Life of An Achalasia

My symptoms started when I was 25. The first problem I remember is regurgitating a completely undigested column of chicken nuggets at a buffet lunch. I was a final year medical student living away and it was disgusting and embarrassing. My GP jumped to th common conclusion that it was due to stress. She called it globus hystericus.

I was an otherwise healthy 25 year old and I knew I wasn’t so stressed that I was imagining vomiting chicken nuggets!  Using my med school connections I bypassed my GP and found a sympathetic doctor who actually listened to my symptoms and believed my story.   e arranged a series of not very nice tests which confirmed the diagnosis of achalasia.

I had a balloon passed into my throat and then inflated to widen my oesophagus – a balloon dilatation. This worked for a while and certainly bought me time as it has now been 10 years since I was diagnosed. Over the years I have found various tricks to help get me through meals. For example, I would never put anything in my mouth unless I had water nearby.  I use water to push the food down through my narrowing throat. I avoid certain foods that were certain to get stuck, like chunky bread or tough meat. I never eat a sandwich on the go at work as I am more likely to choke.

It was after yet another A&E attendance during my second pregnancy that I saw a GP who encouraged me to seek further help. She sent me for a second opinion and I had everything re-evaluated. It was found that my oesophagus had begun to dilate above the narrowing due to all the increased pressure and all swallowing muscle movement was gone. The time had come to get more definitive treatment. The idea of the surgery for achalasia, whatever form it takes, is to cut the ring of muscle at the bottom of the oesophagus so as to allow the food to pass through unhindered. This can be done through keyhole surgery or in some centres now it can be done through the mouth using endoscopic techniques.  This “through the mouth” technique is called the POEM procedure. I opted for the POEM as although it is a new procedure, I felt it left me the option of  having keyhole surgery later should the POEM not work. In addition I loved the idea of not having any wounds post operatively.  As a working Mum of two kids, I wanted to minimise the recovery time and time spent away from them in hospital.