Achalasia

Question 1

What is achalasia?

Answer 1

An oesophageal motility disorder characterised by an inability for the lowere oesophageal sphincter (LES) to relax in response to swallowing.

Question 2

What is the pathophysiology behind achalasia?

Answer 2

Theory:

Involve loss of inhibitory neurons secreting VIP and nitrious oxide within the Auerbach (myenteric) plexus, resulting in unopposed excitatory activity and the inability for LES relaxation.

Achalasia involves lack of peristalsis within the oesophagus = LOS is contracted and oesophagus above is dilated

Question 3

What are the risk factors for developing achalasia?

Answer 3

Genetics (Allgrove syndrome associted)

Infection (Trypanosoma cruzi infection (Chagas disease) causes damage to myenteric plexus)

Autoimmune diseases

HLA class II antigens

Question 4

Who does achalasia most common affect?

Answer 4

Middle-aged people

Affects men and women equally