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How is it that symptoms can come and go for some people when this is supposed to

be a degenerative disease? I thought that would mean once functionality is lost

it wouldn't be able to get better. I sometimes think not enough is known about

this disease and too many assumptions are made. I would like to explore

supplements/vitamins that may help before deciding to alter my anatomy

permanetly.

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On 3/2/2010 10:43 AM, blicky77 wrote:

> ... I sometimes think not enough is known about this disease and too many

assumptions are made. ...

Too much is not known, but the destruction of certain esophageal nerves

is well documented. There is not just one type of nerve that controls

the LES. There is more than one type of nerve that effects LES

relaxation and other types that effect LES contraction. One type of

those for relaxation seems to suffer most of the damage. That damage

does not happen all at once. Like a person that is chronically sick and

may have good days and bad days so too these nerves may have ups and

downs and the other nerves may also perform better under certain

situations in making up the difference. Also it is not completely

understood how other cells in the esophagus, such as ICC, mast cells and

immune cells, effect the nerves, and how those effects may change from

day to day.

notan

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Yes, not enough is known about this disease but it would be a mistake to

believe, that in any degenerative disease, symptoms simply go from bad to worse.

In fact, it is well known that there are many small ups and downs but over time,

overall, the situation degenerates. On any given day you can feel great but

tomorrow you can feel the same, better or worse.

Plus your symptoms are not a good index of what is going on inside your body.

How you feel is the result of a complex interaction among many, many factors.

Your nerves can be dying and you would not feel it because they are responsible

for sensation too. So in some way feeling better means things are getting worse.

However, don't fool yourself; some things are well known about this disease.

Once the esophagus is stretched, it will not go back to its original shape. It

is not like an artery that can be greatly stretched and yet shrink back once the

problem is fixed. It is also known that once an esophagus gets too dilated, it

will sag ever lower than the entrance to the stomach. This is the dreaded " J "

pouch that signals end stage achalasia. The esophagus becomes too damaged to

work anymore or it ruptures. Then your only option is to have it removed.

Surgery was not always an option for achalasia so what happens when nothing is

done is well documented and not pretty.

I understand where you are coming from because none of us wanted to alter our

anatomy, believe me. However, there are no vitamins or minerals that can

possible be effective. There is no protocol that could even theoretically be

useful. I have a masters degree in nutrition from Bastyr University (google it)

and if there was a natural treatment for this, I would know. So explore but

don't wait too long. It may be hard for you to believe, but the best result

comes when surgery is done early.

Beware that there are people on the internet who prey on those who face the sort

of challenges we do. They will tell you what you want to hear and make a profit

off of it. If anyone is telling you a vitamin protocol can prevent esophageal

damage, make sure you know how to reach them off line so you can sue them later.

Maureen in Mukilteo

>

> How is it that symptoms can come and go for some people when this is supposed

to be a degenerative disease? I thought that would mean once functionality is

lost it wouldn't be able to get better. I sometimes think not enough is known

about this disease and too many assumptions are made. I would like to explore

supplements/vitamins that may help before deciding to alter my anatomy

permanetly.

>

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Maureen, I would caution you to be careful with how you word things,

particularly since you try to make it sound like you have professional

expertise in matters of this nature. I'm referring to the following

statements in bold:

> However, don't fool yourself; some things are well known about this

disease. Once the esophagus is stretched, it will not go back to its

original shape. It is not like an artery that can be greatly stretched

and yet shrink back once the problem is fixed. It is also known that

once an esophagus gets too dilated, it will sag ever lower than the

entrance to the stomach. This is the dreaded " J " pouch that signals end

stage achalasia. The esophagus becomes too damaged to work anymore or it

ruptures. Then your only option is to have it removed. Surgery was not

always an option for achalasia so what happens when nothing is done is

well documented and not pretty. > > I understand where you are coming

from because none of us wanted to alter our anatomy, believe me.

However, there are no vitamins or minerals that can possible be

effective. There is no protocol that could even theoretically be useful.

I have a masters degree in nutrition from Bastyr University (google it)

and if there was a natural treatment for this, I would know. So explore

but don't wait too long. It may be hard for you to believe, but the best

result comes when surgery is done early.

Surgery is NOT always the best result, nor is it always necessary. I've

been symptomatic for almost two full decades, and I haven't had surgery,

and I haven't gotten to the point where it's " not pretty " . My last

dilation was a dozen years ago, and there has been no further stretching

of my esophagus.

Since my last dilation, I've seen members of this group go through 1-2

surgeries followed by 1-2 dilations. Surgery for them was NOT a better

result than dilation was for me.

