A 30-Year-Old Woman was diagnosed with a rare disorder Achalasia Cardiac which led to dysphasia (Difficulty in Swallowing))

Pune: – A team headed by Dr. Kedar Patil Bariatric, Hernia, and Advanced Laparoscopic Surgeon at Apollo Spectra Hospital, Pune successfully performed a complex surgery on a 30-year-old woman with a swallowing problem for the last 6 months. The patient who was detected with Achalasia Cardia, where the food pipe gets narrowed down in the lower half due to neuromuscular incoordination was able to eat her first meal orally after a long time.

Nita Rane from Pune a IT consultant had vomiting and intolerance to food which was progressive. This caused severe malnourishment and lead to loss of 16 kgs over 6 months. She consulted various medicos but this condition was misdiagnosed as acidity and reflux disease initially.However, the patient was referred to Apollo Spectra Hospital, Pune wherein she receive timely medical attention.

Dr Kedar Patil Bariatric, Hernia and Advanced Laparoscopic Surgeon at Apollo Spectra Hospital, Pune said, ‘‘On arrival she was dehydrated and malnourished with vomiting as predominant symptom .This rare disorder damages nerves in the esophagus(the tube that passes swallowed food from the throat down into one’s stomach). This condition is seen in 1 in one lakh individuals, predominantly Young females where there is a progressive difficulty with solids and liquids due to neuromuscular incoordination.

To diagnose it endoscopy followed by barium swallow and manometry was done. ( Investigations for diagnosis) The patient was corrected nutritionally with parenteral nutrition following which she underwent a surgical procedure known as Laparoscopic Heller’s Cardiomyotomy with Toupet fundoplication. “The advantage of doing this Surgery is that the food pipe size is enlarged at the site of narrowing and an added procedure to prevent acid reflux is done. Correcting the malnutrition with parental nutrition was necessary because the patient was vomiting for quite a long time. The surgery was challenging as the body habitus had become thin, almost the size of an adolescent child so there was less space to operate inside the body. We could do the surgery laparoscopically, there was very minimum pain and the patient was ambulated the next day, started on a liquid diet and discharged on day 2 post-surgery. Surgery lasted for 2 hours. Laparoscopic surgery has a distinct advantage in areas where the field to operate is narrow due to magnification with laparoscope one can have good vision and perform the surgery more effectively.

She was advised liquid followed by solid diet over 3-4 days after discharge and avoid lifting heavy weights .Not treating her at the right time could have led severe malnourishment and secondary infections ” highlighted Dr Patil.

“I was in a rude shock when I was diagnosed with this rare condition. I was unable to eat even a single morsel of food or drink anything due to a swallowing problem. I looked pale and malnourished. I also lost oodles of weight. I was getting anxious, stressed, and losing hope. I was unable to perform my daily chores with ease. I am thankful to the doctors at Apollo Spectra Hospital who correctly diagnosed my problem and treated me promptly. I have had a full meal after 6 months now and I am happy that I could eat again without any problem,” concluded Patient Nita More.

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