Achalasia and Swallowing Exercises: Debunking the Myth

The Truth About Swallowing More for Achalasia: Debunking the Myth

Introduction

Recently, a speech therapist suggested to one of our readers that they should swallow more to help their esophagus get stronger as part of managing achalasia. However, it is essential to understand what achalasia truly is in order to assess the validity of this advice.

Understanding Achalasia

Achalasia is a rare swallowing disorder that affects the food pipe (esophagus), which runs from the throat down through the chest to the stomach. The condition is characterized by the failure of the lower esophageal sphincter (LES) - a circular muscle at the junction between the esophagus and stomach - to relax properly, preventing food and liquids from passing into the stomach. Instead of opening to allow food to pass, the LES remains tight.

In a normal esophagus, muscles work in a coordinated sequence to push food down towards the stomach through the process of peristalsis. This process typically takes two to three seconds. However, in achalasia, the muscles don't work efficiently, leading to the characteristic symptoms of dysphagia (difficulty swallowing) and regurgitation of undigested food.

The Myth and Reality: Swallowing More for Strengthening

The suggestion to swallow more to help strengthen the esophagus in achalasia is a common myth. While it might seem logical that more swallowing could improve muscle strength, in reality, this is not the case. A speech therapist's recommendation should be evaluated through a medical lens, and patients should consult with a gastroenterologist for proper diagnosis and treatment. The widening of a cramped lower esophageal sphincter is usually achieved through endoscopic or surgical procedures, not through swallowing exercises.

Swallowing a significant amount of food or liquid is not likely to address the underlying issue of the LES not relaxing properly. Instead, it might exacerbate the condition or lead to other issues such as choking or aspiration.

Management of Achalasia

For effective management of achalasia, medical intervention is generally required. The following treatments are typically considered:

Passing a Balloon Through the Esophagus: This procedure, called pneumatic dilation, uses a long, thin tube with an inflatable balloon at the end. The balloon is inserted and then inflated to stretch and widen the lower esophageal sphincter. Surgery: In more severe cases, surgery is an option. The procedure involves cutting the muscle in the lower esophageal sphincter to allow the esophagus to relax more effectively. Lingual Nerve Stimulation: A newer approach involves stimulating the nervous system to improve LES function.

In addition to medical treatments, lifestyle changes and diet modifications may also help manage symptoms. Some strategies include:

Raising the Head of the Bed: Elevating the head of the bed can help gravity facilitate the passage of food into the stomach. Avoiding Late-Night Meals: Eating too late at night can disrupt the natural digestive process, making swallowing difficulties worse. Burping: Practicing self-burping can help release excess air from the stomach, aiding in the passage of food. Yogurt Consumption: Chewing on organic, bio-dynamic yogurt, specifically a batch marked TUB SET without additional additives, can provide a soothing effect. Consuming some before meals might assist the passage of food.

Conclusion

It is crucial to consult with a medical professional when facing issues related to achalasia. Swallowing more is not a proven method for strengthening the esophagus in this condition. Instead, focusing on medical and lifestyle interventions tailored to your specific situation is the best approach. Remember, managing achalasia requires a comprehensive plan that includes physician guidance and personalized care.