Tips for coping with Achalasia

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Helpful Tips Collated from Fellow Achalasia Patients

NB These have not been vetted by the medical profession but are what have worked for some of us

Tips for coping

1Eat smaller meals more frequently.

2Eat slowly and chew well

3Don’t eat too late

4Beware of eating when feeling stressed

5Eat fairly moist food

6Lifting the chest and taking a deep breath also helps.

7Keep a small bottle of water handy in case one’s oesophageal muscles go into spasm when out and about

8Don’t have drinks too cold

9Eat early in the evening

10Don’t drink before bedtime

11Don’t eat too many nibbles such as crisps and nuts or drink too many glasses of wine before a meal in the evening (I know one should only have 1 or 2 glasses of wine but . . . !)

12A good start to the day is a fruit smoothie using a wide variety of fruit liquidised with a live yoghurt and probiotic (actimel) and a good teaspoon of manuka honey.

13Multigrain toast with Somerset brie is also a favourite, helped down with hot water.

14With a good variety of nutrients early in the day, I don't have to worry about having to eat much else. Ironically, that then makes it easier to eat.

15Always have a drink with the meals: sparkling types can be beneficial, and gulps between every few mouthfuls help

16My most important factor in managing my eating has been drinking hot water (temperature is important - half cold and half boiling). Mastering a technique which worked for me took time, but is worth it because I am now comfortable eating out and the only downside is the copious amounts of hot water I might need to drink to get the food down. The technique involves judging how much food I can eat before I have to gulp down some water.

17Soups are a good way of eating a variety of nutrients as they can be liquidised. I include all vegetables and pulses and experiment to get something I really like, sometimes topped with cheddar cheese.

18I avoid eating skins on fruit and veg, but do churn them up in smoothies and soups

19I avoid fatty meat and eat mostly chicken, fish or vegetarian dishes. I can even manage pizza if I drink enough hot water with it.

20I also avoid spicy food and drinking alcohol with food is very difficult.

21Salads are best eaten with lots of dressing and in small quantities.

22Be aware of the types of food you personally need to avoid, and what can be digested easily.

23I avoid the following:-

a) Large lumps of meat. The only meat I consider eating is mince usually in the form of a cottage or shepherd’s pie.

b) Dry chicken can be a problem. Meat in a sauce or casserole is usually better than anything else.

c) Pasta of any sort.

d) Too much bread. I can eat crackers better than bread.

e) Potatoes can be a problem if boiled but thin french fries are not too bad.

f) Rice. My first bad experience of Achalasia was with a dish of paella. Fried rice is better than fluffy stuff.

g) Spotted dick or similar dry sponge puddings are avoided.

24Food that gives me little trouble:-

i) Soup

ii) Fish - salmon or battered cod seem good.

iii) Salads

iv) Stir-fry food is usually fine

v) Funnily enough quiche or similar is usually not a problem

vi) Cheese with crackers

vii) For dessert ice cream is best.

25Basically it seems it is the consistency of the food which has more influence than anything.

26Don’t eat too much bread in one sitting and eat good quality bread rather than soft white bread which is particularly bad for blocking the oesophagus

27Avoid very dry food like falafels, raw cauliflower, raw carrot

28Best foods were weetabix, readybrek, custard, sponge puddings and mashed potato. . Not the most healthy range but I was advised by the dietician at the hospital that it was more important to keep my calorie intake up than eat healthily.

I was prescribed Fortisip milkshakes which were a lifesaver as they are full of vitamins and nutrients.

29Probiotic pills/Acidophilus powder as a major part of immune system is in one’s gut

30Echinacea and Manuka honey to boost immune system

31Sleep propped up with lots of pillows (before the operation) to help stop food and drink coming back up at night

32A bed wedge is a useful alternative to lots of pillows to keep you propped up at night.

33I always finish the day with a good teaspoon of manuka honey and lemon juice in hot water. This is after I have ensured as much as much as possible that all food has been washed down. That way I am left with manuka honey in my oesophagus overnight. I haven't had a cold for the last couple of years so I think it might have given me some protection.

34Relaxation helps to avoid spasms and pain with the sphincter.

35I find yoga helps as does drinking hot water to relieve the pain.

