Achalasia Cardia Flashcard For Exam Fmg Neet Pg

Understanding Achalasia Cardia

Achalasia cardia is a rare and complex disorder of the esophagus that affects the ability to swallow food and liquids. The main issue is the inability to relax the lower oesophageal sphincter, which prevents food from passing into the stomach.

Types of Achalasia Cardia

Achalasia cardia is classified into three types:
1. Type I (classical achalasia)
2. Type II
3. Type III (vigorous achalasia)

Symptoms

The symptoms of achalasia cardia include:
- Dysphagia (difficulty swallowing) that affects liquids more than solid.
- Regurgitation
- Retrosternal chest pain
- Weight loss

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Assessing Severity

The Eckardt Score is used to assess the clinical severity of achalasia cardia.

The Eckardt Score is a clinical severity score used to assess the severity of achalasia.

The scoring system is as follows:
- Dysphagia:
    - 0: No dysphagia
    - 1: Occasional dysphagia
    - 2: Daily dysphagia
    - 3: Severe dysphagia
- Regurgitation:
    - 0: No regurgitation
    - 1: Occasional regurgitation
    - 2: Daily regurgitation
    - 3: Severe regurgitation
- Chest pain:
    - 0: No chest pain
    - 1: Occasional chest pain
    - 2: Daily chest pain
    - 3: Severe chest pain
- Weight loss:
    - 0: No weight loss
    - 1: Less than 5 kg weight loss
    - 2: 5-10 kg weight loss
    - 3: More than 10 kg weight loss

Investigations

Two key tests are used to investigate achalasia cardia:
1. Barium swallow: reveals a characteristic bird beak appearance.

2. Manometry: measures the high resting pressure of the LES.

Complications

If left untreated, achalasia cardia can lead to serious complications, including:
- Aspiration pneumonia
- Oesophageal cancer

Treatment

The Heller myotomy is currently considered the treatment of choice. Other options include:

- Pneumatic dilation
- Endoscopic injection of botulinum