Symptoms of achalasia of the cardia

Typical symptoms of achalasia of the cardia are as follows:

[1], [2], [3],

Dysphagia

Dysphagia (a violation of swallowing) occurs in 95-100% of patients.

Dysphagia is the first and the main symptom of achalasia of the cardia. It has the following peculiarities: it arises inconstantly (with unrest, fast food, insufficient chewing food), provoked by some specific products (often containing a large amount of fiber - fruits, rye bread, etc.), can be paradoxical (dense food passes by the esophagus is better than the liquid, and larger amounts of food are better than small ones).

Dysphagia increases after nervous excitement, fast food intake, especially poorly chewed, accompanied by a feeling of food stoppage in the esophagus and a "dip" into the stomach, decreases under the influence of various techniques found by the patients themselves (for example, walking, gymnastic exercises, repeated swallowing movements, ingestion of air , drinking with a lot of water).

Feeling of overflow in the epigastric region and behind the sternum. This painful feeling causes patients in various ways to induce muscle tension in the upper part of the trunk with a delay in breathing, so as to improve the passage of food from the esophagus to the stomach by increasing the peri-gastric and intra-esophageal pressure. If this is possible and the food enters the stomach - dysphagia and a feeling of overflow immediately disappear.

[4], [5], [6], [7], [8], [9]

Pain in the lower and middle third of the sternum

Vaginal pain is caused by overgrowth of the esophagus and extragnotic movements of the esophagus. Pain radiates to the neck, jaw, interscapular area, associated with food intake. Perhaps the emergence of severe pain outside eating. Usually this is due to unrest, psycho-emotional stress.

• Can be associated with a spasm of the musculature of the esophagus. In this case, pain is stopped by nitroglycerin, atropine, nifedipine.
• Occur with overflow of the esophagus and disappear after regurgitation or passage of food into the stomach.

Regurgitation

Regurgitation (regurgitation) of food or mucus lingering in the esophagus. With a slight expansion of the esophagus, regurgitation occurs after several sips. With a significant dilatation of the esophagus, regurgitation occurs less frequently, but usually the volume of regurgitated food is greater. The contents of the esophagus during regurgitation can enter the respiratory tract.

Regurgitation, as a rule, occurs after the patient has eaten enough food. Promotes the appearance of regurgitation of the inclination of the trunk forward. It also occurs at night ("a symptom of a wet pillow").

Weight Loss

Losing weight is typical, often characterizes the severity of the course of the disease. Loss of body weight often reaches 10, 20 kg or more.

Hiccups

Hiccups occur in patients with achalasia more often compared with patients suffering from dysphagia due to other causes.

Congestive esophagitis

Congestive esophagitis develops with the progression of the disease and manifests itself as nausea, belch regurgitation (stasis and decomposition of food in the esophagus), air, food, increased salivation, and unpleasant odor from the mouth.

The course of the disease is often progressive, with a gradual worsening of the symptoms of cardiac achalasia, so that over time, not only dense food, but also cacheiform, causes difficulties. Expansion of the esophagus increases, food stagnates. The esophagus contains 500-2000 ml of fluid and as a result of stagnation esophagitis develops, the risk of squamous cell carcinoma of the esophagus increases. Pulmonary complications caused by aspirated contents are frequent. Sometimes the disease worsens in the wrong attacks caused by agitation, intercurrent infections, etc .; between periods of deterioration there may be various periods of rest with minimal complaints. Rarely, a significant dilatation of the esophagus is determined in patients without preliminary expressed dysphagic disorders.

[10], [11]