Effective Management of Type 2 Achalasia Cardia Through Peroral Endoscopic Myotomy

Mr. Gautam (CHANGED NAME) had been experiencing difficulty swallowing, known as dysphagia, for several months before seeking help at Kailash Hospital, Noida. Despite the persistent nature of his symptoms, it was only after consulting with Dr. Hardik Ahuja, Consultant Gastroenterologists, that he received an accurate diagnosis. Mr. Gautam was found to have Type 2 achalasia cardia, a rare esophageal motility disorder. This case study highlights the diagnostic process, treatment approach, and significant improvement in Mr. Gautam’s condition following Peroral Endoscopic Myotomy (POEM).

Table of Content

• Presentation of Symptoms
• Diagnosis
• Type 2 Achalasia Cardia: An Overview 
•  Treatment Plan
• Surgical Procedure 
•  Postoperative Care 
• Outcome and Follow-Up 

Presentation of Symptoms

Mr. Gautam came to Kailash Hospital with long-standing complaints of dysphagia. He described difficulty swallowing both solids and liquids, which had progressively worsened over time. The chronic nature of his symptoms had significantly impacted his quality of life, prompting him to seek specialized medical advice.

Diagnosis

Dr. Hardik Ahuja conducted a thorough clinical evaluation, which included a detailed patient history and physical examination. To pinpoint the cause of Mr. Gautam’s dysphagia, a series of diagnostic tests were performed. These included esophageal manometry, which measures the rhythmic muscle contractions of the esophagus, and a barium swallow study to visualize the esophageal function. The results confirmed the diagnosis of Type 2 achalasia cardia, characterized by impaired relaxation of the lower esophageal sphincter (LES) and lack of normal esophageal peristalsis.

Type 2 Achalasia Cardia: An Overview

Achalasia cardia is a rare disorder where the esophagus loses its ability to move food towards the stomach, and the LES fails to relax properly. Type 2 achalasia is identified by esophageal compression and pan-esophageal pressurization during swallowing. This condition can cause severe dysphagia, regurgitation, and chest pain, significantly affecting the patient’s nutritional status and quality of life.

Treatment Plan

Given the severity of Mr. Gautam’s symptoms and the diagnosis of Type 2 achalasia cardia, Dr. Ahuja recommended Peroral Endoscopic Myotomy (POEM). POEM is a minimally invasive endoscopic procedure that involves making an incision in the inner lining of the esophagus to cut the muscle fibers of the LES, thereby allowing it to relax and improving the passage of food.

Surgical Procedure

Mr. Gautam was prepared for the POEM procedure, which was performed under general anesthesia. Using an endoscope, the doctors made a small incision in the inner lining of the esophagus and carefully cut the muscle layers of the LES. This procedure was carried out with precision to avoid complications and ensure effective treatment of the achalasia.

Postoperative Care

Following the POEM procedure, Mr. Gautam was closely monitored to ensure there were no immediate complications. He was placed on a liquid diet initially, gradually progressing to soft foods as his esophagus healed. Postoperative care included managing pain, preventing infection, and monitoring his ability to swallow.

Outcome and Follow-Up

Mr. Gautam showed remarkable improvement following the POEM procedure. His dysphagia symptoms significantly decreased, and he was able to swallow both solids and liquids without difficulty. The success of the procedure was evident in his rapid recovery and improved quality of life.

Mr. Gautam expressed heartfelt gratitude towards Dr. Vishwakarma, Dr. Ahuja, and the entire staff at Kailash Hospital for their exceptional care and treatment. He highlighted the professionalism and compassion of the medical team as key factors in his positive experience and recovery.

The successful management of Type 2 achalasia cardia through Peroral Endoscopic Myotomy at Kailash Hospital, Noida, underscores the importance of accurate diagnosis and advanced therapeutic interventions in treating esophageal motility disorders. Dr. Hardik Ahuja's expertise and the comprehensive care provided by the hospital’s medical team facilitated Mr. Gautam's significant recovery and enhanced quality of life.

This case study exemplifies the effectiveness of POEM in treating achalasia cardia and highlights the critical role of specialized medical care in managing complex gastrointestinal conditions. For further insights and details, Mr. Gautam’s story can be viewed here.