What are oesophageal motility disorders?
Oesophageal motility disorders occur when the contraction in the oesophagus become irregular, unsynchronised or absent. It may be caused by issues in the upper oesophageal sphincter, the body of the oesophagus or the lower oesophageal sphincter.
Achalasia is one of the most common motility disorders, and is a neurological condition where there is damage to the nerves of the oesophageal wall. It also affects the lower oesophageal sphincter, which no longer relaxes effectively to let food pass through to the stomach. Food then builds up in the lower part of the oesophagus, which can cause stretching.
What are the symptoms of achalasia?
Symptoms depend on which issue you have, but can include:
- difficulty swallowing food and liquid,
- spasms and chest pain,
- vomiting and regurgitation of food,
- night-time choking.
What are my treatment options?
The first line of treatment is using medicines to control spasms and the acid. If that doesn’t work, surgery is often considered.
There are two main options: Heller’s Myotomy and fundoplication. These may be done separately or together.
In a Heller’s Myotomy the lower oesophageal sphincter is cut across to break the spasm and reduce the pressure of the blockage. It is the most successful procedure and can give long-lasting relief, however there is a possibility that it may not work and have to be repeated.
In a fundoplication a piece of the fundus (upper stomach) is wrapped around the oesophageal sphincter in such a way that it prevents the stomach acid from going into the oesophagus. It can be successful but can also cause other issues if it is made too tight.
Surgery can be performed laparoscopically (via keyhole) or with open surgery.
What happens after the procedure?
Whether you had the surgery laparoscopically or via open surgery will determine how long you spend in hospital. This is normally one day to a week. Recovery will take 2 to 8 weeks.
Your surgeon will advise how long you’ll need to take pain relief and when you can resume normal duties. A follow up appointment will check that the wound(s) are healing as expected.
What if I have more questions?
Remember to talk to your surgeon about any questions you may have; they’ve done this many times and can help alleviate any anxiety you may have.