Ахалазия: от симптомов к диагнозу и правильному лечению
Нарушение глотания, регургитация, боль в груди или потеря веса: разберитесь в симптомах, диагностике, подтипе и вариантах лечения.
Редакционный черновик · требуется врачебная проверка перед публикацией
Patients start with what they feel—not with a procedure name.
The problem is not simply a “tight valve”.
Normal swallowing combines coordinated peristalsis with relaxation of the lower oesophageal sphincter. In achalasia, peristaltic progression is lost or abnormal and the EGJ does not relax adequately.
Explore achalasia in depth
Why does the “gate” at the end of the oesophagus fail to relax?
Achalasia is a motility disorder involving impaired peristalsis and incomplete relaxation of the lower oesophageal sphincter. Treatment focuses on reducing outflow resistance.
Type I, II and III are not the same manometric pattern.
Subtype is not guessed from symptoms; it is defined by high-resolution manometry. Explore each type with its own explanation, schematic and treatment implications.
Classic achalasia
Abnormal IRP + 100% failed peristalsis; no prominent panesophageal pressurisation.
Открыть →
Panesophageal pressurisation
Abnormal IRP + 100% failed peristalsis + panesophageal pressurisation in ≥20% of swallows.
Открыть →
Spastic achalasia
Abnormal IRP + ≥20% premature/spastic contractions; no normal peristalsis.
Открыть →
Achalasia is not the only cause of swallowing difficulty.
Pseudoachalasia, tumours near the gastro-oesophageal junction, EGJ outflow obstruction, distal spasm, eosinophilic oesophagitis, strictures and oropharyngeal causes can mimic achalasia. This section explains why differential diagnosis matters.
А если это не ахалазия? →Endoscopy or surgery? There is no one-line answer.
The right decision combines subtype, previous treatment, reflux risk, anatomy, patient preference and centre expertise.
POEM
Endoscopic myotomy through the mouth; particularly important in Type III.
Открыть →SURGICALHeller + Fundoplication
Laparoscopic myotomy with an anti-reflux procedure.
Открыть →ENDOSCOPICPneumatic Dilation
Graded balloon dilation; an option in selected patients.
Открыть →SELECTEDBotulinum Toxin
A temporary approach in selected patients not suitable for more durable therapies.
Открыть →“What can I eat?” can be as important as the procedure question.
Swallowing difficulty can reduce energy and protein intake. Nutrition is addressed by disease stage, weight loss and pre/post-procedure needs.
Weight loss, reduced intake and symptom burden should be considered together.
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Выберите симптомы, известный диагноз, предлагаемую процедуру и имеющиеся документы. Сайт сформирует структурированное сообщение WhatsApp для команды.
See the evidence behind the information; make personal decisions with a physician.
Akalazya.com is condition-centred. Assoc. Prof. Süleyman Günay’s clinical and academic identity is shown transparently, while treatment content is supported by independent international guidelines.
Structure your symptoms without turning them into a diagnosis.
Вы можете подозревать ахалазию, однако такие же жалобы встречаются и при других заболеваниях. Выберите симптомы и известные находки. Инструмент не ставит диагноз и не рассчитывает вероятность болезни.