Re: Viruses, Autoimmune, Inflammation, Genetics, Injury, WhatHaveYou.

[Guest guest]

I have some thoughts on causes of achalasia.

First, viruses. " It is a virus. " Virus is unnamed and while it could be

that you got achalasia from " a " virus, it may be that someone else got

achalasia from another virus. There are good reasons to think that it is

one or more viruses. Tissue samples show inflammatory and other immune

system activity that could be due to a virus. The esophagus has a layer

of tissue, squamous epithelium, that can be infected by viruses that

also infect nerves, such as those in the herpes family. Herpes includes,

chicken pox/shingles, mono/Epstein-Barr, Herpes simplex 1 and 2 and

others. There may well be others in this family that have not yet been

identified. See: http://www.patient.co.uk/showdoc/40000367/ . Once you

have these viruses you can have them for life. You get over chicken pox

but you don't get rid of the virus and it sometimes reactivates later

in life as shingles, after hiding for many years in nerves. While being

latent in the nerves they can sometimes be caused to reactivate by:

injury, hormones, menstruation, stress, emotional upset etc.. (Does that

list sound familiar?)

Smoking gun? There are problems with the theory. These viruses are very

very common and achalasia is not. There have been studies done that seem

to rule these viruses out. In spite of the problems there are reasons to

think they could have something to do with causing achalasia. They may

not be enough in themselves to cause it though. See, " _Esophageal

achalasia: is the herpes simplex virus really innocent_, " at:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

4746832 & dopt=Abstract

..

The gist of that article is that even though the virus is not detected

in the samples of esophageal muscle tissue, from achalasia patients,

they have a greater reactivation of immune system cells from those

samples when exposed to Herpes simplex virus type 1 (HSV 1). This seems

to imply that achalasia patients have immune systems that respond

differently than the immune systems of others, when exposed to HSV 1.

Second, autoimmune. There are various researchers that have reported

finding suspicious immune system activity in esophageal tissues from

achalasia patients. This includes, immune system cells, inflammation and

antineuronal antibodies. Antineuronal antibodies are antibodies that

cause the immune system to target certain nerves for destruction. Also,

some researchers have reported that certain HLA (immune system) gene

types are more common in patients with achalasia than in others. You may

find it interesting that the immune system is effected by: injury,

hormones, menstruation, stress, emotional upset etc.. (Sound familiar yet?)

Again, this may not be the smoking gun it seems to be. Some researchers

have pointed out that the amount of activity seems too small to be an

" attack. " They argue that it is probably a " cleanup " process instead,

only enough to get rid of dead and dying cells but not strong enough to

damage healthy cells. See, _Antineuronal antibodies in idiopathic

achalasia and gastro-oesophageal reflux disease_, at:

http://gut.bmjjournals.com/cgi/content/full/52/5/629 .

Third, inflammation. Some simply say achalasia is an inflammatory

process and don't concern themselves with what causes the inflammation.

It is interesting that the nerves that are destroyed in achalasia are

the ones that produce NO (nitric oxide). NO is also produced by immune

system cells during an inflammation response. NO can be destructive to

cells. If the NO producing nerves are targeted by the immune system,

either because of antineuronal antibodies, or a virus among the nerves,

or just because of other damage, the combination of NO sources may be

too much for those nerves. This causes more damage and more

inflammation. The amount of inflammation can be effected by: (you know

what is coming), injury, hormones, menstruation, stress, emotional upset

etc..

