Difference between Achalasia and Stricture


Achalasia is a disorder in which the esophagus becomes dysfunctional, making swallowing difficult. When the esophagus contracts, a condition known as a stricture, swallowing becomes difficult

What is Achalasia?

Achalasia is a disorder with the esophageal function that makes swallowing difficult.

Causes and risk factors − Peristalsis, required for swallowing, is negatively impacted by the loss of nerve cells in the muscles of the esophagus. Autoimmune disorders and Chaga's disease are two possible explanations. Achalasia can also be caused by a malignant tumor or a hereditary disorder called Allgrove's syndrome. These diseases increase the likelihood of developing achalasia

Diagnosis − Esophageal manometry and esophageal endoscopy (esophagoscopy) may be utilized to make a diagnosis. In the latter, the esophageal contractions during swallowing are measured with the help of a catheter. The presence of a stricture in the esophagus can be differentiated from achalasia on an X-ray in which the patient additionally drinks barium.

Symptoms and complications − The symptoms typically begin subtly and escalate to the point where swallowing both solid and liquid meals becomes difficult. In addition to the aforementioned symptoms, achalasia can also manifest itself with chest discomfort, nighttime coughing, belching, and regurgitation of both saliva and food. Aspiration pneumonia is a lung infection that can occur in people with achalasia if food or liquid gets aspirated into the lungs.

Treatment − Heller myotomy is a surgical procedure in which a little piece of the esophageal sphincter muscle is removed as a means of treatment. Pneumatic balloon dilation, in which the sphincter is widened using a balloon catheter, is another possibility. Injections of botulinum toxin are occasionally used to treat esophageal muscular dysfunction. The patient's specific form of achalasia will likely guide their treatment decisions

What is Stricture?

Stricture is a condition in which the esophagus narrows in a way that is not typical.

Causes and risk factors − An esophageal stricture is caused by the esophagus becoming damaged from untreated gastroesophageal reflux disease (GERD). Inflammation and irritation of the esophagus can lead to stricture formation, and anti-inflammatory medications and radiation/chemotherapy treatment are two potential triggers. Esophageal cancer can also cause the tube to become constricted. Risk factors include a history of gastrointestinal reflux disease or malignancy.

Diagnosis − Swallowing barium for an X-ray of the esophagus is the gold standard for diagnosing esophageal stricture. Besides an esophagoscopy, endoscopy, and ultrasound, these diagnostic tools may be useful in determining the cause of the disease.

Symptoms and complications − Struggling to swallow, regurgitate food, experiencing food being trapped in the chest area, feeling heartburn, and belching are all symptoms. Aspiration of food into the lungs, the development of a fistula, and the occurrence of a perforation of the esophagus are all complications associated with a stricture

Treatment − First, the esophagus is dilated using a balloon dilation procedure during endoscopy in many cases. A dilator, which is a rubber tube, may be used in place of a balloon. The tissue blocking the esophagus is sometimes removed surgically, or a stent is placed. The severity and kind of stricture will determine the best course of action.

Differences between Achalasia and Stricture

The following table highlights the major differences between Achalasia and Stricture −

Characteristics

Achalasia

Stricture

Definition

Achalasia is a condition that affects how the esophagus operates.

Stricture is a condition in which the esophagus becomes physically constricted.

Causes

Achalasia is caused by the death of esophageal nerve cells, which can be the result of radiation therapy, chemotherapy, or an inflammatory disorder

Stricture can result from acid reflux disease (GERD), ingestion of a caustic chemical, radiation therapy, or injury sustained when using an endoscope or nasogastric tube.

Age of diagnosis

People between the ages of 25 and 60 are often diagnosed with achalasia.

People over the age of 40 are more likely to be diagnosed with an esophageal stricture.

Treatment

Achalasia treatment options include Heller myotomy, pneumatic balloon dilatation, and Botulinum toxin injections

Strictures can be treated with balloon dilatation, rubber dilaters, stents, or surgical removal of some tissue

Complications

Aspiration pneumonia is a complication of achalasia.

Aspiration, perforation, and the development of a fistula are among the complications that can arise from damage to the esophageal structure.

Conclusion

In this article, we explained in detail how Achalasia is different from Stricture

Updated on: 19-Jan-2023

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