Can achalasia heal itself?

Achalasia refers to the situation where when food eaten by the human body enters the stomach from the esophagus, it will pass through the gastric gate. After the gastric gate closes, the food can no longer come out of the stomach. However, in achalasia, the gastric gate will close relatively slowly, just like the slow reaction of the human body's nerves. Achalasia will cause food reflux, making the patient feel nausea, vomiting, and loss of appetite. So, can achalasia heal itself?

Self-healing methods:

(I) For internal medicine treatment, it is recommended to eat small meals frequently, chew food carefully, and avoid excessively cold or hot foods and spicy foods. Psychological treatment and external agents can be given to those with mental and nervous tension. Some patients use the Valsalva maneuver to encourage food to move from the esophagus into the stomach and relieve discomfort behind the sternum. Sublingual nitroglycerin can relieve esophageal spasm pain and speed up esophageal emptying. Prostaglandin E can reduce the resting pressure of the patient's LES and has a certain therapeutic effect on this disease.

(ii) Esophageal dilation therapy uses a balloon or bougie to relax the connection between the esophagus and the stomach. Under fluoroscopy, an air balloon with a bougie as the leading device is inserted through the mouth. The bougie is passed into the stomach, and the air balloon is fixed at the junction of the esophagus and stomach. Gas or fluid is injected, and the injection of gas or fluid is stopped when chest pain occurs. Leave it in place for 5 to 10 minutes before removing it.

(III) Surgical treatment: There are many surgical methods. The most commonly used method is Heller's lower esophageal myotomy. For patients with excessive esophageal dilatation, severe fibrosis at the diaphragmatic hiatus, or severe constriction of the lower esophagus, cardia and lower esophageal resection and reconstruction should be performed. However, complications such as esophageal mucosal rupture, hiatal hernia, and gastroesophageal reflux may occur.

Patients with achalasia of different degrees and with different complications will have different prognoses. In the early stages of the disease, adherence to medication and traditional endoscopic treatment can generally achieve longer-term symptom relief, but the efficacy is uncertain and the recurrence rate is high. If achalasia is complicated by esophageal cancer or cardiac cancer, the prognosis is poor. If it is very serious, resection is a better method, but resection needs to be repeated after a period of time. If it is not very serious, you can try dilation first. For patients with early achalasia, their condition should be explained, their emotions should be stabilized, they should eat small meals frequently, chew slowly, and take sedatives and antispasmodics, such as oral 1% procaine solution, sublingual nitroglycerin tablets, and the calcium antagonist nifedipine that has been tried in recent years, which can relieve symptoms. To prevent food from overflowing into the respiratory tract during sleep, you can use a high pillow or raise the head of the bed. If necessary, flush the esophagus before going to bed. In severe cases, lower esophageal dilatation may be considered. "