Forth, genetics. Excluding genetic disorders such as AAA there does not

seem to be a gene type that causes primary achalasia, and researchers

have looked for one. There are stories, which are not uncommon with

achalasia, where a person has achalasia and has a relative with the

" same swallowing problems. " One is temped to conclude that both must

have achalasia. It turns out that in most cases the other person does

not have primary achalasia. There are a number of diseases that are much

more common than achalasia that produce the " same swallowing problems. "

That is the patient reports the same symptoms, but tests will reveal

something else. The children of people with achalasia do not seem to be

at more risk of getting achalasia than others. So, in the usual use of

the word inherited, primary achalasia is not inherited. This does not

mean you can't have a family member with it. It just means the odds are

against it

As I said earlier, and even though achalasia is not " inherited " , it has

been reported that some gene types are more common in people with

achalasia than in other people. These gene types are very common in

general though and most people with them will not get achalasia. Only a

very small portion of the people with those gene types will get

achalasia. But, it you have achalasia it more likely that you have one

of those gene types than if you didn't. This implies that the genes can

play a part in causing achalasia but by themselves are not the cause.

They just make you more susceptible to the cause of achalasia. As I

indicated before these genes are HLA genes which control the immune

system's ability to distinguish the body from invaders.

In a cell not all of the genes are active, many are turned off. Which

genes are active and how active they are depends on many factors. Some

of the things that can effect gene activity are: (drum roll), injury,

hormones, menstruation, stress, emotional upset etc.. Even though a gene

will be in cells throughout the body it may normally only be active in

certain cells. If a gene becomes active in the wrong cell it can be a

problem. The gene that makes a call able to move through the body is

normally only active in white blood cells. Sometimes, it become active

in brain cells and causes a very aggressive cancer where the cancer

cells begin moving through the brain, like white blood cells. Problems

with genes are not all " inherited. " It could be that primary achalasia

involves genes that are normal and needed in the body for normal

function but they go bad after some event. You inherited the genes but

you did not inherit the disease.

Fifth, injury. If you damage the nerves that control the esophagus by

injury you can cause achalasia. These nerves are very well protected by

the body and it would take a major blow, such as a very traumatic car

accident, to damage them.

Last, what have you. Diabetes stresses NO producing cells and causes

neuropathies. Double whammy. Likewise other things that cause

neuropathies or stress NO producing cells could be suspect. It has been

suggested that the esophageal nerves in achalasia have poor

distensiblity. They are more easily damaged by stretching. However,

anyone's nerves will be damaged if stretched too far for too long. I had

a temporary neuropathy, three months, in the nerves for my hand because

of the position my arm was in during surgery. In animal studies where

bands were placed around the LES to act as a continuous contraction.

Food accumulated in the esophagus and caused it to distend. In time

peristalsis was effected. If the band was removed soon enough

peristalsis returned. If the band was left on too long peristalsis did

not return. The implication is that a temporary problem could result in

a permanent progressive problem if it is not ended soon enough.

notan

[Guest guest]

Notan,

Your post was extremely helpful to me. Based on everyone's recent

contributions with theories about causes of A, I feel as though I am

at least caught up on the possible theories. So, I have gotten over

my desire to guess the cause (it is obviously naive of me to think I

might guess the cause when others have been researching it for

years). So, I am still interested in what will turn out to be the

true cause, but I feel more satisfied with my understanding of the

current state of knowledge.

Anyway, I am doing better at focusing on my bar studies. Peggy, I

appreciate your encouraging me to go study. Which I will now resume.

Vicki

>

> I have some thoughts on causes of achalasia.

>

> First, viruses. " It is a virus. " Virus is unnamed and while it

could be

> that you got achalasia from " a " virus, it may be that someone else

got

> achalasia from another virus. There are good reasons to think that

it is

> one or more viruses. Tissue samples show inflammatory and other

immune

> system activity that could be due to a virus. The esophagus has a

layer

> of tissue, squamous epithelium, that can be infected by viruses

that

> also infect nerves, such as those in the herpes family. Herpes

includes,

> chicken pox/shingles, mono/Epstein-Barr, Herpes simplex 1 and 2

and

> others. There may well be others in this family that have not yet

been

> identified. See: http://www.patient.co.uk/showdoc/40000367/ . Once

you

> have these viruses you can have them for life. You get over

chicken pox

> but you don't get rid of the virus and it sometimes reactivates

later

> in life as shingles, after hiding for many years in nerves. While

being

> latent in the nerves they can sometimes be caused to reactivate

by:

> injury, hormones, menstruation, stress, emotional upset etc..

