For the past 2 years I have been keeping a health diary of the number of times I threw up, wretched, gagged and had chest pains at the same time as my consultant has tried to identify what was wrong. After a gastroscopy, barium meal and my 2nd oesophageal manometries I was finally diagnosed with achalasia just over a week ago. I would like guidance on what I can do do reduce spasms, choking and wind created in my oesophagus by every mouthful of food, and advice on longer term treatment to help me make informed decisions. I have yet to receive a confirmation of the 'type' of achalasia I have or treatment options have only started losing weight in the past 2 months but have recently started to experience mucus at the back of my throat that is difficult to clear and a sore throat. Can anyone explain these last two symptoms or advise on food less likely to cause spasms. Thanks in advance.
Achalasia newbie: For the past 2 years I... - Achalasia Action
Achalasia newbie
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The problem is likely to be that your lower oesophageal sphincter muscles are shut tight. Therefore anything that you swallow simply increases pressure in your oesophagus around the chest area and it builds up a bit like a blocked hose pipe. So the solution, difficult as it may sound, is to only swallow at the slow rate at which your food can travel from your oesophagus, past your diaphragm and into your stomach; to concentrate on liquid / sloppy food; avoid food like rice and white bread that might congeal; avoid food with a stringy texture or things with skins like tomato; and try to relax around eating because tension and stress tend to make things worse.
The wind aspect might be associated with how you swallow, and this can sometimes be improved by chewing things very carefully and for a long time so that you do not 'gulp' air down so much, but it might also be about the build up of pressure referred to above.
Sometimes people do suffer from thrush or candidiasis in the throat, for which you will need some medication from your GP. There are some hints and tips about this in 'A Patient's Guide to Achalasia' that you can also download as above, but I am possibly making an unwarranted assumption here.
It might be helpful if you have your vitamin/ mineral levels checked. Try and use medication in liquid form as pills can remain in your oesophagus and cause damage to the lining when they are designed to pass direct through into your stomach.
Eating in very small quantities, slowly, will help. Do not try and force your system to accept food to try and regain weight, but think about asking for something like Fortisip or other drinks that will maintain your nutrition levels when it is difficult to swallow.
The spasms are caused either by the pressure under which your oesophagus has been put; by reflux / stagnant or fermenting food in your oesophagus; or by something else triggering a response in the nerve system. The sore throat might be the result of the fermenting food - it all depends on how much remains in your oesophagus at any one time. Or it might be reflux from the stomach itself. You could try Gaviscon Advance in liquid form to see if that makes a difference.
Sometimes people can help food pass through into the stomach by massaging the diaphragm / chest area, or by standing on your toes and dropping on to your heels. Giving some respite by clearing your oesophagus will help, but it is easier said than done.
I hope this is helpful. There will no doubt be other things that you have queries on in due course. We have a helpline on 0300 772 7795 that you can ring, and we will return the call, and you may find it helpful to join one of our meet-up sessions
achalasia-action.org/index....
It is a bit daunting to be diagnosed with what is a rare condition, but there are about 6,000 people with achalasia in the UK, many of whom have had their symptoms relieved or improved by medical treatment and advice.
Hello there. It took about two years for me to get a diagnosis too but that was back in the 1980s. You will find a way of managing it all. It is trial and error and we are all a little different. The other thing that is important to realise is that at some point you will understand it better than some professionals so try and make sure you are being seen by an experienced doctor.
For me I found anything dry really difficult. So cracker biscuits were just ridiculous but I found heavy foods such as pasta quite good as the weight of the food seemed to help. But, not always reliable. Coca cola (or Pepsi or any other brand) was a life saver as the bubbles expanded the oesophagus but some people have found the gas makes them worse. For me I managed my whole condition with Cola. I drank about 6 cans a day and they always needed to be freshly opened. I could always eat out providing i had Cola with me. I had to sneak it into restaurants that only served post mix.
I also learned that some arm positions were helpful. Arms above the head and sometimes if it was really uncomfortable I found a bath helped.
Stress made it all worse. When stressed all our muscles are tense and that includes the ones inside. So, i found there was no point eating when stressed. I needed to manage that first.
