Could me GERD actually be Achalasia

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I was diagnosed with gerd over a year ago. I have my ups and downs. Recently I have been having this problem where food and liquids are being regurgitated soon after eating and sometimes up to a few hours after. I have had the following tests done in the last year:

Endoscopy

Chest X-rays

EKG

Blood works

Stomach ultrasound

Is there any way that I could actually have Achalasia? The internet fills me with fears about my health. Thanks.

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  • Posted

    Hi Nick, those tests should have given you a reasonable indication as to whether you have achalasia. There are variations in this condition and no one person has identical symptoms to others.

    Try to stay calm as being agitated will only worsen the symptoms whatever is ailing you. Perhaps if you get your GP to prescribe a small dose of Valium (say only 2mg tablets) as these may help both your mental state and your regurgitation.

    If you have a variant of achalasia it is likely that you have a blockage in your esopgagus, either the lower esophageal sphincter (LES) or higher up in the esophagus and your test should have revealed this. Most likely the LES is not functioning properly. Ask your doctor(s) about these questions.

    I would not rush things, especially surgical options. Research managing your condition as there are ways to do this. Try medications that keep a lid on regurgitated food or liquids, such as Gaviscon (liquid or tablet form), don't sleep prone but raise your head and torso slightly, manage your diet avoiding spicy food and possibly use meal replacement protein shakes. You could research the use of medications that have the effect of relaxing the LES such as Phenergen and even a carbonated drink before an evening meal (the idea being that they make you burp this opening the LES to expel gas but at the same time allowing food remaining in the esopghus to pass into your stomach). The question remains as to whether the regurgitation of food and liquid is resulting from trapped food/liquid in your lower esophagus or from the LES actually not closing properly allowing stomach content to pass back into your esophagus. Find the answer to that question and you may be on your way to making your symptoms less difficult and choosing a path of action.

    Good luck and let us know how you get on. Remember though stay calm, try to be rational and get answers to underlying causes and in the meantime research possible alleviating approaches and be innovative. Don't be dismayed if after reasonable trial period one approach, one medication or self help does not provide dramatic improvement, you will get there. Cheers.

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  • Posted

    Hi Nick, 

    looks like good advice below. GERD can cause swallowing / regurge issues. I suffer from Achalasia myself, but I have a friend whom had GERD and encountered similar issues to you. He decided to get back into running to focus on something. The GERD/other issues completely disappeared after 6 months, and have not been back. I have heard of many similar stories. There is nothing like cardio exercise to aid digestive issues; unfortunately it doesn't directly apply to Achalasia as this condition is probably more nerve/motor related. 

    Best of luck and healthy karma! 

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    • Posted

      Thank you. I have taken up yoga classes 3 times a week and joined lifetime fitness this week. I am also on lexapro now which has improved my right neck muscles and anxiety to some degree. I still burp up my lunch, but that is the only meal now that doesn't stay down.

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    • Posted

      Thank you. That is great advice. I've already implement significant lifestyle changes this week

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  • Posted

    The way of diagnosing achalasia is normally by means of a barium swallow test and often manometry that measures the pressure at various points down the oesophagus.   I am not sure how long the time period is before regurgitation, but it may be feasible that the barium swallow would illustrate what is happening.

    ​The endoscopy would probably have noted any tightness in the lower oesophageal sphincter, the valve between oesophagus and stomach, and may well have noted food residue that had not passed through.   The endoscopy would have detected any abnormal obstructions in the system.

    When you say regurgitation, I presume you mean that this is undigested food that has not been vomited up from the stomach.   And is the rest of your digestion system working properly (stools / diarrhoea etc).

    If things continue to cause trouble, then further tests might result in a diagnosis.   Trying to become more relaxed is easier said than done, but it may well help.

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    • Posted

      Yours is probably the most comprehensive post I have read,concerning diagnosis of Achalasia.  I had never heard of it until a few weeks ago!  I have been suffering from similar symptoms to those described in this posting for about 3 years, but during the past 12months , have also had choking spasms. This is very frightening. As a result of regurgitation ,and choking, acid and food particles have leaked to lungs, and I have had pneumonia on two occasions.  I first consulted my GP on advice from my dentist--- I would wake in the night, coughing and with a burning in my mouth. It got so bad that the enamel has been destroyed on my teeth!  Doctor just thought it was reflux, but when I started being sick and had problem swallowing food, lost 18 lbs in weight, I was referred to gastroenterologist.  I have had CTscans, PH twenty four hour monitoring, and monometry ,(which my doctor says is the Gold Standard test and the only way to be certain that it is Achalasia and not GERD)  and the result shows that I definitely am suffering fron Achalasia.  I am having a barium swallow this week to help decide the best way forward for me.  My surgeon has told me of botox injections, but I wonder if it's worth it as they give only short term relief.  Has anyone had long term benefit from them ????  He has also mentioned surgery, but as this disease is progressive, I want to put off surgery as long as I can.  Sorry that this is a long posting, but I have so many questions to ask....does any one else become very hoarse? I sometimes wake up and can hardly speak.

       

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    • Posted

      The reflux can indeed affect the enamel on your teeth, and the reflux can also affect your voice.   I think this may be because of the vocal cords getting affected.

      I think the best thing to do is to wait until all the tests have been done.

      Sometimes botox injections can work temporarily, and this sometimes gives the system time to recover.   They are (relatively) quick and easy, but the general trend os for the benefits not to last for very long.   But it can be a good option when surgical procedures are not possible.

      ?A dilatation / stretch can be helpful and sometimes this can give relief for quite a long time (but sometimes for only a relatively short period).   Neither of these procedures close off any options for the future as long as you do not have too many stretches, which can make the flesh fibrous and not so receptive for future surgery.

       

      ?If you are inhaling reflux into your lungs you do have a significant health problem.   The longer you leave it, the worse things migt get, and your oesophagus might get 'baggy' and that much less suitable to take a definitive surgical procedure.  

      So first of all pay attention to the advice of your surgeon.   Don't necessarily go for the simplest, easiest procedure;  go for what will give you most chance of long term relief.  

      Achalasia does not get 'cured' as such, so to that extent it can often be progressive.   The procedures are designed to relieve the obstructions so that gravity can help the digestive process.   The cause is to do with the nerve endings that control the muscles of the peristaltic function (ie pushing food through through the system) and there might feasibly be an issue of whether these nerves / muscles get 'trained' into misbehaving over time, but this is a bit of non-qualified speculation on my part.

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  • Posted

    You need a baruim test done and that will be the 1st sign. Sounds like you could . Watch what you eat ! 1st slow small bites ,pieces, no large chunks, with fluid when you eat. And eat small frequink meals.Good luck
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