The Pulse | Wednesday, February 13, 2019

Word of the Week: Achalasia

This week we are highlighting “Achalasia” as the Word of the Week. As always, all of the terms and definitions are sourced from our very own SGNA GI/Endoscopy Nursing Review Course Certification Study Manual, 3rd Edition (2016).

Achalasia (esophageal) occurs when the nerves in the esophagus that affect muscle contractility and relaxation fail. It is caused by a defect of peristalsis in the esophageal body and elevated lower esophageal sphincter (LES) pressure. It causes food to remain in the esophagus for long periods of time increasing the diameter of the esophagus to appear colon-like with a narrow distal end resembling a "bird beak."

Symptoms:

• Dysphagia
• Chest pain
• Cough
• Nausea and vomiting of undigested food
• Weight loss

Diagnostic tests:

• Barium swallow
• Esophageal manometry to determine lack of contraction
• EGD to rule out abnormal growths and/or scarring

Treatment:  aimed at relaxing the contraction of the LES

• Medications
• Botulinum toxic injection (Botox)
• Achalasia balloon dilatation
• Heller's myotomy (surgery to cut the LES muscle).