Achalasia

Achalasia is a condition whereby the oesophagus loses “peristalsis” or the ability to push food down into the stomach. In addition, the valve at the bottom of the oesophagus becomes excessively tight and won’t let food pass into the stomach. When patients develop Achalasia the have difficulty swallowing solid food, often find that they regurgitate food when they lie down and can get spasms of severe chest pain. Achalasia is diagnosed by Manometry in our lab. There are different types of Achalasia and different treatments available.

Achalasia Treatment

We offer various Achalasia treatment options:

• Botox Injection – At endoscopy Botox can be injected into the lower oesophageal valve or sphincter making looser and allowing people to swallow better. This treatment works in about 60% of patients, but we only recommend it in patients who are to frail for other therapies as it only works temporarily and it creates scarring which can increase the risk and women the results from other procedures.
• Pneumatic (Balloon) Dilation – This therapy uses a balloon to rupture the lower oesophageal sphincter muscle, it is effective but usually needs repeating 2-3 times. Each time the procedure is performed there is a 1% chance of rupturing the oesophagus. This therapy is not as effective beyond 3-5 years as other procedures, so is not our preferred choice for patients who are likely to live longer than this.
• Laparoscopic Heller Myotomy – This keyhole operation takes about 1 1/2 hrs and requires a 2 day hospital stay. Laparoscopic Heller Myotomy has the best known results (15-20 years) and is straightforward to perform. The major complications rate is 1%.
• Per Oral Endoscopic Myotomy (POEM) – This procedure is an endoscopic way of performing a Heller Myotomy. It takes longer to perform than the laparoscopic procedure but has similar risks. Long term outcomes are not as well known, and it likely carries a higher risk of long-term reflux than a Heller Myotomy. This is the preferred therapy in patients with a very complex disease and recurrent or persistent symptoms.

This practice may be the only in Australia with experience in all four treatments, so we will be happy to offer you the therapy that best suits you rather than having to settle for a narrow range of options.