Diagnosis and treatment of cardiac achalasia: clinical lecture

Achalasia cardiac (achalasia cardiac) is a disease of the esophagus, characterized by a loss of the neurons of the Auerbach’s plexus, a progressive de- crease in the tone of the tubular esophagus, leading to disruption of the peristalsis and reflex opening of the lower esophageal sphincter during swallowing. The etiology of achalasia cardiaс (AС) remains largely unknown and the theory of ganglionitis caused by an aberrant immune response to a viral infection explains the loss of esophageal neurons, especially in genetically predisposed individuals. As a result, the eaten food accumulates in the esophagus, which leads to symptoms of dysphagia, regurgitation, chest pain and weight loss and increases the risk of esophageal carcinoma. Currently, pneumatic dilatation and Geller’s esophagocardiomyotomy in conjunction with fundoplication are the most common methods of treating AС.