Did my doctor tell me in a subtle way that I have Achalasia?

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I have been having difficulty swallow foods, but liquids go down easy, with the occasional incident (like once in a while) where I guess the liquid hits something and i have to cough.

Today, I underwent an oesophageal dilatation. The doctor was also supposed to take biopsies but he did not. This is my second dilation. Last year, around March, I had the procedure and was fine until August, when I started having problems swallowing food again which got progressively worse to the point where I could not even eat oatmeal or mashed potatoes and had to blend all of my food.

Now I was half expecting him to find erosions, strictures, barrets, or something else, but he did not see anything.

While I was in recovery, still under the effects of the Propofol anethesia, the doctor that performed the procedure comes in, asks me how I am doing, and then tells me if I continue to have swallow problems they can do botox injects and ultimately there is a sugery they can do that involves cutting of the oesophagus.

I didn't think anything about it at first but after getting home and resting, I got on my computer and started doing some research and found that the only thing they treat with botox injections in the oesophagus and that surgery he was talking about...is Achalasia.

So now, I am wondering if this was his subtle way of letting me know that I indeed have Achalasia, especially with the cancelling of the biopsy which I believe he told me some foods can cause an allergic reaction where the oesophagus swells, causing difficulty swallowing.

I have a follow up with his nurse practitioner. During that follow up, I am going to ask her if that was his way of telling me that I do in fact have Achalasia. He had a manometry done before I had this procedure but I guess he never examined the results until today.

So...now I'm like, Idk. I was already beaten up because all I could do before the operation was fruit smoothies, ice cream, water, and blended soups like brocolli, carrot, or cauliflower soup. But if this is coming back again...in six months, like it did last time...

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5 Replies

  • Posted

    I'm no doctor, but I'll eat Heller Myotemy if you don't have Achalasia.

    Get thee to a gastroenterologist who specializes in esophageal problems. You want this done right. If this were me, I would not allow anymore dilations, nor botox, at least until you get information from a gastroenterologist who knows what they are doing.

    Keep me posted!

  • Posted

    I'd agree with 'meowspace'... sounds like a certain case of Achalasia (and possibly Diffuse Esophageal Spasm for good measure); that was the diagnosis in my case, with very similar symptoms.  I've not had balloon dilations or Botox treatment, but the operation (Heller's Myotomy) certainly improved matters with immediate effect.  My diet now is 'measured and managed', but not too limiting ;o)

    Hope you get a satisfactory resolution.

    Cheers,

    Mick

     

  • Posted

    You have had an endoscopy and manometry, and might perhaps have also had a barium swallow test?   It does sound like achalasia, but the label of a diagnosis can help rather than be a problem if it is the correct diagnosis.   It is not unusual to have a dilatation or two, or a botox injection - these can sometimes be relatively effective.   Sometimes they work for a signiifciant time;  sometimes they don't.   Yes, there may be surgery like a myotomy further down the line, and it would be important to try and get the best long-term solution applied as soon as possible after any further problems because repeated dilatations can tend to affect the texture of the lining of the oesophagus around the lower oesophageal sphincter and make surgery more difficult.   Surgery does sound scary, but if you need it, do not put it off because if you end up with a baggy oesophagus, that can make things worse in the long term.   You do need to have treatment from a specialist centre.   I think you are being sensible in working through this in your mind so that you can ask the right questions when you go for your appointment.
  • Posted

    Barium Swallow Xrays, Endoscopies rule out obstructions or narrowing problems with the esophagus but Manometry is the only test that will sufficiently diagnose Achalasia. I wouldn't undergo further injections or surgeries until that's done, you have a definite diagnosis and a doctor that makes sure you COMPLETLY understand what he's telling you, without Propofol. 
  • Posted

    Barium Swallow Xrays, Endoscopies rule out obstructions or narrowing problems with the esophagus but Manometry is the only test that will sufficiently diagnose Achalasia. I wouldn't undergo further injections or surgeries until that's done, you have a definite diagnosis and a doctor that makes sure you COMPLETLY understand what he's telling you, without Propofol.  A Gastroenterologist is who you should be seeing.

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