Sir Ganga Ram Hospital achieves major milestone in battle against Achalasia Cardia

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Achalasia cardia is a debilitating disease that affects the food pipe, also known as the esophagus. A recent advance called POEM or Per Oral Endoscopic Myotomy has dramatically improved treatment outcomes for this complex disorder.

New Delhi: Sir Ganga Ram Hospital has achieved a great position in the fight against Achalasia Cardia.

Achalasia cardia is a debilitating disease that affects the food pipe, also known as the esophagus. A recent advance called POEM or Per Oral Endoscopic Myotomy has dramatically improved treatment outcomes for this complex disorder.

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The Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences (ILGPS) at Sir Ganga Ram Hospital has consistently been at the forefront of performing and pioneering POEM procedures in North India. The Chairman of ILGPS recently announced the successful completion of 375 POEM processes in his department. in the last five years. These patients were in the age range of 14–90 years, with a mean age of 47 years, with 43% being female and 57% male.

The esophagus performs an important function of carrying the food that we eat into the stomach for digestion. A valve-like muscle called the lower esophageal sphincter (LES) is present between the esophagus and the stomach that allows unilateral transit of esophageal contents into the stomach.

According to Dr. (Prof.) Anil Arora, Chairman, Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, “In achalasia cardia, the LES fails to relax during swallowing and hence food cannot enter the stomach. Might get stuck. in the food pipe (Figure 1). As a result, patients with achalasia cardia have difficulty swallowing, chest pain followed by vomiting from swallowed food. Symptoms can be devastating for most patients suffering from weight loss and poor quality of life.”

According to Dr. (Prof.) Anil Arora, “The biggest puzzle in diagnosing this rare condition occurring in one in 100,000 individuals is that the disease is often left early and mistakenly referred to as gastroesophageal reflux disease (GERD). which is very common. The condition characterized by chest pain, vomiting and food reversal in one fifth of the population is equally prevalent in both diseases with contrast treatment. This is where the patient A good and careful history of the disease associated with barium studies, endoscopy and high-resolution manometry studies of the esophagus makes it easier to make an appropriate diagnosis and choose the appropriate treatment regimen.”

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According to Dr. Srihari Anikhindi, Consultant, Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, “Among the various treatment options available for achalasia cardia, POEM has now become the preferred treatment option due to its minimally invasive non-surgical nature and rapid and almost complete symptom relief with excellent results. In POEM, the non-relaxing LES is cut from within the cavity of the esophagus using endoscopy (Figure 2). Reporting on his experience, He has seen an excellent success rate of up to 95% at his centre.”

The whole procedure takes around 1-1.5 hours and is performed under general anesthesia and hence is painless and quite comfortable for the patient. Pro. Anil Arora said that most of the patients are able to resume the diet from the very next day and are discharged within 48 hours.

Dr. (Prof.) Anil Arora added, “Thanks to the recent advances in medical technology, there has been a huge change in the diagnosis and treatment of swallowing disorders. What we can achieve today in this area is 10 Even years ago this was almost impossible.With state-of-the-art advanced diagnostic procedures such as high resolution esophageal manometry and high definition endoscopes, we can pinpoint diagnosis in all patients with swallowing disorders such as achalasia cardia. High definition for esophagus stomach intestine and rectum Having an established and well endowed advanced endoscopy unit with pressure and motion monitoring manometric equipment helps us in providing suitable diagnostics and well planned state of the art solutions to their complex problems.

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Pro. Anil Arora also said that it would be important to note that even though the rare problems of food pipe motility disorders such as achalasia cardia, more common problems such as chest pain, vomiting and swallowing may occur early in life due to their shared common symptoms. Gone. GERD diagnosis is often missed and delayed resulting in serious complications. Hence timely counseling and properly guided tests can provide a proper treatment and save many miseries.

First published:October 22, 2021, 6:27 pm

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