Achalasia of the esophagus - neuromuscular lesion of the esophagus with a violation of its peristalsis, the ability of the lower esophageal sphincter (muscle pulp or valve, which carries out a blockage mechanism between the esophagus and stomach) to relax and expand the above-mentioned areas, resulting in a discontinuous violation of the gullet.

In European countries, the frequency of this pathology is 5-8 per 1 million. of population. In the world, this figure is 4-6 per 1 million. of population. The disease occurs with the same frequency in men and women aged 25-60 years.

Synonyms: cardiac achalasia, esophagus esophagus, megaeophagus, chiatospasm, idiopathic esophagus expansion, functional obstruction of the cardia.

Achalasia of the esophagus A complex of neuromuscular disorders leading to a decrease or total absence of the ability of the lower esophageal sphincter to relax during swallowing. In addition, patients show a decrease or a complete absence of motor activity in the middle third of the esophagus. As a result, the transport of food through the esophagus is disrupted, the food remains in the esophagus for a long time without passing into the stomach.

The mechanism of the disease is associated with a violation of the process of passage of nerve impulses to the muscles of the esophageal wall - beginning with the middle third of the esophagus. This occurs as a result of the appearance of pathological changes in nerve cells located between the muscular layers of the esophageal wall, which are responsible for providing the motor activity (peristalsis) of the esophagus.

There are two types of esophagus ahalasia. At the first type, the tone of the walls and the shape of the esophagus are preserved, with the second - the tonus of the walls of the esophagus is lost, the organ is curved and greatly expanded. The most common idiopathic achalasia - up to 95% of cases, family achalasia is 2-5% of all cases.

To treat achalasia of the esophagus, non-pharmacological, medicamentous and surgical methods of treatment.

Non-drug treatment is performed at the first stage of the disease. It is in the normalization of the food regime. The composition of sparing diets includes, in the first place, food products that are weak exciters of secretion, rapidly leaving the stomach and not irritating its mucous membrane. Gentle mode of functioning of the stomach is also promoted by regular and fractional meals, which facilitates the conditions of digestion and assimilation of food. After eating, you need to drink liquid to remove food from the esophagus.

Medication:.

- nitrates - contribute to lowering the pressure in the lower esophageal sphincter;.

preparations of nitroglycerin group;.

- calcium channel blockers - having contraindications for surgical treatment;.

- sedatives.

Together with drug treatment, psychotherapy is recommended.

With this disease in remission or during rehabilitation after surgery, treatment in the profile sanatorium.

Late rehabilitation is carried out at a local sanatorium or in a polyclinic using all the methods of sanatorium treatment of the esophagus. Rational nutrition is prescribed, mineral water of small and medium mineralization heated to 38-39 ° C at a rate of 3-4 ml / kg for 30 min before meals 3 times a day, psychotherapy, exercise therapy, low-frequency pulsed currents.

Restorative treatment includes hardening and prevention of relapses. In this case, sedatives, psychotherapy, coniferous baths, exercise therapy, walking and sleeping in the air, SMT (sinusoidal modulated currents on the epigastric region).

In 6 months after the completed sanatorium rehabilitation phase can continue rehabilitation at the resort or use resort factors of rehabilitation in the conditions of the polyclinic.

nedug. en Key words:.