(Does that

> list sound familiar?)

>

> Smoking gun? There are problems with the theory. These viruses are

very

> very common and achalasia is not. There have been studies done

that seem

> to rule these viruses out. In spite of the problems there are

reasons to

> think they could have something to do with causing achalasia. They

may

> not be enough in themselves to cause it though. See, " _Esophageal

> achalasia: is the herpes simplex virus really innocent_, " at:

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=14746832 & dopt=Abstract

> .

> The gist of that article is that even though the virus is not

detected

> in the samples of esophageal muscle tissue, from achalasia

patients,

> they have a greater reactivation of immune system cells from those

> samples when exposed to Herpes simplex virus type 1 (HSV 1). This

seems

> to imply that achalasia patients have immune systems that respond

> differently than the immune systems of others, when exposed to HSV

1.

>

> Second, autoimmune. There are various researchers that have

reported

> finding suspicious immune system activity in esophageal tissues

from

> achalasia patients. This includes, immune system cells,

inflammation and

> antineuronal antibodies. Antineuronal antibodies are antibodies

that

> cause the immune system to target certain nerves for destruction.

Also,

> some researchers have reported that certain HLA (immune system)

gene

> types are more common in patients with achalasia than in others.

You may

> find it interesting that the immune system is effected by: injury,

> hormones, menstruation, stress, emotional upset etc.. (Sound

familiar yet?)

>

> Again, this may not be the smoking gun it seems to be. Some

researchers

> have pointed out that the amount of activity seems too small to be

an

> " attack. " They argue that it is probably a " cleanup " process

instead,

> only enough to get rid of dead and dying cells but not strong

enough to

> damage healthy cells. See, _Antineuronal antibodies in idiopathic

> achalasia and gastro-oesophageal reflux disease_, at:

> http://gut.bmjjournals.com/cgi/content/full/52/5/629 .

>

> Third, inflammation. Some simply say achalasia is an inflammatory

> process and don't concern themselves with what causes the

inflammation.

> It is interesting that the nerves that are destroyed in achalasia

are

> the ones that produce NO (nitric oxide). NO is also produced by

immune

> system cells during an inflammation response. NO can be

destructive to

> cells. If the NO producing nerves are targeted by the immune

system,

> either because of antineuronal antibodies, or a virus among the

nerves,

> or just because of other damage, the combination of NO sources may

be

> too much for those nerves. This causes more damage and more

> inflammation. The amount of inflammation can be effected by: (you

know

> what is coming), injury, hormones, menstruation, stress, emotional

upset

> etc..

>

> Forth, genetics. Excluding genetic disorders such as AAA there

does not

> seem to be a gene type that causes primary achalasia, and

researchers

> have looked for one. There are stories, which are not uncommon

with

> achalasia, where a person has achalasia and has a relative with

the

> " same swallowing problems. " One is temped to conclude that both

must

> have achalasia. It turns out that in most cases the other person

does

> not have primary achalasia. There are a number of diseases that

are much

> more common than achalasia that produce the " same swallowing

problems. "

> That is the patient reports the same symptoms, but tests will

reveal

> something else. The children of people with achalasia do not seem

to be

> at more risk of getting achalasia than others. So, in the usual

use of

> the word inherited, primary achalasia is not inherited. This does

not

> mean you can't have a family member with it. It just means the

odds are

> against it

>

> As I said earlier, and even though achalasia is not " inherited " ,

it has

> been reported that some gene types are more common in people with

> achalasia than in other people. These gene types are very common

in

> general though and most people with them will not get achalasia.

Only a

> very small portion of the people with those gene types will get

> achalasia. But, it you have achalasia it more likely that you have

one

> of those gene types than if you didn't. This implies that the

genes can

> play a part in causing achalasia but by themselves are not the

cause.

> They just make you more susceptible to the cause of achalasia. As

I

> indicated before these genes are HLA genes which control the

immune

> system's ability to distinguish the body from invaders.

