Hiccups

[Guest guest]

Hi Notan

As you already know I am 4 years post ectomy and continue to have swallowing

problems for which I continue to have the occasional dilatation. Now I also have

bad episodes of Hiccups when my little bit of Oesophagus (that was left in after

the ectomy) goes tight and is really painfull. I am waiting for my next

dilatation next month sometime. Is it normal to have long episodes of hiccups as

well as gurgles when trying to swallow with Achalasia of the upper sphincter of

the Oesophagus? This puzzles me and as I know that you are a font of knowledge

on Achalasia. Thank you.

________________________________

From: notan ostrich <notan_ostrich@...>

achalasia

Sent: Tuesday, January 6, 2009 7:52:38 PM

Subject: Re: Bird's Beak post myotomy?

wrote:

> ... If it is gravity that helps push things along, why is it that we have such

trouble with certain things ( bread, meats, etc) ...

The density of even meat is not much more than water. The density of

bread can be a lot less. Meat and vegetables can be stringy and chunky

which can cause resistance and blockages going down. Bread, some types

more than others, can be spongy or become a sticky goo. Being light and

not fluid, gravity has a harder time moving this sponge or goo than water.

Think of your esophagus as a pipe with the bottom something like a tight

opening for a balloon. If you pour water in the top of the pipe it will

quickly flow to the bottom and the pressure from gravity will expand the

balloon opening and let most of it right through. The tighter the

balloon opening the slower it will go. Now think of putting meat or

bread into the pipe. It will probably need some water poured in too to

make it go down and keep the balloon open.

If the esophagus is badly dilated it is like having a larger cylinder

between the pipe and the balloon. In some cases the balloon would still

be attached to a hole in the bottom, but in other cases you would now

have to attach the balloon to an opening on the side of cylinder. The

higher the balloon opening the worse it is going to be to get food into

the balloon because now food is going to just sit in the bottom of the

cylinder and not produce much pressure against the balloon even with a

little water.

If you want to add peristalsis to our pipe just replace the part of the

upper pipe with a hose that you can squeeze with your hands. You start

by putting one hand at the top of the hose and squeezing. Then place a

hand below that and squeeze. Move the top hand below the lower one and

squeeze and so on. With achalasia the part bellow the hose is still pipe

and can not be squeezed. Nor can a cylinder below that be squeezed. The

more cylinder and pipe you have and less hose the worse things can be.

Swelling and or scarring can make the " balloon opening " (LES) tighter.

We don't all produce the same amount of scarring and some people will

need a dilatation to break the scarring.

notan