Mr. Luyen (57 years old, in Ho Chi Minh City) suffered from acid reflux every night and slept sitting up for 2 years; the doctor diagnosed him with achalasia, the esophagus dilated 3 times more than normal.
On March 5, Dr. Do Minh Hung, Director of the Endoscopy and Gastrointestinal Endoscopic Surgery Center, Tam Anh General Hospital, Ho Chi Minh City, said that Mr. Luyen was admitted to the emergency room in a state of exhaustion due to not being able to eat or drink.
Serious illness due to subjectivity
During the examination, in addition to acute enteritis, the doctor discovered that he had achalasia. This is a type of functional disorder in which the esophagus cannot push food down to the stomach, the esophageal sphincter does not open completely, causing food to stagnate in the esophagus.
Taking a medical history, Mr. Luyen suffered from dysphagia, chest tightness, nausea, and gastroesophageal reflux for many years. In the past 2 years, the reflux became more severe, forcing him to sleep sitting up to prevent reflux attacks.
Doctor Minh Hung (near the screen) performs a digestive endoscopy surgery.
The results of the esophagogastric X-ray with contrast showed that Mr. Luyen's esophagus was 3 times larger than normal (4-5 cm in diameter), the lower 1/3 of the esophagus had a beak shape (indicating that this part of the esophagus had narrowed). A chest computed tomography (CT) scan showed fluid retention throughout the esophagus along with several small lymph nodes in the cardia. Suspecting esophageal motility disorder, the doctor ordered Mr. Lam to undergo high-resolution esophageal motility manometry (HRM). Based on the diagnostic results, the doctor determined that Mr. Luyen had type 2 achalasia.
"The patient lost a lot of weight due to poor eating and sleeping, but subjectively did not go to the doctor because he thought the reflux disease would gradually go away," said Dr. Minh Hung.
Symptoms can be easily confused with other movement disorders.
Mr. Luyen was indicated for surgery to cut the lower esophageal sphincter using the Peroral Endoscopic Myotomy (POEM) method. This method has many advantages, is minimally invasive, has long-term effectiveness, and leaves no scars. Previously, the patient had been treated for stable gastritis.
After the patient is anesthetized, the doctor performs a wide endoscopy to explore the esophagus. Then, a scalpel is used to burn open the esophageal mucosa, down to the esophagogastric junction under water. At the same time, a submucosal cavity and muscle layer are created from the middle esophagus to the beginning of the stomach, and the esophageal sphincter is cut at the esophageal-cardia junction (6 cm in the esophagus and 2 cm in the stomach). Finally, the doctor closes the mucosal hole with a clip to clamp the blood vessels.
After 1 day of surgery, Mr. Luyen's health was stable, he could drink water and was discharged from the hospital. In the first week, the patient was instructed to eat liquid food and then gradually switch to a solid diet.
Doctor Minh Hung said that achalasia is a rare disease and the exact cause is not yet determined. The symptoms are easily confused with other movement disorders, so it is easy to misdiagnose or delay. The disease causes food to stagnate in the esophagus for a long time, which can cause esophageal ulcers, aspiration pneumonia due to vomiting, cancer in the chronically inflamed area, and physical weakness due to choking and inability to eat or drink.
Doctor Minh Hung advises that when symptoms such as difficulty swallowing, choking on food, vomiting, chest pain behind the sternum, heartburn, weight loss, etc. appear, patients should go to reputable medical facilities and hospitals with full specialized equipment for accurate diagnosis and timely treatment.
Source: https://thanhnien.vn/nguoi-dan-ong-ngu-ngoi-suot-2-nam-185250305135654762.htm
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