36Pain from the sphincter can be avoided by warming up cold food and drink in the mouth first before allowing it to go down. Avoid letting the chest get cold. Cold wind can set up pain. |I wear a scarf even if I don't feel cold.

37Talk to other Achalasia sufferers. It helps so much to know you’re not alone!!

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  • Posted

    Thanks for the tips. I've tried most of them over the years. I'd be interested in meeting up with fellow sufferers if someone will let me know where and when there is a meeting.
  • Posted

    Great Post, They really ring true and I will agree with most of the tips. THe one major thing I can add and Have helped me significantly in the past 6 months has been Coca Cola.... Life changin litterally. I can sleep at night pretty comfortably. I have about 1/2 a glass 1 hour before I sleep. I have not had a problem sleeping since December which is phenomenal considering the nights I spent coughing up my lungs with undisgested food. 
    • Posted

      I have been treated for Achalasia at the Veterans hospital, and one of my Dr's told me about Coca Cola, but over time I had forgotten it, thank you for reminding me
  • Posted

    I don't think it makes any difference what you do.

    Once the muscles start to spasm and anxiety spirals out of control it's too late.

    You can't consciously ignore globus sensation. It's a horrible condition.

    Drinking blackcurrent/blackberry fruit tea helps. Maybe.

     

  • Posted

    These tips are really good - definately will try the Manuka honey and lemon drink
  • Posted

    Hello i am new here. I've been dealing with this since Oct of 2014. Just recently been diagnosed with Achalasia. My esophagus does not contract at all and the nerves at the bottom do not work either. The bottom stays contracted shut due to the esophagus not contracting. The food or beverages i consume very rarely reach my stomach which causes me to throw up multiple times daily. I am down to eating just soup. I cannot keep water down for some reason. I have lost over 60 lbs in 41/2 months. I had lost 80 prior to this so i'm down 141 which i needed to lose but not like this. I'm seeing a surgeon in April to try and get the problem fixed. I read your list of dos and don'ts and some I can do most I cannot. I am very tired and weak all the time so hopefully I can get some kind of relief soon. Thank you for your post a friend of mine sent this to me and I am very glad to be able to talk to someone who knows what I am dealing with. Thanks for all the tips.

    Sincerely,

    Terry

    • Posted

      Hi

      I was diagnosed in 2014 after suffering for over 18 months and loosing 3 stone - like you I could not eat and what I did eat I threw up - I an aksi tyoe 2 and underwent surgery.  You should try taking liquid supplements like floradix, or nutrient milkshakes.  You should have a good look over the site as there are lots of tips about what can be eaten - soup, mashed banana and custard, try some pasta with lots of sauce, weetakbix and readybreak, and creamed rice.  Eat litlte and often, and do not drink before or with your meals.  Good luck 

  • Posted

    I am going to continue to look over the website I am so glad my friend sent this to me. Pasta of any kind is a no no for me no matter how it's prepared. I have cut it up as small as possible but I just can't keep it down. Yogurt sometimes and sometimes not because it's thick. No bread of any kind. I was thinking about getting some Pedialite popsicles. I know cold is bad but I am not a hot beverage drinker however when it's bad I will drink room temperature drinks and I get my soups pretty hot. There are alot of things on here I have never heard of and don't know where to get it. I live in a very small town and I am limited as to what I have available to me. Thanks again so much for trying to give me ideas.

    Terry 

    • Posted

      The honey and lemon is great - it can be any honey, and can be drunk nice and hot
    • Posted

      Hi Terry - welcome to the forum - I've not posted before, although I have followed the discussions and the advice (Guest's advice list is very good, and AlanT's shows the breadth of our common condition) I was diagnosed with Achalasia at the age of 22 - I am now 57, so its important to learn to live with it, but also to enjoy living. I had a Hellers myotomy at 23 and things improved for many years, though A's "interference" in my day to day life gradually crept back. Yes- because our condition is rare ( 1 in 10,000 I was told, so I have never met another of us in person) the feeling of fighting it alone can exist.

      A group like this is excellent for dispelling that, for that I am grateful for all postingsI have read.

      If I have any advice from 35 years of coping, its about learning your own bunch of strategies - what works and what does not - experiment when you can, and then stick to what works best.

      For me that includes:

      Never start a meal (or even a snack) without a supply of liquid close to hand, the more the better.

