Managing Achalasia after surgical treatment?

Posted , 4 users are following.


So I have had Achalasia type 2 for about 3 years now and was treated with a Heller Myotomy with a fundoplication back in May 2019. So far there has been a big improvement, I'm not having food stuck in my throat and food does move into my stomach (some times, I'll bring this up soon). I can go to bed now and not worry about choking in my sleep from the food stuck in my throat. I'm still getting some minor difficulties with liquids moving down my throat and I usually have to resolve this with burping. Solids can move down okay and after a few swallows, a piece of food might get stuck - once again burping to resolve this. With reflux, I'm barely getting any which I am happy with. Regurgitation is a sometimes but not very noticeable, much better than what it was. Heartburn controlled with Gaviscon and a back up of omperazole if needed. Chest pains controlled by paracetamol and about the same, so no change there.

So I just wanted get other peoples opinions around the condition and experience, so just a few questions:

If you've had the surgery how have you been since - any ongoing symptoms where solids and liquids still get stuck?

Does anyone else need to burp to relieve the stuck feeling in the throat?

Does anyone know how to improve the throat contracting, so swallowing can be improved?

If I think of any other questions, I'll leave them in my comments.

Many thanks.

1 like, 10 replies

10 Replies

  • Posted

    i had my Hellers nearly 35 years ago and it was a great success. take time with eating and try not to stress too much. stick to easily digested and swallowed foods for a month or two, fish, cheeses etc and avoid things like steak or sausages which caused problems in the past until you are eating comfortably again.

    there were no drugs like Omeprazole when I had my op, just Gaviscon. I was prescribed Omeprazole morning and late evening andthat controlstheinevitable reflux really well.

    However, I now have some swallowing difficulties again and my oesophagus does go into spasm from timeto time. i have no motility in my oesophagus at all so need to drink water with my meals and my diet has become a bit more limited.

    Good luck with your recovery

    • Posted

      Since my op, it seems like I have bad days and good days depending what I eat or when the spasms flair up. I'm keeping my chin up and not letting this get to me.

      Thank you for telling me your experiencing.

      Stay strong!

    • Posted

      I think it is always a good thing for your situation to be reviewed by a specialist even (or especially) after a long period. When you say 'depending on what I eat' this may give a clue as to what foods might cause you trouble. Keeping a food diary may be helpful.

  • Posted

    It is great that the procedure has been successful; around 85% of patients report improvements like yours but it is often the case that some foods continue to give problems or that people sometimes get spasms afterwards. The surgery does not really cure the condition, but does make it easier to cope with life and makes it less uncomfortable.

    There is now a HealthUnlocked community for Achalasia Action that you can google to see what others think.

    • Posted

      Thank you for the reply.

      I will have a look into the community and look for advise from there as well.

      Many thanks again.

  • Posted

    Thank you for the advise and feedback, its all appreciated.

  • Posted

    I copied this when I replied to another "sufferer" so please excuse me if you've already read that note.

    I hope that you are continuing to heal well after your POEM surgery and reaping the benefits that it is intended for...

    "I had POEM surgery done in the Spring of 2016. To live a life "with a good measure of comfort" after POEM taught me some basic rules.

    1. Drinking plenty of fluids with meals, snacks and medications is necessary.

    2. Nothing to eat at least 3-4 hours before bed. I head to bed between 10-11pm. My last portion of food shouldn't be later than 7pm. No late night or middle of the night snacking except light fluids.

    3. No horizontal reclining immediately after any meal or snack. Napping has to be done in a chair or propped up in bed with pillows.

    4. Heavy breads, rough foods/raw vegetables, carbonated drinks have to be limited or avoided.

    5. Intermittent small meals/snacks throughout the day are better tolerated than a few heavier meals. I eat less and less as the day goes along so that by my 7pm all eating for the day is done.

    6. Drinking alcoholic beverages can also cause digestive problems. Just like food, being done with "conservative" consumption (not alot and not late) is always, ALWAYS, the wiser choice.

    7. I take a prescribed and over the counter medications to assist with the control of stomach acids.

    8. I cannot exercise vigorously, walking, swimming, running, etc within the hour or two after eating.

    9. Life is unpredictable and when sometimes my time table and/or "rules" are 'bent' or 'broken', I just know that there are consequences. How much do I want to "pay" for how I "play".

    I underwent Esophageal Manometry and then a Heller Myotomy in 2014 for problems from Achalasia but by 2016 another Manometry showed that I was having trouble again. Food was getting stuck, pills as well. The awful chest pain had returned.

    Since the POEM, even with my new "rules", and some new medication, my life is so much better.

    I have no regrets. Today more than ever, we have to be our own Patient Advocate. See something, say something...? Notice something not resolving, make an appt and get some answers. Keep a notebook and take it with you to the doctor appointments. I see that it has been a few weeks since you posted this note. I pray by now you have gotten some medical help and some relief. If you're not getting results, keep pressing your medical professionals for answers. God Bless!!"

    • Posted

      Thank you for your message, your advice is noted.

      I have a question on the Chest Pain. Before the surgery, I was getting a lot of chest pains. I would always get confused if the pain was heartburn or spasms. Still not really sure. Its definitely not related to other conditions, this is the same pain I was getting before.

      The pain feels like an ache and discomforting.

      Just want to know is the pain you feel? And do you know what causes it? As well, how to resolve this?

      Now since the surgery, the food can enter the stomach and it’s not getting stuck at the bottom of the oesophagus, but can feel stuck a few times just a bit further up the oesophagus - like I mentioned resolved with a burp.

    • Posted

      I think the chest pains are difficult to pin down sometimes, so you have my sympathy. The spasms are caused either by a) reflux, or b) nerve interference / damage or c) (unhelpfully) something else.One way you may resolve whether it is reflux or not is to take generous amounts of Gaviscon Advance to see whether that makes a difference or not. This creates a protective coating that can normally help with heartburn for a few hours. Heartburn is the effect of reflux on the delicate lining of the oesophagus that is not built to withstand stomach acid etc like the lining of the stomach. There may be other medication like PPIs that could protect you against stomach acid but they are normally on prescription rather than over the counter.Reflux may well be worse at night or when you are lying down because gravity allows the stomach fluid to rise towards your throat. So sleeping propped up and on your left side might make a difference.

      Some people do suffer from spasms after surgical procedures sometimes. This may settle down after a while, but it is not guaranteed. Some people find that relaxation techniques can help to reduce the tension that might make these worse.

      There are schools of thought that spasms are connected with blood supply in some way, so medication like Buscopan or some of the nitrates may be able to help. Some people even try Viagra / Cialis but it is always best to consult your doctor on this.

      Analysing pain is a very technical thing so I think it would be worth returning to your surgeon if things do not improve.

  • Posted

    Thank you for your reply and great reply! several helpful ideas.

    Doctor has prescribed Pantoprazole and Sucrafate for stomach/reflux issues and trying Lyrica for chest pain that all seem to be working form the moment. Doctor believes that chest pain might be same pain I had when sick with Histoplasmosis and the large lesions it left behind that are pressing on nerves since. Lyrica seems to be working for now. pray it continues.

    Thank you again for your reply.

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