Achalasia: How We Can Help

What Is achalasia?

Achalasia is a rare disorder where the muscle at the end of your esophagus fails to relax, resulting in the inability of food to pass into the stomach. It is thought to be secondary to damage of nerves in the esophagus. It can occur at any age but is usually diagnosed between ages 25 and 60.  Men and women are affected equally.

What symptoms may I experience?

The main symptom is trouble swallowing your food (dysphagia) You may also experience pain in your chest a result of food being stuck in your esophagus.  Patients also experience regurgitation of their food or saliva to varying degrees. Many patients have significant weight loss as a result. Patients may also experience heartburn or indigestion and may be misdiagnosed with GERD.

What tests should be performed?

There are a few tests required to make the diagnosis of achalasia. The first is an endoscopic gastroduodenoscopy (EGD) where a flexible lighted camera is passed into your esophagus by way of your mouth to allow for direct visualization. A swallow study (esophagram) is also useful to evaluate the extent of disease. Lastly, an esophageal manometry is completed which provides a definitive diagnosis and details of achalasia type (I-III).

What are your treatment options?

The mainstay and definitive treatment is to undergo myotomy, which stands for cutting of the muscle at the end of your esophagus. This can be completed with an open surgery such as a laparoscopic Heller Myotomy; but for the past 12-14 years the preferred and least invasive method is to undergo a POEM procedure.

Peroral Endoscopic Myotomy (POEM) is a minimally invasive endosurgical procedure for treatment of achalasia. During this procedure, the endoscope is used to create a small tunnel underneath the lining of the esophagus through which the inner muscle layer of the lower esophageal sphincter is cut. This relieves esophageal pressures and allows for the improved passage of food into the stomach.

How do you find expert treatment?

Dr. Pitea is one of two advanced endoscopists in the state of Arizona capable or providing expert level endoscopic management of achalasia. Since 2017, Dr. Pitea has performed over 450 Peroral Endoscopic Myotomy (POEM) procedures for patients with achalasia.

Please contact our office to schedule an appointment with Dr. Pitea or with one of our highly trained Advanced Practice Providers. We will review your records, discuss your symptoms, and order any additional testing needed prior to recommending and scheduling treatment.

We work hard to schedule our patients with achalasia in a timely manner as we understand the severity of symptoms, and desire to return to a normal life such as enjoying a meal with family and friends.  We also provide comprehensive post procedure care and expert long term follow up.

Author

Melinda Gutierrez, PA-C Melinda graduated in 2010 with her Masters of Medical Science in Physician Assistant Studies from Midwestern University in Glendale, AZ. She has practiced in the field of Interventional Endoscopy since 2017. Prior to joining our team, she practiced in the field of Cardiovascular Disease for seven years. Melinda has a passion for serving our senior population and deeply believes in the importance of patient education so that each of our patients can play an integral role in their own care. She is an Arizona native who enjoys spending time with her family, hiking and is an avid fan of Indycar racing.