>

> In a cell not all of the genes are active, many are turned off.

Which

> genes are active and how active they are depends on many factors.

Some

> of the things that can effect gene activity are: (drum roll),

injury,

> hormones, menstruation, stress, emotional upset etc.. Even though

a gene

> will be in cells throughout the body it may normally only be

active in

> certain cells. If a gene becomes active in the wrong cell it can

be a

> problem. The gene that makes a call able to move through the body

is

> normally only active in white blood cells. Sometimes, it become

active

> in brain cells and causes a very aggressive cancer where the

cancer

> cells begin moving through the brain, like white blood cells.

Problems

> with genes are not all " inherited. " It could be that primary

achalasia

> involves genes that are normal and needed in the body for normal

> function but they go bad after some event. You inherited the genes

but

> you did not inherit the disease.

>

> Fifth, injury. If you damage the nerves that control the esophagus

by

> injury you can cause achalasia. These nerves are very well

protected by

> the body and it would take a major blow, such as a very traumatic

car

> accident, to damage them.

>

> Last, what have you. Diabetes stresses NO producing cells and

causes

> neuropathies. Double whammy. Likewise other things that cause

> neuropathies or stress NO producing cells could be suspect. It has

been

> suggested that the esophageal nerves in achalasia have poor

> distensiblity. They are more easily damaged by stretching.

However,

> anyone's nerves will be damaged if stretched too far for too long.

I had

> a temporary neuropathy, three months, in the nerves for my hand

because

> of the position my arm was in during surgery. In animal studies

where

> bands were placed around the LES to act as a continuous

contraction.

> Food accumulated in the esophagus and caused it to distend. In

time

> peristalsis was effected. If the band was removed soon enough

> peristalsis returned. If the band was left on too long peristalsis

did

> not return. The implication is that a temporary problem could

result in

> a permanent progressive problem if it is not ended soon enough.

>

> notan

>

[Guest guest]

notan, this is the most interesting discussion of the virus theory

that i have ever come across. thank you. i know there aren't any

easy answers (and that frustrates so many of us) but it's very

interesting to hear more about some options, at least.

vicki, if you are reading this get back to studying! " california is

a community property state... "

>

> I have some thoughts on causes of achalasia.

>

> First, viruses. " It is a virus. " Virus is unnamed and while it

could be

> that you got achalasia from " a " virus, it may be that someone else

got

> achalasia from another virus. There are good reasons to think that

it is

> one or more viruses. Tissue samples show inflammatory and other

immune

> system activity that could be due to a virus. The esophagus has a

layer

> of tissue, squamous epithelium, that can be infected by viruses

that

> also infect nerves, such as those in the herpes family. Herpes

includes,

> chicken pox/shingles, mono/Epstein-Barr, Herpes simplex 1 and 2 and

> others. There may well be others in this family that have not yet

been

> identified. See: http://www.patient.co.uk/showdoc/40000367/ . Once

you

> have these viruses you can have them for life. You get over chicken

pox

> but you don't get rid of the virus and it sometimes reactivates

later

> in life as shingles, after hiding for many years in nerves. While

being

> latent in the nerves they can sometimes be caused to reactivate by:

> injury, hormones, menstruation, stress, emotional upset etc.. (Does

that

> list sound familiar?)

>

> Smoking gun? There are problems with the theory. These viruses are

very

> very common and achalasia is not. There have been studies done that

seem

> to rule these viruses out. In spite of the problems there are

reasons to

> think they could have something to do with causing achalasia. They

may

> not be enough in themselves to cause it though. See, " _Esophageal

> achalasia: is the herpes simplex virus really innocent_, " at:

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=14746832 & dopt=Abstract

> .

> The gist of that article is that even though the virus is not

detected

> in the samples of esophageal muscle tissue, from achalasia

patients,

> they have a greater reactivation of immune system cells from those

> samples when exposed to Herpes simplex virus type 1 (HSV 1). This

seems

> to imply that achalasia patients have immune systems that respond

> differently than the immune systems of others, when exposed to HSV

1.

