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medicalmeds.eu Gastroenterology Cardia achalasia

Cardia achalasia


Description:


The achalasia of the cardia is the chronic disease of the neuromuscular device of a gullet which is characterized by disturbance of reflex opening of the lower sphincter of a gullet at an entrance to a stomach during swallowing. It is followed also by disturbance of peristaltic movements of a gullet. As a result passing of food to a stomach is at a loss.


Cardia Achalasia symptoms:


The achalasia of the cardia arises at patients of any age and develops gradually. The patient is disturbed by vomiting by just eaten food without signs of its digestion. There are pains. Pain can be the first symptom of a disease. Character their most various: from diffuse thorax pain to the place which is precisely specified by the patient. Pains can give to a shoulder, a neck, a shovel, an ear, etc. Painful feelings appear after food, but rather often pains can not depend on meal. Eventually the pain syndrome decreases. The patient can complain of feeling of untimely receipt of food to a stomach. Some patients precisely specify the place of a delay of food on the front surface of a thorax.

Often patients apply various ways to facilitate penetration of food into a stomach: drink off a large amount of liquid, incline or reject a trunk, hold hands a neck or a breast. Regurgitations or regurgitation appears right after meal in the beginning, then gradually, owing to expansion of a lower part of a gullet the increasing volume of food collects there. This food is ruminated already later. But in this case the large volume of food is ruminated at once. Such state is called sometimes esophageal vomiting. Unlike usual vomiting, otrygnuty food masses represents the chewed food without signs of its digestion in a stomach. Regurgitation of food can lead to its throwing parts of a food lump in a trachea and further in lungs. There are inflammatory diseases of lungs, aspiration pneumonia. Sometimes the patient has complaints to a persistent hiccups. Often the achalasia of the cardia is followed by locks.

Distinguish four stages of an achalasia of the cardia:
Initial stage or stage of the functional alternating spasm. Narrowing of the lower sphincter of a gullet (cardia) and expansion of the gullet over the cardia are absent. Difficulties at a proglatyvaniye of food occur periodically.
This stage is called stable. In this case there comes the constant (stable) spasm of the cardia. The gullet over the cardia is slightly expanded. Complaints at the patient become constants.
In the third stage there occur cicatricial changes in fabric of the lower sphincter of a gullet. The sphincter is exposed to a sklerozirovaniye, loses the elasticity and cannot reveal completely. The gullet over a sphincter sharply extends.
The fourth stage is a stage of complications. The stenosis (narrowing) of the cardia is expressed sharply. The gullet over the cardia is expanded considerably. There are inflammatory phenomena in a gullet wall (esophagitis), necrotic ulcers on gullet walls. The inflammatory phenomena can extend to surrounding fabrics. There is a mediastinum inflammation – a mediastinitis.

Ахалазия кардии при рентгенконтрастном исследовании

Cardia achalasia at a X-ray contrast research


Cardia Achalasia reasons:


Cardia achalasia origins are up to the end not established. It is considered that the achalasia of the cardia arises owing to a mismatch of the nervous regulatory mechanisms which are responsible for the peristaltic movements of a gullet and reflex disclosure of its lower sphincter when approaching to it of a food lump. Some researchers consider that in developing of a disease the large role is played by disturbances of food, especially insufficient receipt with food of vitamins of group B.


Treatment of the Achalasia of the cardia:


Endoscopic balloon dilatation (expansion) of the lower opening of a gullet (cardia) is applied to treatment of an achalasia of the cardia. At the same time enter the endoscope with a special cylinder which then is inflated into a gleam of the lower sphincter of a gullet and the cardia extends. In most cases this method is effective, but in certain cases the procedure should be repeated. If this way does not help, carry out an operative measure.




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