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Tackling achalasia, a condition that takes the joy out of eating, makes it hard to swallow

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Monday, August 1, 2022
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Every year, thousands of people develop an unusual condition that can take the joy out of eating. Temple Health doctors describe how they treat achalasia.

COOPERSBURG, PA. (WPVI) -- Most of us look forward to meals.

Every year, thousands of people develop an unusual condition that can take the joy out of eating.

For 30 years, Jack Svoboda had problems swallowing, with food not going down.

"It would take me 20 minutes to drink a glass of chocolate milk," recalls Svoboda.

Treatment attempts at a hospital near his Coopersburg home failed.

"They shot Botox in my throat, they also stretched my esophagus. That did nothing," says Svoboda.

"It got worse and worse," he says with a shrug, remembering his frustration.

Jack gave up on a solution until he decided to see Dr. Zubair Malik, a Temple Health gastroenterologist.

A test showed Jack had achalasia, an abnormality of the muscle at the base of the esophagus.

During eating, that muscle should open, letting food into the stomach.

But in achalasia, weakened nerves prevent that.

"That bottom muscle just doesn't relax enough for food to go down easily," notes Dr. Malik.

Difficulty swallowing is just one symptom.

"Regurgitation of undigested food, particularly when you lay down, sometimes chest pain, food getting stuck in the chest," says Dr. Malik.

"In advanced cases, they actually can be malnourished and lose weight," notes surgeon Dr. Roman Petrov.

Doctors says surgical options usually work best, especially the newer POEM procedure.

POEM stands for Per Oral Endoscopic Myotomy.

Surgeons like Dr. Roman Petrov go directly into the esophagus with an endoscope to cut the muscle.

"We go in and actually do all the cutting with a camera scope on the inside. There's no incisions. It's more permanent than the balloon stretch,"

"The usual procedure lasts anywhere between, you know, a little under an hour to maybe about 2 hours," notes Dr. Petrov, adding, "Usually, patients sometimes spend only one night in the hospital."

Jack got immediate relief, and now really enjoys eating.

"I have no trouble at all whatsoever," he says with a smile.

Dr. Petrov says, "Food brings us tremendous pleasure in life, and enjoying food is very important."

Temple was one of the first to adopt the POEM procedure, doing its first procedure nearly a decade ago.

Patients who get have a POEM procedure can develop reflux later, however, that can usually be controlled with medication.