Dr. Eisner on Achalasia and Acid Reflux (GERD)
What can be done to treat Achalasia and Acid Reflux (GERD)?
Achalasia is a primary esophageal muscle disorder in which the valve between the esophagus and stomach fails to relax, and the esophagus does not appropriately contract. The most common symptoms are difficulty swallowing, regurgitaion and chest pain. treatment includes medications such as Calcium channel blockers and nitrates to decrease the pressure of the valve. Another type of treatment involves doing an endoscopy, and injecting botulinum toxin (BOTOX) into the valve in an attempt to decrease the pressure. A dilation of the esophagus through a scope is another option as well. Finally, although invasive, because of excellent results, a short hospital stay, and a fast recovery time, the primary treatment is considered by many to be a surgical repair with a laparoscopic Heller myotomy and partial fundoplication. If you do have Achalasia, check with your doctor for your best treatment option.
As far as acid reflux is concerned, there is a wide range of treatment. Initially, you may try dietary measures such as avoiding foods that typically induce reflux. This would be those products containing caffeine, chocolate or peppermints. Elevating the head of the bed with either pillows or cinder blocks can help as well. Most importantly is not to lie flat for several hours after a meal. If those measures don't work, then medical therapy with antacids, H2 blockers and proton pump inhibitors, sometimes in combination, are started. Medications that help empty the stomach are beneficial, but do have side effects. As a last resort, surgery can be considered, but usually is only effective in those patients that respond to medical therapy as well. The rationale for surgery would be to avoid a lifetime of expensive medications. You should check with your doctor to see what the best treatment option for you would be.