We're all different, and there simply hasn't been enough research to be

able to say that XYZ is the optimal treatment for achalasia.

Debbi in Michigan

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wow, that is a confrontational statement.

>

> Maureen, I would caution you to be careful with how you word things,

> particularly since you try to make it sound like you have professional

> expertise in matters of this nature. I'm referring to the following

> statements in bold:

>

> > However, don't fool yourself; some things are well known about this

> disease. Once the esophagus is stretched, it will not go back to its

> original shape. It is not like an artery that can be greatly stretched

> and yet shrink back once the problem is fixed. It is also known that

> once an esophagus gets too dilated, it will sag ever lower than the

> entrance to the stomach. This is the dreaded " J " pouch that signals end

> stage achalasia. The esophagus becomes too damaged to work anymore or it

> ruptures. Then your only option is to have it removed. Surgery was not

> always an option for achalasia so what happens when nothing is done is

> well documented and not pretty. > > I understand where you are coming

> from because none of us wanted to alter our anatomy, believe me.

> However, there are no vitamins or minerals that can possible be

> effective. There is no protocol that could even theoretically be useful.

> I have a masters degree in nutrition from Bastyr University (google it)

> and if there was a natural treatment for this, I would know. So explore

> but don't wait too long. It may be hard for you to believe, but the best

> result comes when surgery is done early.

>

> Surgery is NOT always the best result, nor is it always necessary. I've

> been symptomatic for almost two full decades, and I haven't had surgery,

> and I haven't gotten to the point where it's " not pretty " . My last

> dilation was a dozen years ago, and there has been no further stretching

> of my esophagus.

> Since my last dilation, I've seen members of this group go through 1-2

> surgeries followed by 1-2 dilations. Surgery for them was NOT a better

> result than dilation was for me.

> We're all different, and there simply hasn't been enough research to be

> able to say that XYZ is the optimal treatment for achalasia.

> Debbi in Michigan

>

>

>

>

>

>

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Debbi wrote:

> We're all different, and there simply hasn't been enough research to be

> able to say that XYZ is the optimal treatment for achalasia.

> Debbi in Michigan

>

Like you said, " be careful with how you word things. " Statistically

speaking, myotomy may be the best treatment for achalasia. Whether or

not those statistics provide the best answer for any particular

achalasic is a different problem. So if a person is considering myotomy

it would be, statistically speaking, a good guess that it would be best,

but that does not mean that in the end it will turn out to be a good

guess for that person.

I am still of the opinion that when it comes to achalasia there are no

right answers, just good guesses.

For reference links about dilatation see:

http://www.zotero.org/groups/achalasia_atheneum/items/collection/2179158

For about dilatation failures see:

http://www.zotero.org/groups/achalasia_atheneum/items/collection/2179160

For about myotomy see:

http://www.zotero.org/groups/achalasia_atheneum/items/collection/2179005

For about myotomy long-term see:

http://www.zotero.org/groups/achalasia_atheneum/items/collection/2179157

For about myotomy failure and predictors see:

http://www.zotero.org/groups/achalasia_atheneum/items/collection/2179041

notan

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In achalasia , " toomuchclutter " <sandycarroll@...> wrote:

> wow, that is a confrontational statement.

Wow, that is a helpful statement <not>.

I'm not interested in starting flame wars here, Sandy. If you feel the need to

engage in such activities, please at least take it off-list so other people

don't have to get involved.

The point of this forum is to HELP each other, not run each other down. That

was the purpose of my reply -- to point out that speaking in absolutes is not

necessarily in everyone's best interests. I'm not anti-myotomy, either. I just

like to point out that there are different options and NONE of them offer any

guarantees.

In achalasia , notan ostrich <notan_ostrich@...> wrote:

> Like you said, " be careful with how you word things. " Statistically

speaking, myotomy may be the best treatment for achalasia. Whether or

not those statistics provide the best answer for any particular

achalasic is a different problem. So if a person is considering

myotomy it would be, statistically speaking, a good guess that it

would be best, but that does not mean that in the end it will turn out

to be a good guess for that person.

> I am still of the opinion that when it comes to achalasia there are

no right answers, just good guesses.

My qualifier " we're all different " at the beginning of the paragraph was

intended to convey that sentiment, but I can see that the message doesn't

necessarily come across the same without adding " for any one person/individual "

at the end of the sentence.

Thank you, notan, for further clarifying my message. As usual, your posts are

helpful and informative.

Debbi in Michigan

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toomuchclutter wrote:

> wow, that is a confrontational statement.

>

>

I think how it comes across depends on the voice you read it with. Try

reading it like it is your own words to a friend you are trying to

caution because you want that friend to be able to do the best she can

for the community here.

notan

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