Achalasia can it mimic reflux
Posted , 4 users are following.
Can Achalasia mimic reflux. Can you still have reflux/sour taste even without normal pathological reflux.
0 likes, 10 replies
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Notes on Achalasia can it mimic reflux
AlanJM gaildutton
Posted
All of which is not a direct answer to your simple question, but you will have to have a medical examination / investigation to be sure.
cathy35794 gaildutton
Posted
Two different entities I know cause my Mom had it for many decades of her life. Sadly many in healthcare blame reflux as the cause it gives them an easy answer and usually some how blame the suffer. Reflux is a weakened or DAMAGED SPHINCTER that cause stomach acids to back flow up your esophagus . That can happen in over weight, over eating, bad diet,... Achalasia prevents solids and sometimes fluids from passing down into the stomach. There seems to be something wrong that interferes with the healthy movement in the esophagus and it spasms . Many blame it on stress and anxiety, but my experience the stress and anxiety comes when the person can swallow and feels like they are choking and can't move what ever either way. It helps not to get nervous and reassure the person, but if you feel as though you are choking that would give any normal human a feeling of panic! The sx are usually accompanied by chest pain and tell me that ain't scary. In truth most doctors really know very little, but pretend to be experts .doing a grave disservice to those who suffer. Personally I think it maybe a neurological thing like a hiccup . those who suffer. God Bless anyone who suffers from this scary disorder. A site like this one although it may not give you answers it may help you manage and know when someone is blowing smoke at you. I saw on here someone suggesting perhaps allergies . That would seem worth investigating after all when people get a bee sting who are allergic their throat swells!
gaildutton cathy35794
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Robert13450 gaildutton
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gaildutton Robert13450
Posted
Yes this is my real name. I do remember your name now. I have had 3 years of hell going through every doctor, consultant, private, NHS, tests galore, and have eventually told I may have Achalasia. Just had a Gastroscopy and awaiting a barium and my 6th PH study and Manometry. I was going to have Stretta but wanted to check it may make it worst. It could certainly make it worst if Stretta tightens the LES, when I assume Achalasia is because LES is opening properly. I am still awaiting full diganosis of Achalasia but I know I am having difficulty swallowing. I do have a constant sour taste in my mouth though and I have a irritated throat which I believe is from reflux. How are you, how were you diagnosed? Regards.
AlanJM gaildutton
Posted
For most people, the barium swallow test and manometry would be sufficient to diagnose achalasia, but there are all kinds of permutations and variations so the tests are sometimes necessary to diagnose exactly where the problem is.
?Most of the time with achalasia the lower oesophageal sphincter does not open properly, or hardly at all, causing food to back up in the oesophagus rather than pass through into the stomach. Opening this by surgical procedure (cutting the muscles) tends to make reflux worse, and that is why the procedure like Heller's myotomy also includes fundoplication to recreate the valve effect of the lower oesophageal sphincter (los).
?It is possible that you have reflux, because having the sour taste in your mouth and the irritation is consistent with that. And it may be that if the reflux has inflamed your oesophagus you then have difficulty in swallowing.
?The endoscopy may well have shown evidence of inflammation; if so, controlling the reflux would be a priority. This is usually done with medication, but not everyone responds well, so then you have the options like Stretta, which has been controversial. Linx is a magnetic bracelet that helps recreate the valve effect of the los. Or one can have fundoplication. But this all depends on whether the reflux is indeed the basis of your problem. Any restriction of the los to stop reflux going upwards might exacerbate the problem if there is also an issue of food moving downwards through the los, so you are quite right to be wary.
Does it make a difference if you take an alginate like Gaviscon Advance? This works for a few hours and creates a protective raft on the top of your stomach and you can get it from a pharmacy. If that gives you relief for a while and your swallowing improves, it would tend to suggest that the reflux is the problem. Have you been prescribed PPIs - proton pump inhibitors - like Omeprazole or Lansoprozole, and, if so, did these work?
gaildutton AlanJM
Posted
It would take me a year to explain the journey of my reflux/LPR over the last 3 years. To summarise, I had H Pylori and was treated by 2 x antibiotics. I still felt a little nauseous after the anti-biotics so they did a Gastroscopy. I now know the nausea was because I had Candida (no doubt from the anti-biotics) and bile in stomach. I also know with certainty that 1 - 2 days after the gastroscopy my symptoms started. I had never had reflux in my life until that point even when pregnant. My symptoms first started with breathing difficulties (which was later identified by and ENT to by a damaged larynx caused, he believed, by acid reflux). The journey continued with test after test, PH, Manometry, etc. the Manometry only ever showed some tertiary contractions and the last one this year showed high residual pressure of 16mg which was what stopped me having Stretta just in case it made it worst. The last PH study showed some weakly acid reflux but not pathological reflux.
I have tried all the PPIs they helped only the smallest amount and Gaviscon Advance did absolutely nothing. I started Amitriptyline after there was a suggestion that maybe the vagus nerve had been damaged during the gastroscopy (this is what I believe to this day). The Amitriptyline had an almost instant positive effect and my LPR type symptoms were reduced by about 70%. However over the last year my main symptom has been awful sour taste, throat irritation and hoarse voice, and more recently severe nausea.
I decided to seek out a private Consultant who had a good knowledge of Achalasia and lower and upper GI experience. He has currently carried out the Gastroscopy and I am awaiting the barium swallow and PH/Manometry studies (again!).
My own belief is that the original Gastroscopy 3 years ago started my reflux by causing the vagus nerve to stop sending the correct message to the LES/LOS, the continuing reflux I believe is likely to have caused some irritation/sensitive oesophagus leading to the swallowing issues.
I have seen 5 Consultants, 3 GPs, had 5 PH/Manometry studies, 3 x Gastroscopies, 1` x Barium and I am still without any definitive answer.
The nausea which is the most recent worsening symptom is unmanageable. Even a prescribed anti nausea tablet does not help. My reflux is noticeably worst immediately after eating.
It is all very confusing and exacerbating!
Thank you again.
AlanJM gaildutton
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AlanJM
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gaildutton AlanJM
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Thanks for your reply. I don't have Candida anymore, but yes I agree that the sphincter was definitely stretched/compromised during that first endoscopy 3 years, it is not co incidence that the reflux and all my problems started the day after the procedure.