Managing Achalasia [type 1]

Thanks for responding, Joy.  Its really odd, isn't it,  some things work for awhile, and then they don't.  I used to be able to tolerate egg-whites, but now I have problems with them.  Same with mashed potatoes - like you said, one day its okay the next time, not.  I haven't had any salad, as I was told salads would not work.  Its really hard to manage our diet with Achalasia, isn't it!  I can eat whole-wheat saltine crackers, and I have 6 of them with peanut butter & soup at noon.  Its all washed down with water, and so far okay.  Low-salt potato chips, in a small amount, also work because I guess the fat in the chips help them to slide down with water.  Its all about texture.  Anything that goes into my mouth has to pretty much be able to dissolve in my mouth before going down with water.  I haven't had bread since December, and I really miss it.  But bread 'congeal's in the esophagus, and blocks. 

Yes it is very odd as is this disorder. No two people are the same when it comes to Achalasia. I still have trouble with all kinds of food, but I continue to eat them anyway. I've just learned how to make it work better for me I guess. I eat salads, love them, but I pay the price from time to time. Same with bread, pizza, granola etc. I just have to be careful. I really enjoy being able to talk with others, like you, that have had the surgery and have some of the same issues. Helps to know we're not alone!

Thanks, Alan. After having had the HM surgery, and the subsequent balloon-dilation, the specialist ordered a barium swallow to be done.  The results of all this is that even after the surgery and dilation, I have very 'poor clearance,' from the esophagus unto the stomach.  And, to be quite frank, I have no idea if the food is going down.  Do you think this is because the esophagus is paralyzed, that perhaps some nerves are dead, the ones that give a movement sensation?  Eventually, stuff goes down.  For awhile after eating a meal, I feel the water that I have to drink, sitting on top.  I do try to get nutrition into my diet, and I drink a nutritional supplement, high-protein every day.  This is a complicated journey with Achalasia.

The barium swallow test usually gives the best picture of what is happening.

?Achalasia often does involve the muscles of the lower oesophageal sphincter being clamped tight, with perhaps also some lack of flexibility in allowing food to pass through the bottom of the oesophagus into the stomach.   The Heller's myotomy cuts the muscles, thereby reducing their effectiveness in creating this block, and it then allows gravity to help with the food passing through.   So it is likely that your sphincter has not regained normal strength and effectiveness.   The operation involves an element of surgical judgement about the length of muscle to cut, and the degree of fundoplication 'wrap' that recreates the valve effect to stop reflux travelling up the other way, but the surgery can only be effective at relieving the symptoms rather than creating an absolute cure.     I think many people  still have to be careful about what they eat, and how they eat afterwards.

?If the food does not go down it has to go somewhere, so if it is not congealing in your oesophagus and is not being regurgitated, it must be going down into your stomach;  but it is probably happening slowly.   After the meal when all the food has not gone through, ir probably creates its own bloackage that stops the water running through.   So you probably have to eat (even?) slower; and perhaps separate drinking from eating in time, perhaps?   It is quite a nit of trial and error.

Thanks, Alan.  Post-surgery, for a short period of time, I could feel food, etc., moving down into the stomach.  It was a weird feeling, like a 'shiver.'  This no longer happens.  And you are so right, everything does eventually go down, albeit very slowly.  And living with Achalasia, certainly is 'trial and error,' pretty much all of the time.  I appreciate your information and advice, because I know that if you aren't sure, that you consult with the OPA specialist.  Thank you again. 

Carol, thank you for all the information.  Since I live in Canada and I think you are in the UK, some of our terminology is different.  What are 'super foods?' And what does 'cook them down,' mean? Is 'blanc manages' a custard dessert? Do you pre-cook Quinoa and then add it to the soup?  Has your husband had any problem with Quinoa congealing?  Has he eaten Quinoa as a side-dish with a meal?

 Unfortunately , I cannot tell when food goes down.

Hi Donna--I don't know anything about Quinoa but I certainly know about hummus.   If you have ever tried it, you know that it is a thick paste or spread made from ground chickpeas and sesame seeds, olive oil, lemon, and garlic--a Middle Eastern concoction often spread on pita [flat ME bread].  I don't think a lot of people who have no connection to the Middle East [like Israel] eat it and so those here may never have even sampled it.  I have dysphagia but I don't find hummus difficult to swallow.  It's the pita I have to chew very well or it gets stuck.  I don't think I have achalasia, though, so can't really say how hummus would work for you--but my guess is that a thick paste may not be your best bet.  Trial and error, certainly, but the error part can reselt in a lot of discomfort.

Thanks Jane.  I`ve been on study-leave to the Holy Land twice, and hummus was always on the table, but I never tried it.  Am not sure that I will try it now, because my body has an intolerance to garlic, and citric fruit is also a problem ie, the lemon.  I went to my Dietician for advice; she hadn`t heard of Achalasia, but she did some research.  And as Alan from OPA has said, eating is so much `trial and error,` and for myself, it is often èrror.  I am managing the Achalasia now, and stable, by simply sticking to a very limited diet, and keeping a routine of when I eat and drink; the amounts are very small, and when I have had enough, I have had enough.  A toddler probably eats more at a meal than I do.  Soup is my comfort food - always have it at lunch, and if my system seems off, I will have it for supper as well, but drink an extral high protein drink supplement to make up the nutrition.  I make a protein shake every afternoon and add fruit as well as spinach to it.  Never had liked eating or drinking anything that is green in colour, but I do now!  Bread is out for me, even pita, as it congeals.  Thank you for posting.