Ayurvedic Treatment for Achalasia Cardia focuses on the impaired digestive system and calms the body and mind. Achalasia Cardia is a rare disorder in which there occurs difficulty when food and liquid to pass from the swallowing tube connecting your mouth and stomach (esophagus) into your stomach. This condition usually happens when the nerves in the esophagus get damaged resulting in a paralyzed and dilated esophagus over time. As a result, food gets collected in the esophagus and it gets bitter slowly. Some people mistake this for gastroesophageal reflux disease (GERD). Usually, this is found in adults. It is very rare in childhood.
- Signs and symptoms of Achalasia cardia
- Causes of Achalasia cardia
- Causes of Achalasia cardia
- Pathophysiology of Achalasia cardia
- Diagnosis of Achalasia cardia
- Treatments of Achalasia cardia
- Prognosis of Achalasia cardia
- Complications of Achalasia cardia
- Achalasia cardia in Ayurveda
- Nidana- Causes of Achalasia cardia
- Purvaroopam (Premonitory Symptoms) of Achalasia cardia
- Samprapthi (Maturation) of Achalasia cardia
- Lakshana of Achalasia cardia
- Chikitsa (Treatment) of Achalasia cardia
- Commonly used medicines for Achalasia cardia
- Diet desirable to prevent Achalasia cardia
- Yoga
- Research articles link.
Signs and Symptoms
In Achalasia cardia the symptoms develop gradually and get worsen over time.
- Inability to swallow food and drink (dysphagia) and may feel like they are stuck in the throat
- Regurgitating food or saliva, vomiting
- Heartburn and Belching
- Chest pain that comes and goes
- Coughing at night
- Weight loss
Causes
The exact cause of Achalasia cardia is still unknown. The possible reasons include
- Due to the loss of nerve cells in the esophagus.
- Viral infections and autoimmune responses
- Achalasia cardia may be caused by an inherited genetic disorder or infection.
Pathophysiology
Diagnosis
Diagnosis is difficult because its symptoms usually resemble other digestive disorders like GERD. So it is ideal to carry out,
X-rays of your upper digestive system (esophagram): here X-ray is taken after drinking a chalky liquid that fills the inner lining of the digestive tract and so it helps to visualizes the esophagus. Barium pills can also be used.
Esophageal manometry – A test that measures the rhythmic muscle contractions of the esophagus at the time of swallowing. Monitors how the lower esophageal sphincter relaxes or opens during swallowing. This is ideal in diagnosing motility problems.
Upper endoscopy: here the Gastroenterologist inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat to examine the inner parts of the esophagus and stomach. This also helps to collect the sample of tissue for biopsy
Treatments
The main treatment principle of Achalasia cardia is to relax or stretch open the lower esophageal sphincter. This enables the easy swallowing of food and liquid. The medicine which facilitates the relaxing of muscles is suggested before eating. Specific surgical interventions include,
- Heller Myotomy: here the muscle at the lower end of the esophagus is cut to allow the passage of food and drinks to the stomach. GERD is a common complication of this surgery and to prevent this, a procedure called fundoplication can be performed where the surgeon wraps the top of your stomach around the lower esophagus to create an anti-reflux valve, preventing acid from coming back (GERD) into the esophagus.
- Peroral endoscopic myotomy (POEM) is a procedure in which an endoscope is inserted through the mouth and down the throat to create an incision in the inside lining of the esophagus. Then, as in a Heller myotomy, the muscle at the lower end of the esophageal sphincter is cut. This can also be combined with fundoplication to prevent GERD.
Prognosis
With proper surgical intervention, there is a good prognosis rate of 60 to 70 % is seen in Achalasia cardia.
Complications
The complications of includes,
- Aspiration Pneumonia- a rare but serious complication.
- GERD- this is due to the weakening of the lower esophageal sphincter.
- Esophagitis
- Perforation of the esophagus- due to chronic inflammation and irritation of esophageal lining which causes ulceration.
- Malnutrition
Disease and Ayurveda
The symptoms of Achalasia cardia is similar to those said in Amlapitta which has more resemblance to Gastric Esophageal Reflex Disease (GERD)
Nidana- Causes
- Impaired food habits
- Unhealthy daily regimen, sleep pattern, lesser water intake, dry food
- Food which cause vitiation of pitta dosha like hot beverages etc.
- Incompatible and contaminated food
- Sour and spicy food
Purvaroopam- Premonitory Symptoms
No classical reference of Purvaroopa for amlapitta.
Samprapthi Maturation
Doing nidana sevana causes the vitiation of Vata, pitta doshas leading to agnimandhya and Ajeerna. Later on gradually develops Amlapitta.
Lakshana Signs and Symptoms
- Regurgitation of sour food substances.
- Acid belching
- Heart burn and distension of abdomen
- Irregular digestion
- Burning sensation of stomach
Divisions based on Dosha
Based on gati (travel) of pitta- Urdwaga Amlapitta and Adoga amlapitta
Based on Dosha- Vatika, Vatakaphaja, Sakapha, kaphapittaja
Prognosis
Amlapitta can be cured if it is of recent origin and become difficult to cure as it becomes chronic. If associated with complications it is incurable.
Chikitsa- Treatment
Treatment aims at pacifying vitiated pitta dosha.
Sodhana chikitsa: In severe condition, Vamana (emesis) is advised. This helps to take out vitiated doshas in the gut.
Samana chikitsa: Tikta rasa (bitter taste) is used for treatment. Fasting and use of light food are advised accordingly.
Commonly used medicines
- Avipathikara choornam
- Sankha vati
- Drakshadi kashaya
- Sootasekhara rasa
- Pravala pshti
- Kamadugdha rasa
- Nalikera khanda
- Guloochyadi kashaya
Brands available
- Kashmir
- Baidyanath
- Kottakal Aryavaidya saala
Home Remedies
- Taking food at proper time in proper quantity
- Ideal sleep pattern
- Cold milk
- Water boiled with coriander
- Buttermilk added with a pinch of asafoetida, turmeric, and fenugreek at night for drinking.
Diet
Avoid sour and spicy food, food like barley, wheat old rice, warm water, sugar candy, pomegranate, dry grapes, etc. are desirable. Cold milk sometimes gives relief.
Yoga
Mind relaxing meditations are good because stress is an important cause of gastritis
Yoga postures like Vjrasana, Padmasana, and Pavanamuktasana are good because they help in maintaining digestion.
Research articles link.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395928/
https://pubmed.ncbi.nlm.nih.gov/25878463/
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