>

> Second, autoimmune. There are various researchers that have

reported

> finding suspicious immune system activity in esophageal tissues

from

> achalasia patients. This includes, immune system cells,

inflammation and

> antineuronal antibodies. Antineuronal antibodies are antibodies

that

> cause the immune system to target certain nerves for destruction.

Also,

> some researchers have reported that certain HLA (immune system)

gene

> types are more common in patients with achalasia than in others.

You may

> find it interesting that the immune system is effected by: injury,

> hormones, menstruation, stress, emotional upset etc.. (Sound

familiar yet?)

>

> Again, this may not be the smoking gun it seems to be. Some

researchers

> have pointed out that the amount of activity seems too small to be

an

> " attack. " They argue that it is probably a " cleanup " process

instead,

> only enough to get rid of dead and dying cells but not strong

enough to

> damage healthy cells. See, _Antineuronal antibodies in idiopathic

> achalasia and gastro-oesophageal reflux disease_, at:

> http://gut.bmjjournals.com/cgi/content/full/52/5/629 .

>

> Third, inflammation. Some simply say achalasia is an inflammatory

> process and don't concern themselves with what causes the

inflammation.

> It is interesting that the nerves that are destroyed in achalasia

are

> the ones that produce NO (nitric oxide). NO is also produced by

immune

> system cells during an inflammation response. NO can be destructive

to

> cells. If the NO producing nerves are targeted by the immune

system,

> either because of antineuronal antibodies, or a virus among the

nerves,

> or just because of other damage, the combination of NO sources may

be

> too much for those nerves. This causes more damage and more

> inflammation. The amount of inflammation can be effected by: (you

know

> what is coming), injury, hormones, menstruation, stress, emotional

upset

> etc..

>

> Forth, genetics. Excluding genetic disorders such as AAA there does

not

> seem to be a gene type that causes primary achalasia, and

researchers

> have looked for one. There are stories, which are not uncommon with

> achalasia, where a person has achalasia and has a relative with the

> " same swallowing problems. " One is temped to conclude that both

must

> have achalasia. It turns out that in most cases the other person

does

> not have primary achalasia. There are a number of diseases that are

much

> more common than achalasia that produce the " same swallowing

problems. "

> That is the patient reports the same symptoms, but tests will

reveal

> something else. The children of people with achalasia do not seem

to be

> at more risk of getting achalasia than others. So, in the usual use

of

> the word inherited, primary achalasia is not inherited. This does

not

> mean you can't have a family member with it. It just means the odds

are

> against it

>

> As I said earlier, and even though achalasia is not " inherited " , it

has

> been reported that some gene types are more common in people with

> achalasia than in other people. These gene types are very common in

> general though and most people with them will not get achalasia.

Only a

> very small portion of the people with those gene types will get

> achalasia. But, it you have achalasia it more likely that you have

one

> of those gene types than if you didn't. This implies that the genes

can

> play a part in causing achalasia but by themselves are not the

cause.

> They just make you more susceptible to the cause of achalasia. As I

> indicated before these genes are HLA genes which control the immune

> system's ability to distinguish the body from invaders.

>

> In a cell not all of the genes are active, many are turned off.

Which

> genes are active and how active they are depends on many factors.

Some

> of the things that can effect gene activity are: (drum roll),

injury,

> hormones, menstruation, stress, emotional upset etc.. Even though a

gene

> will be in cells throughout the body it may normally only be active

in

> certain cells. If a gene becomes active in the wrong cell it can be

a

> problem. The gene that makes a call able to move through the body

is

> normally only active in white blood cells. Sometimes, it become

active

> in brain cells and causes a very aggressive cancer where the cancer

> cells begin moving through the brain, like white blood cells.

Problems

> with genes are not all " inherited. " It could be that primary

achalasia

> involves genes that are normal and needed in the body for normal

> function but they go bad after some event. You inherited the genes

but

> you did not inherit the disease.

