach. In achalasia, which means failure to relax, is a rare esophageal motility disorder in which the normal esophageal peristalsis and the lower esophageal sphincter relaxation are impaired.” Said Dr. Vikas Singla, Director & Head, Gastroenterology, Hepatology & Endoscopy, Max Super Specialty Hospital, Saket, New Delhi.

Such ailments need to be diagnosed correctly, for which a test known as Esophageal manometry is used. The procedure involves passing a thin tube through the esophagus to assess the contraction and relaxation timing during swallowing. Max Superspeciality hospital is one of the very few centres in India to perform manometry along with an incisionless endoscopic procedure to treat Achalasia.

“The non-invasive endoscopic procedure known as Per oral endoscopic myotomy (POEM) is one of the latest treatment modules for patients with the complaints of Achalasia. Being a scarless procedure it is highly safe and provides excellent long-term results with a minimal hospital stay. The procedure is followed by an X-ray after 24 hours and the patient can be put on liquid diet initially.” He added