Achalasia: A Swallowing Disorder
My Son at 13 Years of Age
A rare swallowing disorder, achalasia, is not very common in young people. However, my son was diagnosed with this esophageal motility disorder at the age of thirteen. At first, our family doctor thought that his symptoms were caused by stress from school and social pressure. Not the case.
What Is Achalasia?
When you eat or drink anything, it goes down your esophagus from your mouth to your stomach. There is a valve (sphincter) between the esophagus and the stomach that opens and closes. When one has achalasia, this valve does not do what it is supposed to. There is a malfunction in the nerves, and when it does not open, it causes the food or drink to come back up.
Our family doctor sent my son off to a specialist to have testing done. The first one was a barium x-ray. You drink a liquid then have your esophagus x-rayed. This will show if your esophagus is dilated—meaning enlarged or widened then narrowing on the lower end—and if the barium solution stays in the esophagus longer than average before going into the stomach. If so, achalasia is present.
The next test was pretty horrific for a thirteen-year-old to have to endure—an endoscopy. The way in which this is done is a tube with a camera is put down the throat and into the area where the valve (sphincter) is between the esophagus and stomach. He was given something to help him relax but was fully awake for the procedure. It did not look like a very pleasant experience.
Then, the esophageal manometry test was done, and this is quite similar to the last test. This measures and records muscle contractions while you swallow. For someone without achalasia, there would be pressure waves recorded.
After the above three tests were done, it was back to the family doctor to find out that my son did indeed have achalasia. The next step was to go see a gastroenterologist, who was a three-hour drive away from our home. After going to the appointment, much to our disappointment, my son had to go through all the same testing again as the specialist wanted it done in his own hospital.
Treatment for Achalasia
There are three types of treatments available for achalasia. My son tried two of the three.
- Botulinum toxin injection
- Balloon dilatation
The Botox Injection Only Worked Temporarily
First was a botulinum toxin injection. An injection into the esophagus by an endoscopy is done to relax the muscle in the sphincter to allow food to enter the stomach. This worked for about one week until the symptoms returned.
The Balloon Dilatation Did Not Help
Second was a balloon dilatation. A balloon is inserted by an endoscopy into the sphincter and blown up to enlarge the opening. In most cases, this works and needs to be repeated every few years. However, it did not work for my son.
Surgery Was the Last Option—We Chose to Opt Out
There was a third option which was to have surgery done. This is where they go in and cut the sphincter. It was explained to us that if my son was to have this done, there could be problems down the road. They told us that if he were to have too much to drink, say at a party, and need to throw up, he might just have to have his stomach pumped. My son, by this time, was seventeen. All of these doctor visits and procedures took almost four years. He decided to live with the achalasia rather than have the surgery done.
He is now twenty-five and still has the same problem but puts up with it. He eats foods that will go down easily and always has a glass of water in front of him every time he eats.
The treatments do help some people, but there is no cure for achalasia, and normal functions never return.
I wanted to add that I am in no way an expert on any medical conditions. I have tried to explain here, in layman's terms, what achalasia is and how it affected my son.
© 2011 Susan Zutautas