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Oesophageal Achalasia

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ramgobind
ramgobind

My daughter in law age 36 year was been diagnosed with Achalasia cardia. After unsuccessful in balloon therapy She was operated by  laparoscopically (myotomy) in 2008. Now again problem started from last one month and doctors has diagnosed by Barium swallow test and Endoscopy that it is recurrence of Achalasia cardia. Now she is taking allopathic medicines and doing all normal activities.

I need advise for best medical treatment in this case preferably without operation.

0 likes, 5 replies

5 Replies

  • Dr_Reg
    Dr_Reg ramgobind

    Posted

    25 mg phenergen before evening meal and glass of sodium bicarbonate immediately before meal.
    • Dr_Reg
      Dr_Reg

      Posted

      Phenergen should be taken about 2 hours prior to meal to have desired effect.
  • AlanJM
    AlanJM ramgobind

    Posted

    Sometimes the myotomy surgery needs to be revised and it would be sensible to consult the original surgeon about why this has happened, and exactly where problems are occurring, ideally with high resolution manometry. If you are not happy with the diagnosis, you can always ask for a second opinion. Further surgery would need to be carried out by a very experienced surgeon.
    • ramgobind
      ramgobind AlanJM

      Posted

      @OPA_AlanM.Thanks for your response. The surgeon who has done surgery has suggested that some time reccurrance of problem happen and suggested for POEM. What is your opinion for POEM beeing new process and not yet fully establish. However now  following medicines are taken before meals: calcigard-10 and Domperiodone & Cinnarzine Tablet. This has given relief and normal diet can be taken. Can you please advise how long this medicine can be used and side effect if any.
    • AlanJM
      AlanJM ramgobind

      Posted

      I am not medically qualified so I cannot give you formal advice.   You should ask your surgeon about POEM and what experience there is a) about undertaking POEM after earlier myotomy surgery, and b) what would happen in relation to stomach acid reflux after the surgery, including whether you would have to be on PPI medication for the rest of your life.   POEM is indeed a new procedure, and involves cutting the muscles within the lining of the lower oesophageal sphincter, but without a fundoplication wrap to re-create the valve effect of the lower oesophageal sphincter.   It is possible that the problem has occurred in relation to muscles affecting peristalsis higher up the oesophagus than first envisaged at the time of the first surgery, but the surgeon will tell you whether this is so or not.
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