Achalasia cardia

Achalasia cardiaACHALASIA of the CARDIA (kardiospazm, hatespam, megaaaa-Fagus, idiopathic enlargement of the esophagus and others) is a relatively rare disease characterized by degenerative changes of intramural nerve plexus of the esophagus and cardia, atony, expansion of esophageal motility disorders its walls and reflex disclosure achalasia swallowing, as well as any resulting violation of the passage of food into the stomach and a long delay in her esophagus. Etiology and pathogenesis are not well understood. The symptoms for. Typical retrosternal pain, dysphagia and regurgitation. Chest pain is manifested in the form of painful crises often occur at night; sometimes pain occurs when empty or, on the contrary, crowded esophagus. Dysphagia initially episodic, in apparent cases observed at each meal and especially if swallowed dry or poorly chewed food, increases with the unrest. To facilitate the passage of food patients drink in one gulp a glass of water or swallowing air, taking deep breaths, arches torso back and so on , which in some cases helps. Regurgitation is manifested regurgitation stuck in the esophagus saliva, mucus, and food residues arising from the torso, in a crowded esophagus or at night, during sleep. In the latter case, possible aspiration srygivany masses, which often is a cause of aspiration pneumonia. The diagnosis is confirmed by chest x-ray that detects various degrees of expansion and elongation of the esophagus, in some cases combined with its S-shaped curvature, motility disorders, accumulation in the esophagus of a liquid on an empty stomach. Barium suspension long delays in the esophagus, the upper level often reaches the level of the clavicles, and then it suddenly as if "fails" in the stomach. Cardiac segment of the esophagus is narrowed, has smooth contours and a tip carrots" or "rat tail", is not disclosed when swallowing, restraining the flow of contrast into the stomach; the gas bubble of the stomach is absent (pathognomonic sign). The intake of 1-2 tablets of nitroglycerin relaxes the cardiac sphincter, resulting in the contents of the esophagus easier passes into the stomach and temporarily eliminated dysphagia. This pharmacological test facilitates the differential diagnosis falutin the cardia and organic stenosis of the esophagus. Esophagogastroscopy helps in the differential diagnosis of these diseases. The course is usually progressive with increasing dysphagia and other symptoms of the disease, with progressive emaciation. Complications: re-aspiration pneumonia and chronic bronchitis. Marked by more frequent occurrence of esophageal cancer in these patients. The prognosis for timely treatment is favorable. Patients contraindicated work associated with high physical load and irregular meals..



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