and the longitudinal muscle of the esophagus

[Guest guest]

Hello to all of you brave souls!

Someone asked if there was any scientific research bearing on achalasia.

There is. The results of a radiologist's 33 year research on the

esophagus (mine) are

on the following web page:

http://www.inxpress.net/~oastiennon/index.html

If you forget that URL, just do a search on " longitudinal muscle " and it

should top the list because it is the only article (300 pages) ever

published on the longitudinal muscle of the esophagus. Over 50% of the

esophageal muscle is longitudinal, yet all of the medical writing is on

the circular muscle! The reason is the LM does not affect a manometer

and the endoscopist can't see it. Yet it is responsible for 90% of

esophageal disease including GERD and achalasia.

Briefly, a strong contraction of the LM can pull the top of the stomach

into a

hiatus that is too small for it where it gets caught causing an

obstruction of the fundus that is misdiagnosed " achalasia. " All you

people have misdiagnosed intestinal

obstruction. None of the fanciful conventional theories of achalasia

make any sense.

Read the book or the long chapter on achalasia and perhaps some of you

can persuade a surgeon to do the logical thing and simply pull the

stomach out of the hiatus and relieve the obstruction.

O. Arthur Stiennon, M.D.

[Guest guest]

Hello Dr Stiennon,

Thank you so much for your post. I have seen and read your research

article and struggled to understand parts of it - it is clearly

directed more to the medical community than to computer programmers!

Your brief synopsis here clears up a lot for me. I agree that the

current theory of achalasia the doctors tell us makes no sense, and I

can't find any proof of anything that the doctors say about it.

My main question to you is would the problem you describe show up

with endoscopy? I thought they checked for obstruction, hiatal

hernia, etc. Is it something that they wouldn't pick up on during

this procedure? Is there some definitive test or view they can do to

see that the problem is indeed as you indicate?

And if they did pull the stomach out of the hiatus would they have to

do something to ensure that it was not pulled back in? Can you

describe this procedure a bit more?

I really dislike the current proposed treatments because they cause

damage to the esophagus - rupturing the sphincter muscles, cutting

them, etc, with no clear indication of what causes the problem.

I also am alarmed that it seems to be only speculation that the

nerves of the esophagus fail and are the start of the problem. Yet

it doesn't seem there is any proof of this and indeed like the

chicken and the egg I wonder which comes first - the nerve problem or

the dilation of the esophagus.

If, as you say, the problem can be treated by relieving the

obstruction through pulling the stomach out of the hiatus, would the

dilation of the esophagus reduce? And perhaps the nerves would have

greater effect making esophageal peristalsis effective? So I guess

I'm asking if this could in fact be (for some) some kind of " cure "

and not just a treatment of the dysphagia symptom.

I think I read that you were or are living in Wisconsin. Are there

any physicians in Wisconsin who you can recommend? Someone who would

take the time to determine if your suggested treatment would work for

me? I currently see a GI doc at the UW in Madison but I'm not very

happy with my treatment thus far.

I'm 31 years old, diagnosed with achalasia for just under 1 year. I

had chest pains for several years before dysphagia. I wrote them off

to heartburn or gas, although they seemed to be neither. When my

dysphagia began I wrote it off to stress, as I was under a great deal

at the time. My chest pains nearly ceased the minute my dysphagia

started and they have not returned except very occasionally.

I've had barium swallow, manometry, endoscopy and one endoscopic

balloon dilation (the effect of which was negligible). I still can

eat most of the time but generally have to drink a lot of water in

order to get food or drink down.

Thank you, Dr Steinnon, for your article and research. Your

information makes a lot of sense to me. Please keep posting to this

group. I for one would like to hear more.

Rusch

Madison, WI

> Hello to all of you brave souls!

>

> Someone asked if there was any scientific research bearing on

achalasia.

>

> There is. The results of a radiologist's 33 year research on the

> esophagus (mine) are

> on the following web page:

>

> http://www.inxpress.net/~oastiennon/index.html

>

> If you forget that URL, just do a search on " longitudinal muscle "

and it

>

> should top the list because it is the only article (300 pages) ever

> published on the longitudinal muscle of the esophagus. Over 50% of

the

> esophageal muscle is longitudinal, yet all of the medical writing

is on

> the circular muscle! The reason is the LM does not affect a

manometer

> and the endoscopist can't see it. Yet it is responsible for 90% of

> esophageal disease including GERD and achalasia.

>

> Briefly, a strong contraction of the LM can pull the top of the

stomach

> into a

> hiatus that is too small for it where it gets caught causing an

> obstruction of the fundus that is misdiagnosed " achalasia. " All you

> people have misdiagnosed intestinal

> obstruction. None of the fanciful conventional theories of achalasia

> make any sense.

>

> Read the book or the long chapter on achalasia and perhaps some of

you

> can persuade a surgeon to do the logical thing and simply pull the

> stomach out of the hiatus and relieve the obstruction.

>

> O. Arthur Stiennon, M.D.