I lost a lot of weight but it stabilised and i supplemented my diet with nutritional drinks which kept me away from any nutrition issues.
But, I did require a huge amount of dilatations. Two or three a year at one point and then not so many and then back to two or three a year. It really varied.
My over riding message is that you will find a way of managing it. Do keep writing everything down and you will realise what makes it all easier.
Is the sore throat the irritation of food at the back of the throat at night when you lie down? I have slept upright for so long now. Sometimes my achalasia was so bad I found it difficult to manage my saliva but again a can of Cola would help.
I hope that is a little helpful?
Thank you, it’s so helpful to know not just what helps, but how it helps and, that trial and error isn’t a waste of time. I get so frustrated with my consultant casually asking me to try this muscle relaxer or that and taking weeks to feed back test results, but I will endeavour to be patient.
The sore throat, I think, is from dry mouth as I tend to get dehydrated. I just bought a new water bottle so I can monitor my water intake and add vitamin supplements. Coke-a-cola helps sometimes but not always and I will have to try pasta, as that’s one thing that has as dropped out of my diet.
My heart goes out to you. I have had Achalasia for about 13 years. Undiagnosed for about 8 years. I am 74 years old. I have learned to live with it. But!! I cannot live without my Coca Cola. As I cannot keep most liquids down, including water, it is about the only liquid that helps me stay hydrated. It helps with the chest spasms also. I drink about 3 to 4 cans a day, sugar free of course. I don't know where I would be without it. Just part of coping with a tedious, and frustrating, affliction. I have an endoscopy every so often, when I really get bad. I lost a lot of weight at first, but stabilized. You find your own way of coping. I don't take anything for my Achalasia. You just learn how to deal with it, eating wise, in a way that keeps you as healthy as possible. You soon learn what you can and can't eat without suffering dire consequences. I would love a piece of steak but absolutely cannot eat it. I wish you well.
Rose, it sounds like the sphincter between your stomach and your esophagus is closing. This is like scar tissue. I don’t think there is anything that can stop it. The easiest things I found to eat was soup, and protein shakes. Soft vegetables and fruits like cooked squash, avocado, bananas, mashed potatoes. Try to avoid corn that has the outer coating on the kernel. So cornmeal, grits even cereal are all okay, but corn on the cob not! You can substitute hominy for canned corn.
Your throat is sore because your food is coming up over and over. Many have hoarse voices because of this too. The mucus in your esophagus is thicker now, yes, sometimes it is foamy too. Your trouble swallowing is called dysphasia and seems to go with achalasia. Try taking a swallow of water and see if it helps.
Try elevating the head of your bed. Yes, you will slide down, but you will do better with the stomach acid staying in or around your stomach. You are reaching the point where you have to eat or drink upright. Food doesn’t get to your stomach as quickly, or as well as it did before. So spend the time and allow your food to go down a very slow drain. Also try very small meals frequently.
Thank you for taking the time to explain all of this. You are spot on with symptoms and what I can eat. I’ve been sleeping sitting up for months now and on a good night, when all seems calm, I treat myself to almost lying horizontally 🙂. I had noticed saliva or mucus being thicker and that standing or walking around after a meal seems to help.
Sorry for your diagnosis but now you can move forward. Trial and error, everyone is a little different. For me so many things became choking hazards like raw vegetables/salads - lettuce or sausage with casings. Milk seemed to catch on the phlegm and made the spasms worse. Use lots of extra butter on everything, increases calories and helps the food slide. Not really heart health but weight loss and malnutrition has its own complications. You will learn what works for you and will always be the last one done eating.
Thank you. I’m only now realising that I’ve had some of my symptoms for years but didn’t know it. I’ve never been able to drink large volumes of anything and I’m always the last to finish eating 🙁
It's so difficult Achalasia had 2 ops the first lasted quite a few years n I could eat then about 2 yrs ago became more difficult had another op Nov 2022 where part of my oesophagus was taken away n rejoined to my Stomach think,it was called Cardia plasty but it removed my OES which means acid just pumps up have tried to get in touch with the surgeon but he hardly ever replies .any help,?
