Which Achalasia treatment for a 28 y.o?

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Hi there, I've been diagnosed with Achalasia and am due to have a balloon dialation treatment for it soon. Having looked into it myself and spoken to a number of friends and family (some of who are doctors and nurses) I'm in doubt that the dilation is the right choice to take.

I am 28 years old, male, and other than minor/moderate reflux (which I take lansoprazole for) I'm healthy. I believe that the myotomy may be the best treatment to take due to my age as it means a much smaller chance of further treatment if successful. My consultant seemed to be on the fence when deciding which treatment to give me which has put me in doubt as I'd lean towards getting a perminant fix.

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  • Posted

    Hi there,

    I was 19 when I was diagnosed with achalasia and am now 20. I've had two balloon dilations and will have a third in April. 

    I've to say that having a myotomy doesn't mean that it will be a permanent fix. Achalasia is a life long illness which can only be restrained. There hasn't been a cure yet. That doesn't mean that a myotomy won't help for maybe several years but it can worsen over time. Next to this, a myotomy can also leave scar tissue which won't help in the long run.

    I'm only giving you advice and am not a proffesional, but can't you first try a dilation and see what happens? My second dilation had gotten me some relief and even though I'll have a third dilation, a myotomy has really long heal process and next to this you'll probably get more problems with reflux. 

    How is it going with eating in your daily life and with sleeping? Do you have a lot of spasms etc. etc? 

    Hope I helped a bit and good luck

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  • Posted

    Hi, I'm 41 and have been told by my consultant that the myotomy is the best solution for me as it is a more long term solution.

    I have yet to find anyone who's had the balloon procedure and not had to go back for more treatments, also I was told the more you have the less likely a myotomy will be successful if you need one.

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    • Posted

      Just to add this was the advice I was given based on my symptoms though, I have days where I can only take liquids, and some when I can't even drink very well so a myotomy is the best solution for me.

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  • Posted

    I'm 31 and I had a Heller myotomy with Toupet fundoplication 16 months ago. I was told by my surgeon that a balloon dilation has a higher risk of failure in Achalasia patients (e.g. esophageal rupture). My surgeon performed quite a few Heller myotomies, and the wife of my gastroenterologist had it done as well. She's going on strong 15 years later without the need for additional surgery, and I was told to expect similar long-term results. I'm hoping that medicine progresses in 5-10 years to the point that if my surgery fails in the long-term, there will be better options than the horrible esophagectomy followed by displacement of the stomach up into the chest. Research is currently being done on growing an esophagus from a "scaffolding" of cells, creating a completely artificial esophagus, and transplanting an esophagus. 

    To answer your question though, I'd recommend what I had. The Toupet isn't too loose or too tight, and I'm eating fine now more or less. I have acid reflux and take one Gaviscon before bed every night. Sometimes I sleep with a pillow at a slight elevation. Doing this, I can drink coffee, beer...etc without any trouble. 

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    • Posted

      Kevin,

      I was just diagnosed with achalasia. Can you tell me the name of your surgeon and his location? I live in Michigan and I'm willing to travel any distance to find a surgeon that has a lot of experience with this condition and the surgery to correct it.

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    • Posted

      I live in Michigan and My surgeon is actually in Grand Rapids, she is wonderful. She is located in the office of Surgical Oncology at Spectrum. 
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    • Posted

      Hi Rsmfire. I saw you msg asking someone the name of their Dr and wanted to tell you that I too am flying to have my surgery. I can't give you a Dr's's name but I can tell you Northwestern in Chicago and Johns Hopkins in Baltimore are two of the leading institutions who specialize in Alchalasia. They are world renoun. I'm currently researching the chief of staff in the GI division there. I want the very best and will not settle. Good luck!

      DWJRN

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  • Posted

    Please do yourself a favor and start out with less invasive procedures first. They would include, pneumatic dilatation, Botox, Nitrates and calcium Chanel blockers. I didn't respond well to Botox. And it isn't long lasting. But by all means see if you are a candidate for a dilatation. It could buy you up to two years then possibly have another. I would be careful wanting to jump into surgical procedures first.

    DJRN

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