In the early stages of the disease, pharmacological tests with nitrates and cholinomimetics, as well as esophagotonometry, can be informative, which can reveal the lack of opening of the cardia after swallowing.
There is a diagnostic method of bougienage with a bag filled with mercury, which passes into the stomach in the absence of stricture under the influence of its own weight. Differential diagnosis is carried out with tumors of the esophagus, esophagitis, cicatricial narrowing, diverticula and ulcers of the esophagus, hiatal hernias, esophagospasm and coronary heart disease. The finding of diverticula of the esophagus does not exclude achalasia of the cardia. Possible combination of achalasia cardia with esophagitis.
In the differential diagnosis of achalasia cardia and coronary heart disease, the age of patients and the effect of taking nitrates are not always significant. Dysphagia, regurgitation, pain relief after 1-2 sips of water and the absence of autonomic disorders (changes in blood pressure, perspiration, etc.) should be taken into account, even with prolonged chest pain in the case of achalasia of the cardia. Significantly facilitate the diagnosis of ECG and the study of enzyme activity.
With spasmodic retrosternal pain, it is recommended to drink water in sips, nitrates and antispasmodics. In mild cases of achalasia of the cardia, conservative treatment is acceptable, including fractional sparing nutrition. Patients are advised to drink some warm or carbonated water after meals.
Most often, in case of achalasia of the cardia, cardiodilation is used with the help of dilators of various designs (metal Stark cardiodilator, elastic cardiodilators - hydrostatic and pneumatic). In most patients, cardiodilatation gives quite satisfactory results. With its failure, with a pronounced expansion and tortuosity of the esophagus, a combination of amantadine cardia with other diseases (esophageal diverticula, hiatal hernia, heart aneurysm, etc.), surgical treatment is indicated.
Achalasia cardia is a disease of the esophagus caused by the absence of reflex opening of the cardia during swallowing and is accompanied by a violation of amantadine and a decrease in the tone of the thoracic esophagus.
Information about its prevalence is very contradictory, since it is based on the data of negotiability. The share of achalasia cardia accounts for 3.1 to 20% of all lesions of symmetrel 100mg case of the disease is registered approximately per 100,000 population.
Achalasia cardia (cardiospasm) is a chronic neuromuscular disease of the esophagus, caused by changes in its tone and peristalsis, the lack of necessary relaxation of the lower esophageal sphincter during the act of swallowing.
