Are the Botox and balloon test necessary and are they painful?

Hi I had botox and ballon test ask to be heavily sedated and you wont be aware of the procedure i then went onto have surgery which was successful by the time i had surgery i could not even swallow my saliva i had surgery at St Thomas's london in 2012 and i can eat most things just have to be careful with bread pasta and meat i put on the 3 stone i lost and would recomend the surgery

Did your surgeon do all the tests? Like the barium swallow and the PH manometry? I've had my esophagus stretched twice and Botox twice. It didn't hurt either time. The problem did get worse for about a week after the Botox, but settled down and I was better (not cured.)

Last time my doctor cut a "ring" out of my esophagus. My esophagus has completely closed and I felt like I had become the star of some horror movie. Walking around spewing food and liquid without any control.

We had intended to do the POEM, but the situation called for immediate action at the time. I'm learning to be different at the moment.

Stretching and Botox should be find for starters. Good luck!

I'm assuming "the balloon test" you speak of is Esophageal Manometry. I passed on the Botox injection in that I understood it to be a temporary fix. If you haven't had Manometry testing I dont know how you can move forward towards answers and maybe needed surgical correction.

Esophageal Manometry is a nasogastric tube that is inserted and runs down your esophagus. It is set up to take pressures in your esophagus as you swallow sips of water. It's not super painful, but I have such an active gag reflex that I had to be sedated to get the tube down. They woke me enough to do the sips of water without choking to finish the test.

I pray that your doctors are actively assisting you in getting answers and much needed and awaited relief! Stay after the constant pursuit of answers and help!

Botox and balloon dilation are not tests but treatments for achalasia. Bit uncomfortable but you will likely be mildly sedated and would not describe as painful. Manometry is the diagnostic test. Can't comment on surgical options as fortunate to have disease under control.....after almost 35 years.

I was diagnosed with Achalasia "jackhammer esophagus". Heller Myotomy with fundoplication in 2014 and in 2016 needed to have the POEM along with a few medications and behavioral adjustments, I've been doing fairly well. But needed Endoscopy and results from Myotomy to get that process going.

I didnt get any relief until after Heller Myotomy in 2014 and in 2016 POEM.

Nothing else worked. Here we are almost to 2020 and with some minor medication and eating and behavioral adjustments I've been doing pretty well.

Prayers and fingers crossed it will continue. Nothing else to do.

Getting back to your original questions, the way in which the surgeon would be able to establish a diagnosis is firstly an endoscopy, or miniature camera passed down your throat to see whether there is any physical / visible reason for the problem. People often have a sedative for this, and that normally avoids any discomfort or pain. Secondly a barium swallow test involves swallowing a white liquid whilst being filmed on an X-ray machine. This sometimes also involves swallowing a series of things with different consistencies (eg a marshmallow) to observe how your swallowing function is working.Not normally painful at all, but there may be very slight discomfort. Thirdly a manometry test measures the pressure exerted by the muscles at various points down the oesophagus. It can be uncomfortable. This is the process of peristalsis, the way muscles propel food down into your stomach.If these tests have all been done then it may well be possible to reach a diagnosis of achalasia with confidence.It is not always possible to conduct the manometry test properly as the tube sometimes does not pass through into your stomach.

It really is important that the tests are done before a diagnosis is reached. It is possible that you may have something other than achalasia. These conditions are no always straightforward, and sometimes a prudent surgeon may recommend having a dilatation first to assess how that goes before committing to more major treatment.

As stated above the dilatation, botox or myotomy /POEM are treatments that are subject to judgements according to the details of the tests and how serious your condition is. Some people have a dilatation every so often and cope with that. For others a definitive surgery is more appropriate straight away.

A dilatation is done with the same endoscopy instrument and the balloon stretches the lower oesophageal sphincter muscles to make them relax more and allow food to pass through better.

All of this emphasises the importance of asking these questions direct to your surgeon, whether further tests should be carried out and/or whether you should be referred to a specialist Upper GI centre if you are not attending one already. If in doubt go back to your GP for a more specific referral.

I hope this helps

AlanJM ! Very well stated!

Agree 1,000%

Dear all: Thank you very much for your comments. I have done all the tests(barium swallow and the PH manometry )and I am heading towards a Heller myotomy with fundpilcation. However, it is extremely slow to get one, the surgeon wants me to do the botox and ballon first before even put me on the waiting list

Dear all: Happy New Year to you all. Thank you for your replies.

I originally plan to get a surgery from you as soon as possible but my doctor said that I need to try Botox first at this moment. However, according to the secretary of that doctor , it will not be possible for me to have a Botox until after my consultation appointment at the end of Jan. Tired of waiting, I am thinking of finding a private doctor in greater Manchester area to have the Botox asap. Also according to my humble knowledge, the Botox injection should not be undertaken by a surgeon, rather it is taken by a gastrologist? Also, do I have to have a gastroscopy in order to have Botox ( do these two go together) , or can I just have Botox directly without gastroscopy?

If any of you can help me with these questions, I would be very grateful.