      For me, a warm/hot drink is better than a cold one for washing down food. However, a cold beer on its own is always possible!

      If eating in company, choose food that works - soup, sloppy pasta, fish, chicken,stews, sausage, banana, avoid Steak (reluctantly) any other fibrous meat, rice, Apple, doughy bread.

      Pick a chair at the end of a table, so I can get up and have a short walk , as movement helps to unstick food.

      Learn to talk less if eating with others - use the time to chew, and chew more until its mush in my mouth.

      Always chose an upright chair if sitting at a table, low seats make me fold too much and give trouble.

      Take solace in the fact that the condition (mostly) will prevent weight gain from over eating - I am 6ft tall and 75kg (165lb) - that has not varied by much in the last 20 years.

      The advice on de-stressing at mealtimes is important - allow enough time, or switch and eat when you are relaxed.

      I know I've been lucky - others with Achalasia are more restriced in diet. However, I get rare occasional incidents of total spasm - maybe lasts a couple of days every 2-3 years. When that happens then any food with texture is off limits, so I live on milkshake and tomato soup for a few days and it can take a while to swallow a bowl or cupful. It clears after a few days and I get back to (my) normality.

      The main thing is to keep up calorie intake- so experiment and persist with thin, high calorie liquids. Become your own expert.

      A Heller Myotomy will remove peristalsis from your esophagus, along with ending the spasm contractions, so you will depend on gravity for successful swallowing. My surgeon told me 35 years ago that after the operation my chances of being an astronaut were finished - he was right, I have had to rely on gravity ever since!!

       

  • Posted

    Hello from AZ   I am 83 years old, have been copeing with Achalasia for 25 years, slow start and now can not make my mind up about performong , the cutting of the lower sphincer, I have had bowtox injections 5 times but they only last for 6 to9 months. has anyone had this procedure?  I am told after this has been done you could develop acid reflux
    • Posted

      Hi

      I had the operation so that mine is open all the time - where the stomach is wrapped around the sphincer - although in theory there is nothing to stop the acid rising, I dont really suffer from reflux - now and again, but it is not constant, and there are tablets that can help

  • Posted

    Well, I have always suffered since I was in my mid teens with indigestion.  I've been through stages of regurgitation, food as well as mucus, which was disgusting, but then that passed.  I am now in my early 40s and still suffer but not as bad, as I know what foods seem to trigger, I eat little but often.

    Anyway, 10 years ago I had Cervical Cancer, where I underwent CT and MRI scans, which eventuated in a Radical Hysterectomy.  10 Years on and I am still here.  I hear you say - what has this got to do with Achalasia - well, a work colleague has just had surgery for Endometriosis, which I too had.  Which got me thinking, I wonder if anything was noted down about Endo and how bad it was - so flicking through my notes, I read the reports from my CT and MRI, which I have never done before (I have my whole medical history as I now live in Australia).  On the reports it states - Is the patient aware of their Achalasia?  No one have ever mentioned this to me.  All these years of suffering, and now I know what it is....huge sigh of relief, but now is what to do about it, if anything!!

  • Posted

    Hi All  Bill87487 again, I am 83 and have suffered with Achalasia for years,however reading some of your symptoms, I feel I am not to bad off.

    I would like to discribe my symptons, I have always eaten fast, I( sometimes do not chew properly) after a few swallows, the lower sphincer will contract shut. food in my esophagaus,will back up if the sphincer will not open then siliva fills up then I vomit. in due time  n3to5 min. the sphincer will open and the food enters my  stomach   I don't feel sphams that some of you discribe and hardly any pain. I have had bowtox injections this will help for 6 to 9 months. my present Dr. feels due to my age operating might not be wise, thanking you in advance your comments would be welcomed   Bill

  • Posted

    Many of the tips and suggestions are helpful. But the success of any or most will vary from one person to another and from one time to another.

    What I have found is that taking a 25mg Phenergen pill a couple of hours before dinner often helps with allowing the food to pass down past the sphincter and into the stomach. Drinking water (room temperature, not cold) also assists. Bread is definitely a worry as is over cooked meat. Protein shakes can assisit maintaining health. Finally, try to have as much sleep as possible and do at least moderate exercise.

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