Oesophageal achalasia is a motility disorder of the oesophagus as a result of disturbed peristalsis and incomplete relaxation of the LES manifested by difficulty in swallowing, regurgitation, and chest pain (O’Neill, Johnston, & Coleman 2013). In this regard, diagnostic evaluation is of great value as it is a challenge for clinicians to diagnose achalasia due to clinical manifestations being equivocal of the disease which can be attributed to other diseases, such as GERD or scleroderma (O’Neill, et al, 2013). Patients presenting with achalasia will all have a complete history taken to aid in the diagnosis (Constantini, et al, 1993) and according to Professor J. Windsor (personal communication, April 20, 2017), “it can usually take a period
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The appearance of narrowed gastroesophageal junction, the slow emptying of barium and absence of peristalsis are characteristics of achalasia (Allaix, et al, 2016).
The barium swallow defines the shape of the oesophagus and lower oesophageal sphincter (LES) and may also show increased peristalsis and spasm trying to overcome the LES that does not relax. This condition is called vigorous achalasia (Fisichella, Raz, Palazzo, Niponmick, Patti, 2008).
Oliveira, et al (1997) reported that in some cases, the barium oesophagram may not present anomalies especially in the early stages of the disorder. A radiologist’s objective interpretation will help establish a diagnosis. Otherwise, patients will be subjected to a further approach, such as the Timed Barium Esophagram (TBE) which involves ingesting a large quantity of barium and eventually, give objective evaluations to patients with achalasia post treatment.
Oesophageal …show more content…
Classic achalasia
2. Achalasia with compression effects
3. Spastic achalasia
This classification helps in treatment decisions, with Type 2 achalasia being the most responsive to Pneumatic Dilatation, Hellers Myotomy and Botox Injection, thereby having best outcomes in the palliative treatment of the achalasia (O’Neill, et al, 2013).
According to Alonso, Gonzalez-Conde, Macenlle, Pita, Vazquez-Iglesias (1999), the increasing use of the traditional and HR manometry, before and after treatments for achalasia, assesses the success of these interventions, while benchmarks for successful outcomes still have not been precise. Therefore, the success of manometry in general should be accompanied by a symptomatic interpretation of the favourable therapeutic treatment of
The appearance of narrowed gastroesophageal junction, the slow emptying of barium and absence of peristalsis are characteristics of achalasia (Allaix, et al, 2016).
The barium swallow defines the shape of the oesophagus and lower oesophageal sphincter (LES) and may also show increased peristalsis and spasm trying to overcome the LES that does not relax. This condition is called vigorous achalasia (Fisichella, Raz, Palazzo, Niponmick, Patti, 2008).
Oliveira, et al (1997) reported that in some cases, the barium oesophagram may not present anomalies especially in the early stages of the disorder. A radiologist’s objective interpretation will help establish a diagnosis. Otherwise, patients will be subjected to a further approach, such as the Timed Barium Esophagram (TBE) which involves ingesting a large quantity of barium and eventually, give objective evaluations to patients with achalasia post treatment.
Oesophageal …show more content…
Classic achalasia
2. Achalasia with compression effects
3. Spastic achalasia
This classification helps in treatment decisions, with Type 2 achalasia being the most responsive to Pneumatic Dilatation, Hellers Myotomy and Botox Injection, thereby having best outcomes in the palliative treatment of the achalasia (O’Neill, et al, 2013).
According to Alonso, Gonzalez-Conde, Macenlle, Pita, Vazquez-Iglesias (1999), the increasing use of the traditional and HR manometry, before and after treatments for achalasia, assesses the success of these interventions, while benchmarks for successful outcomes still have not been precise. Therefore, the success of manometry in general should be accompanied by a symptomatic interpretation of the favourable therapeutic treatment of