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What are the treatment options for difficulty in swallowing due to achalasia cardia?

Q: I am a 39 years old man having achalasia cardia and have undergone dilation thrice in the last three decades. How long does this disease take to get cured?

A:There are three treatment options for achalasia cardia.

  1. Endoscopic botilunus toxin injection: This is the simplest treatment, with very few side effects, but is not the treatment of choice. Long term results are poor.
  2. Endoscopic dilatation: Some persons consider this the treatment of choice. Long term results are good, and the treatment is less invasive than surgery. The difficulty is that it is difficult to decide how much to dilate. Under-dilatation results in failure of treatment and continued symptoms. Overdilatation results in a rupture of the esophagus, a potentially dangerous complication. (Rupture can be well managed these days, actually.)
  3. Surgery: I think that this is the best treatment. It gives the best long-term results. It is very safe. Laparoscopic surgery is as good as open surgery, and has the advantage that pain and hospitalization are minimized.
If you have failed dilatation thrice, go in for surgery.

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