>

> Fifth, injury. If you damage the nerves that control the esophagus

by

> injury you can cause achalasia. These nerves are very well

protected by

> the body and it would take a major blow, such as a very traumatic

car

> accident, to damage them.

>

> Last, what have you. Diabetes stresses NO producing cells and

causes

> neuropathies. Double whammy. Likewise other things that cause

> neuropathies or stress NO producing cells could be suspect. It has

been

> suggested that the esophageal nerves in achalasia have poor

> distensiblity. They are more easily damaged by stretching. However,

> anyone's nerves will be damaged if stretched too far for too long.

I had

> a temporary neuropathy, three months, in the nerves for my hand

because

> of the position my arm was in during surgery. In animal studies

where

> bands were placed around the LES to act as a continuous

contraction.

> Food accumulated in the esophagus and caused it to distend. In time

> peristalsis was effected. If the band was removed soon enough

> peristalsis returned. If the band was left on too long peristalsis

did

> not return. The implication is that a temporary problem could

result in

> a permanent progressive problem if it is not ended soon enough.

>

> notan

>

[Guest guest]

Thank you for making this complicated issue understandable!

Joy in cloudy San

>

> I have some thoughts on causes of achalasia.

>

> First, viruses. " It is a virus. " Virus is unnamed and while it

could be

> that you got achalasia from " a " virus, it may be that someone else

got

> achalasia from another virus. There are good reasons to think that

it is

> one or more viruses. Tissue samples show inflammatory and other

immune

> system activity that could be due to a virus. The esophagus has a

layer

> of tissue, squamous epithelium, that can be infected by viruses

that

> also infect nerves, such as those in the herpes family. Herpes

includes,

> chicken pox/shingles, mono/Epstein-Barr, Herpes simplex 1 and 2

and

> others. There may well be others in this family that have not yet

been

> identified. See: http://www.patient.co.uk/showdoc/40000367/ . Once

you

> have these viruses you can have them for life. You get over

chicken pox

> but you don't get rid of the virus and it sometimes reactivates

later

> in life as shingles, after hiding for many years in nerves. While

being

> latent in the nerves they can sometimes be caused to reactivate

by:

> injury, hormones, menstruation, stress, emotional upset etc..

(Does that

> list sound familiar?)

>

> Smoking gun? There are problems with the theory. These viruses are

very

> very common and achalasia is not. There have been studies done

that seem

> to rule these viruses out. In spite of the problems there are

reasons to

> think they could have something to do with causing achalasia. They

may

> not be enough in themselves to cause it though. See, " _Esophageal

> achalasia: is the herpes simplex virus really innocent_, " at:

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=14746832 & dopt=Abstract

> .

> The gist of that article is that even though the virus is not

detected

> in the samples of esophageal muscle tissue, from achalasia

patients,

> they have a greater reactivation of immune system cells from those

> samples when exposed to Herpes simplex virus type 1 (HSV 1). This

seems

> to imply that achalasia patients have immune systems that respond

> differently than the immune systems of others, when exposed to HSV

1.

>

> Second, autoimmune. There are various researchers that have

reported

> finding suspicious immune system activity in esophageal tissues

from

> achalasia patients. This includes, immune system cells,

inflammation and

> antineuronal antibodies. Antineuronal antibodies are antibodies

that

> cause the immune system to target certain nerves for destruction.

Also,

> some researchers have reported that certain HLA (immune system)

gene

> types are more common in patients with achalasia than in others.

You may

> find it interesting that the immune system is effected by: injury,

> hormones, menstruation, stress, emotional upset etc.. (Sound

familiar yet?)

>

> Again, this may not be the smoking gun it seems to be. Some

researchers

> have pointed out that the amount of activity seems too small to be

an

> " attack. " They argue that it is probably a " cleanup " process

instead,

> only enough to get rid of dead and dying cells but not strong

enough to

> damage healthy cells. See, _Antineuronal antibodies in idiopathic

> achalasia and gastro-oesophageal reflux disease_, at:

> http://gut.bmjjournals.com/cgi/content/full/52/5/629 .

