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Re: Re: End-stage

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I had end stages A had to finally have an ectomy in Dec. I had this condition

for 30 years, I'm 46 now. I can't tell you how wonderful it has been. I have no

reflux or E pain and things that I have never had before I'm enjoying, It is a

new life. It took me a long time to wrap my mind around it and did everything to

try and save my E, however the size of my E got so large it was on my heart.

Having an ectomy is a welcome surgery for me.

________________________________

From: josef <schmundt@...>

achalasia

Sent: Fri, March 4, 2011 3:23:05 AM

Subject: Re: End-stage achalasia

My doctor called my achalasia end stage because of the pig tail shaped esophagus

and pockets in it.It doesn't seem to be stretched too bad yet I don't think. I

now have Barretts also, so I must be scoped once a year.I am hoping I can go at

least another ten years before they even think about an Ectomy.I had no idea I

even had Achalasia until 1 1/2 years ago.

>

> This message is for those wanting to know what end-stage achalasia is.

>

> End-stage achalasia, typically is a massively dilated and tortuous

> oesophagus. It is also known as Stage IV achalasia or megaesophagus. The

> stages of achalasia are; Stage I-esophageal dilation up to 2-2.5 cm;

> Stage II-dilation up to 2.5-4 cm; Stage III up to 5-8 cm and Stage IV –

> lengthening and dilation of the esophagus over 8 cm. I have seen some

> paper refer to end-stage as starting a 6 cm. As the esophagus lengthens

> it bends (becomes tortuous) that often produces an S shape called

> sigmoid (the Greek letter for S is sigma). Stage IV is called End-Stage

> because there is no stage V and it is final result of lengthening and

> dilation. Sometimes, but not always, at this stage the esophagus is so

> dysfunctional and unresponsive to treatment that esophagectomy becomes

> the treatment option. End-stage does not mean it will kill you though

> for some tube feeding or esophagectomy are needed to survive.

>

> notan

>

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Kay wrote:

> ... Is there evidence that end stage reverts on it's own.

Sorry, no, not that I know of.

> My deterioration since the myotomy has been gradual and the severity can

fluctuate.

I assume you are talking about your symptoms. Like how easy it is to

eat. That is not always a good indication of the progression. The

esophagus can dilate and lengthen without causing much change in

symptoms. Then one day it seems to not work and you get a barium X-ray

and find it is now sigmoid. If you get regular checkups of the esophagus

you can probably avoid the surprise but you may not be able to avoid the

progression. Many of us have better days and worse days or even months

at a time. It can make knowing what long-term changes are actually

happening. There are probably people who have end-stage and have no idea

that they do. They just fight on as they have for years.

The good news is that most people don't ever make it to an end-stage

diagnosis. Some because they either just stop progressing or do so

slowly and others because they are older when they get achalasia. And

possibly some are never diagnosed because they stopped going to doctors

for their achalasia and just live with it still being able to get by

somehow.

notan

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