Surgical options for treating achalasia
Written in association with:Achalasia is a rare disorder of the oesophagus where the lower oesophageal sphincter (LOS) fails to relax properly, making it difficult for food and liquids to pass into the stomach. While non-surgical treatments such as medications and botulinum toxin injections can provide temporary relief, surgical options are often more effective for long-term management.
What is involved in surgery for achalasia?
Surgical treatment aims to relieve the obstruction caused by the LOS and improve the ability to swallow. The two primary surgical options are:
- Heller myotomy: This procedure involves cutting the muscles of the lower oesophageal sphincter to allow food and liquids to pass more easily. It is usually performed laparoscopically (minimally invasive), reducing recovery time.
- Peroral endoscopic myotomy (POEM): A newer, less invasive alternative, POEM is performed through the mouth using an endoscope. The surgeon makes an internal incision in the oesophageal muscles to improve swallowing function without external cuts.
Both surgeries may be accompanied by a procedure to prevent acid reflux, such as a partial fundoplication.
What are the advantages of surgical treatment?
Surgical options for achalasia offer several benefits, including:
- Significant and lasting relief from swallowing difficulties.
- Reduced risk of complications compared to prolonged reliance on temporary treatments.
- Short recovery times, especially with minimally invasive techniques.
Are there risks or complications?
As with any surgery, there are potential risks, such as infection, bleeding, or damage to surrounding organs. Additionally, patients undergoing these procedures may still experience acid reflux or require lifestyle adjustments to manage symptoms.
Post-surgery recovery and outcomes
Following surgery, most patients experience a significant improvement in their ability to eat and drink. Recovery generally includes:
- A short hospital stay, especially for laparoscopic or endoscopic procedures.
- A gradual reintroduction of solid foods after surgery, starting with liquids and soft foods.
- Regular follow-ups with a specialist to monitor long-term outcomes.
Achalasia surgery has a high success rate, offering patients a substantial improvement in quality of life. For those struggling with severe symptoms, these surgical options can provide the relief needed for normal daily activities.
