Achalasia: Definition, Symptoms, and Treatment Options in Turkey

What is Achalasia, Its Symptoms and Achalasia Treatment in Turkey

The human body needs nutrition to sustain life, and this need is met through the mouth. Food taken through the mouth progresses sequentially through the esophagus, stomach, small and large intestines; after the body absorbs the necessary vitamins and minerals, waste materials are removed from the body through defecation. When the esophagus, which plays a critical role in this digestive chain, fails to function properly, a disease called achalasia develops. So what is achalasia, why does it occur, and how is it treated? In this article, we examine the subject in detail.

What is Achalasia?

Achalasia is a swallowing difficulty disease that develops as a result of the disruption of the normal functioning of a person's esophagus. The esophagus is a tube-shaped structure that connects the mouth and stomach and allows the food we eat to reach the stomach. In the presence of achalasia, the esophagus cannot function properly and has difficulty moving food toward the stomach.

This disease does not develop suddenly but progresses gradually in stages over time. As the disease progresses, the person begins to experience increasing difficulty in swallowing food. Currently, there is no definitive cure for achalasia; the treatments applied aim to alleviate the symptoms caused by the disease and improve the patient's quality of life.

Who Develops Achalasia?

There is no definitive answer about who will develop achalasia. Achalasia, a rare disease, occurs in approximately one out of every 100,000 people. Its frequency increases with age, which is why every apparently healthy individual is at some risk.

What Causes Achalasia?

Although the exact cause of achalasia is not fully known, several factors are thought to play a role in the development of the disease:

• Hereditary predisposition: Having a history of achalasia in the family or among close relatives can increase the likelihood of developing this disease.
• Autoimmune mechanisms: The immune system attacking its own tissues, particularly nerve cells in the esophagus, can create a foundation for achalasia.
• Cancers developing in the esophagus: In some cases, tumors forming in the esophagus can lead to presentations similar to achalasia.

The exact cause of achalasia is still being researched by scientists in Turkey and worldwide.

What are the Symptoms of Achalasia?

The body responds to changes occurring within itself through various symptoms. For this reason, it is important for a person to be aware of changes in their own body and to notice unusual situations in time. The main symptoms of achalasia can be listed as follows:

• Difficulty swallowing all types of solid or liquid food
• Food returning to the mouth after swallowing (regurgitation)
• Chest pain and burning sensation
• Coughing or urge to cough after eating
• Weight loss without dieting

If these symptoms are noticed, it is recommended to consult a doctor without delay.

How is Achalasia Diagnosed?

Achalasia diagnosis typically begins when a person visits a doctor with complaints of swallowing difficulty. A doctor suspecting achalasia may request certain tests to confirm the diagnosis. The three main methods used in diagnosis are:

• Gastroscopy (endoscopy): The most frequently used diagnostic method. A thin instrument with a camera at its tip is inserted through the mouth to directly examine the inside of the esophagus.
• Manometry: A method in which the pressure inside the esophagus is measured. The pressure values obtained play an important role in confirming the achalasia diagnosis and determining its type.
• Barium radiography (esophagography): An evaluation is made by visualizing how much of the barium substance given to the patient passes into the stomach and how much remains in the esophagus. Due to its radiation content, this method is not recommended for use in pregnant women.

What are the Types of Achalasia?

Achalasia is divided into three main types according to manometric findings, and the type of disease is of great importance when determining the treatment plan:

• Type I (Classic Achalasia): The classic form in which no significant contractile activity is seen in the esophagus.
• Type II (Achalasia with Esophageal Compression): The type in which increased pressure throughout the esophagus occurs.
• Type III (Spastic Achalasia): The type in which irregular and strong spasms are seen in the esophagus, with more variable treatment response.

How is Achalasia Treated?

