Guest guest Posted May 22, 2011 Report Share Posted May 22, 2011 You can purchase a wedge pillow at a medical supply store. They come in different sizes so pay attention to how high you want your head before buying. I purchased one about 10 inches and that was too high, so I had to go back and buy one that was 6 " and I like it alot better, I put a pillow on top of the wedge because they are firm. Good luck!! Barb > > Hi guys, > > Well, I just got the official diagnosis of achalasia last week. Everything is fine for my eating, at least tolerable, but the coughing is pretty bad. I have allayed it by sleeping propped up, not eating before bedtime, and doing all the things you all have been so gracious to recommend to me. The question I have is, if I am eating ok, but inhaling liquid, does that mean some sort of surgery is really going to help? My sphincter muscles is tight but not extremely tight. However it is tight all the time. > > I cough when I eat, drink, wake up, go to sleep, walk around, and during the night. The eating and drinking cough is prevalent even when the food is not backed up. I don't understand why I cough so much in the morning, unless it is because maybe the saliva has basically been sitting there all night. Is that really because things are backed up, or is it more of a nerve issue with the upper part of the esophagus? > > I was going to send my test results to Dr. Rice and Dr. Luketich, but wanted to check with other people first. I want to avoid surgery. > > Basically, is it possible that the flap between the esophagus and trachea has issues, and what can one do about that? > > Also, what causes the sphincter muscle to be tight? I can understand that there is no motility, but don't understand why that results in a tight sphincter. > > Just curious if anyone else has this problem. > > Also if anyone can recommend a place to get a wedge pillow I would appreciate it. > Thanks, > Gunn > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2011 Report Share Posted May 28, 2011 wrote: > > ... if I am eating ok, but inhaling liquid, does that mean some sort > of surgery is really going to help? > You really want to put an end to inhaling the liquid as much a possible. There are a number of germs that can be in the esophagus that you would not want to get into the lungs. Also there can be bits of food that can also be inhaled. That food can also become a place for infection to start in the lungs as it rots there. You can get aspiration pneumonia, aspiration bronchiolitis and lung damage. There are a number of studies on the subject linked to at: http://www.zotero.org/groups/achalasia_atheneum/items/collection/JDB8RG27 Among them are: Prevalence of respiratory symptoms in patients with achalasia http://www.ncbi.nlm.nih.gov/pubmed/21073619 " In the subset of patients with respiratory symptoms who had undergone Heller myotomy, respiratory symptoms improved in the majority after the procedure. " Improvement of respiratory symptoms following Heller myotomy for achalasia. http://www.ncbi.nlm.nih.gov/pubmed/21170600 " The frequency and severity of all respiratory symptoms decreased significantly. Twenty-four of the 29 patients (82%) who reported a history of pneumonia prior to surgery did not experience recurrent episodes after Heller myotomy. " Structural and functional abnormalities in lungs in patients with achalasia. http://www.ncbi.nlm.nih.gov/pubmed/19222759 " More than half (53.3%) of patients with achalasia have structural and/or functional abnormalities in lungs. " > Basically, is it possible that the flap between the esophagus and > trachea has issues, and what can one do about that? > The Upper Esophageal Sphincter (UES). It is possible. Also in that collection is a link to: Esophageal achalasia and coexistent upper esophageal sphincter relaxation disorder presenting with airway obstruction. http://www.ncbi.nlm.nih.gov/pubmed/7557103 " The patient was initially treated with Heller's myotomy but had a recurrence of respiratory distress. She was successfully treated by cricopharyngeal myotomy. " See also: Long-Term Results of External Upper Esophageal Sphincter Myotomy for Oropharyngeal Dysphagia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929428/ > Also, what causes the sphincter muscle to be tight? I can understand > that there is no motility, but don't understand why that results in a > tight sphincter. > The muscles at the sphincter (LES) are not controlled by just one type of nerve. There are a number of types of nerves and some control constriction and some control relaxation. You may think that just one type controls both but that is not the case. Primary achalasia seem to be due to the dysfunction and destruction of a nerve type that controls relaxation but the type of nerve that controls constriction is not damaged. Without those relaxation nerves effectively challenging the constriction nerves for control the constriction nerves over constrict the LES and the relaxation nerves can not bring about good enough relaxations. We don't all have the same damage or loss of those relaxation nerves so our symptoms are not all the same and can change as things progress. In some the pressure at the LES will be greater than in others and in some there will less motility or more dysfunctional motility than in others. notan Quote Link to comment Share on other sites More sharing options...
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