Achalasia secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Many of the causes of achalasia are not preventable. However, treatment of the disorder may help to prevent complications.

Secondary Prevention

Lifestyle changes

• Achalasia patients need to eat slowly, chew very well, drink plenty of water with meals, and avoid eating near bedtime.
• It is helpful to sleep with the head elevated by raising the head of the bed or using a wedge pillow.
• Proton pump inhibitors may help prevent reflux damage after surgery by inhibiting gastric acid secretion.
• Foods that can aggravate reflux, including ketchup and other tomato products, citrus fruits, chocolate, mint, alcohol, and caffeine, should also be avoided.

Follow-up monitoring

• Even after successful treatment of achalasia, swallowing may still deteriorate over time.
• It's important to check every year or two with a timed barium swallow because some may need pneumatic dilations, a repeat myotomy, or even esophagectomy after many years.
• Some doctors recommend pH testing and endoscopy to check for reflux damage, which may lead to a stricture or cancer of the esophagus if untreated.