>

> Third, inflammation. Some simply say achalasia is an inflammatory

> process and don't concern themselves with what causes the

inflammation.

> It is interesting that the nerves that are destroyed in achalasia

are

> the ones that produce NO (nitric oxide). NO is also produced by

immune

> system cells during an inflammation response. NO can be

destructive to

> cells. If the NO producing nerves are targeted by the immune

system,

> either because of antineuronal antibodies, or a virus among the

nerves,

> or just because of other damage, the combination of NO sources may

be

> too much for those nerves. This causes more damage and more

> inflammation. The amount of inflammation can be effected by: (you

know

> what is coming), injury, hormones, menstruation, stress, emotional

upset

> etc..

>

> Forth, genetics. Excluding genetic disorders such as AAA there

does not

> seem to be a gene type that causes primary achalasia, and

researchers

> have looked for one. There are stories, which are not uncommon

with

> achalasia, where a person has achalasia and has a relative with

the

> " same swallowing problems. " One is temped to conclude that both

must

> have achalasia. It turns out that in most cases the other person

does

> not have primary achalasia. There are a number of diseases that

are much

> more common than achalasia that produce the " same swallowing

problems. "

> That is the patient reports the same symptoms, but tests will

reveal

> something else. The children of people with achalasia do not seem

to be

> at more risk of getting achalasia than others. So, in the usual

use of

> the word inherited, primary achalasia is not inherited. This does

not

> mean you can't have a family member with it. It just means the

odds are

> against it

>

> As I said earlier, and even though achalasia is not " inherited " ,

it has

> been reported that some gene types are more common in people with

> achalasia than in other people. These gene types are very common

in

> general though and most people with them will not get achalasia.

Only a

> very small portion of the people with those gene types will get

> achalasia. But, it you have achalasia it more likely that you have

one

> of those gene types than if you didn't. This implies that the

genes can

> play a part in causing achalasia but by themselves are not the

cause.

> They just make you more susceptible to the cause of achalasia. As

I

> indicated before these genes are HLA genes which control the

immune

> system's ability to distinguish the body from invaders.

>

> In a cell not all of the genes are active, many are turned off.

Which

> genes are active and how active they are depends on many factors.

Some

> of the things that can effect gene activity are: (drum roll),

injury,

> hormones, menstruation, stress, emotional upset etc.. Even though

a gene

> will be in cells throughout the body it may normally only be

active in

> certain cells. If a gene becomes active in the wrong cell it can

be a

> problem. The gene that makes a call able to move through the body

is

> normally only active in white blood cells. Sometimes, it become

active

> in brain cells and causes a very aggressive cancer where the

cancer

> cells begin moving through the brain, like white blood cells.

Problems

> with genes are not all " inherited. " It could be that primary

achalasia

> involves genes that are normal and needed in the body for normal

> function but they go bad after some event. You inherited the genes

but

> you did not inherit the disease.

>

> Fifth, injury. If you damage the nerves that control the esophagus

by

> injury you can cause achalasia. These nerves are very well

protected by

> the body and it would take a major blow, such as a very traumatic

car

> accident, to damage them.

>

> Last, what have you. Diabetes stresses NO producing cells and

causes

> neuropathies. Double whammy. Likewise other things that cause

> neuropathies or stress NO producing cells could be suspect. It has

been

> suggested that the esophageal nerves in achalasia have poor

> distensiblity. They are more easily damaged by stretching.

However,

> anyone's nerves will be damaged if stretched too far for too long.

I had

> a temporary neuropathy, three months, in the nerves for my hand

because

> of the position my arm was in during surgery. In animal studies

where

> bands were placed around the LES to act as a continuous

contraction.

> Food accumulated in the esophagus and caused it to distend. In

time

> peristalsis was effected. If the band was removed soon enough

> peristalsis returned. If the band was left on too long peristalsis

did

> not return. The implication is that a temporary problem could

result in

> a permanent progressive problem if it is not ended soon enough.

>

> notan

>