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In achalasia, therapy can also be carried out using balloon dilatation (expansion).
However, especially in children and adolescents, the effect after treatment lasts only a short time.
This is a special endoscopic instrument that the doctor inserts into the esophagus and stomach. This procedure mechanically expands the narrowed lower esophageal muscle. Balloon dilatation is considered the most effective non-surgical treatment for achalasia: after a single injection, signs of swallowing disorders in most cases improve for several months, in half - even for several years. Then re-dilation may be required.
The advantage of treating achalasia with balloon dilation is that the procedure is performed during refraction of the esophagus and stomach and does not require surgery.
However, complications may occur during treatment: during dilatation, the esophagus may rupture (3%). In rare cases (2-5%), bacteria can enter the chest cavity and cause inflammation of the middle layer (mediastinitis). Antibiotics are used for its treatment. Endoscopic injection of botulinum toxin. In achalasia, endoscopic injection of botulinum toxin is also suitable for therapy.
In 9 out of 10 cases, botulinum toxin improves the symptoms of amlodipine over time. However, the symptoms often recur within a year of treatment.
Botulinum toxin is a neurotoxin produced by a specific bacterium (Clostridium botulinum). This highly toxic substance causes botulism in humans, a dangerous food poisoning that can lead to death. However, if this poison is injected diluted into the muscles of the lower esophagus (the valve between the stomach and esophagusm), it blocks the nerves located there, which reduces occlusal pressure.
In general, endoscopic botulinum toxin injection for achalasia is less risky than balloon dilatation and is especially beneficial for the elderly in poor health.
If the condition does not improve with conservative therapies, surgery may be required. The surgeon splits the muscles of amlodipine esophagus from the outside (called a myotomy). The procedure can be performed either with a classic abdominal incision (transabdominal) or with laparoscopy (laparoscopic, minimally invasive surgery).
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All therapies used in achalasia that successfully reduce occlusive pressure in the muscles of the lower esophagus can cause aggressive gastric juice to flow back into the esophagus, causing reflux disease.
During the operation, this problem can be immediately solved with the help of Amlodipine additional fundoplier: The surgeon puts a muscle cuff on the ring around the upper part of the stomach to permanently prevent reflux.