Four different approaches can be applied in achalasia treatment depending on the stage of the disease, its type, and the patient's general health status:

• Medical (Drug) Therapy: Generally in cases with mild disease progression, medications aimed at relaxing esophageal muscles are used to alleviate symptoms.
• Botox Injection Therapy: Botulinum toxin is injected endoscopically into the esophageal-gastric junction to relax the muscles. The effect of this treatment usually lasts 6-12 months and the procedure may need to be repeated as the effect diminishes.
• Balloon Dilatation Therapy: An endoscopic balloon is used to try to widen the narrowed passage area between the esophagus and stomach.
• Surgical Operation (Heller Myotomy): The goal is to surgically cut the muscles near the junction of the stomach and esophagus to facilitate passage. Today, this procedure can often be performed using laparoscopic methods.

The choice of which treatment method to apply is determined by the specialist physician after evaluating the patient's examination and test results.

What Happens if Achalasia is Not Treated?

Achalasia is an important disease that can lead to serious complications if left untreated. This process, which begins with swallowing difficulty, can develop into more serious health problems over time:

• Aspiration pneumonia: A lung infection that develops when food that cannot be swallowed and returns from the throat enters the lungs.
• Esophageal perforation: Can develop as a result of weakening and dilation of the esophagus over time; this condition can rarely also occur during treatment.
• Risk of esophageal cancer: Untreated achalasia for long periods can trigger esophageal cancer development.

Does Achalasia Increase Cancer Risk?

In individuals with achalasia, swallowed food tends to remain in the esophagus for longer periods. This can lead to chronic irritation and inflammation of the esophageal mucosa. In the long term, this irritation can cause cellular changes and increased cancer risk. Studies show that achalasia patients not receiving treatment have a significantly higher risk of developing esophageal cancer compared to healthy individuals. For this reason, it is of great importance that patients diagnosed with achalasia undergo regular medical check-ups.

What Should Achalasia Patients Be Careful About in Daily Life?

Achalasia is a long-term disease that cannot be completely eliminated with modern medicine. The treatments applied aim to reduce symptoms and improve quality of life. After treatment, it is recommended to visit a doctor once or twice a year. Some recommendations that patients should be mindful of in their daily lives include:

• If smoking, it should be stopped.
• Consumption of foods and beverages that can cause gastric acid should be avoided.
• Food should be chewed thoroughly in the mouth, and swallowing should be facilitated by consuming plenty of fluids during meals.
• Small meals at frequent intervals should be preferred.
• Eating late in the evening should be avoided.
• Patients with increasing nighttime symptoms can try keeping their heads elevated while sleeping.

Achalasia Treatment in Turkey

Turkey is among the preferred countries for diagnosis and treatment of many diseases thanks to its advanced health infrastructure and current medical methods. Particularly patients living abroad prefer Turkey for treatment of conditions requiring specialized expertise such as achalasia. The main factors contributing to this preference include:

• Application of current and scientifically-based treatment methods
• Hospitals equipped with advanced technological devices
• Hospital environments being spacious, comfortable, and hygienic
• Doctors and nurses being experienced and expert professionals in their fields
• Experienced institutions providing support to patients in patient guidance processes
• Provision of courteous and helpful service within health tourism
• Turkey's natural and historical beauty offering sightseeing opportunities in addition to the treatment process
• Treatment, accommodation, and other needs being affordable

Achalasia Treatment Costs in Turkey

One of the most frequently asked questions by patients considering treatment in Turkey is the treatment costs. However, achalasia treatment prices vary depending on many factors such as the type and stage of the disease, the treatment method to be applied (medical therapy, botox injection, balloon dilatation, or surgical operation), and treatment duration. For this reason, rather than providing fixed price information, a personalized evaluation is needed.

If you wish to obtain detailed information about achalasia treatment and the process, clarify your treatment plan, and receive support during your travel to Turkey (including invitation letters and visa procedures if necessary), you can contact us.

Note: This content is for general information purposes and does not constitute medical advice. Individuals with suspected achalasia or those diagnosed with achalasia must consult a healthcare facility and undergo evaluation by a specialist physician for a definitive diagnosis and appropriate treatment planning.