He thought it was acidity: It turned out to be a rare disorder that made swallowing impossible

24-year-old Vishal Raj had always taken an active part in life’s social moments. Yet, for more than 4 years, daily activities like eating and drinking felt like a burden to him, making him anxious. Vishal struggled to swallow food and water normally, with every meal a slow ordeal; food remained stuck in his esophagus. Out of embarrassment, he tried to eat even less and less when with friends and family.

Like any other young adult, he initially dismissed it as a mere gastric or acidity issue and thought that his symptoms would disappear with time, so he resorted to various remedies.

After conducting a comprehensive examination, it was diagnosed that Vishal was suffering from ‘Achalasia Cardia Type II,’ an extremely rare disease that affects the esophagus, the channel that carries food from the mouth to the stomach. In general, "Achalasia Cardia" is known for the lower esophageal sphincter (LES) not relaxing when you swallow. This causes food to build up in the esophagus. Other signs are trouble swallowing, chest pain, and losing weight.

In order to treat Vishal’s disease, Dr Veerendra Sandur, Consultant- Medical Gastroenterology, Manipal Hospital, Kanakapura Road, suggested Peroral Endoscopic Myotomy, or POEM, an advanced medical treatment that is offered at our hospital for the first time. This treatment involves making incisions in certain muscles in the lower esophagus. This treatment has been successful, and Vishal is relieved. For the first time in his life, Vishal is able to consume liquids and eat his meals without hesitation.

Why Awareness About Achalasia is Important

• Sometimes people do not pay attention to swallowing difficulties, thinking it is caused by indigestion or acidity.
• Delay in seeking medical treatment can cause the condition to worsen over time.
• Timely medical treatment can improve the outcome of the disease.
• Underlying achalasia can cause severe weight loss, enlarged esophagus, or food in the lungs.

Prevention & When to Seek Help
Achalasia is not preventable in all cases, but seeking medical treatment can prevent complications.

Symptoms that require medical treatment:

1. Difficulty in swallowing that does not go away.
2. Frequent regurgitation of ingested food.
3. Unexpected weight loss.
4. Chest pain while eating

If the symptoms don't go away, the patient needs to see a doctor.

Good eating habits, eating slowly, and undergoing medical tests can help prevent the disease.

"Many people tend to ignore persistent symptoms, hoping they will resolve on their own," said Dr Sandur. However, when it comes to conditions like achalasia, timely medical attention can save lives. We want people to understand that persistent symptoms should be taken seriously, especially if it is making difficult to do basic routine like eating. They need proper expert attention, and with modern, minimally invasive techniques like POEM, we can offer immediate and profound relief.

The results post-surgery was immediate, as Vishal could tolerate clear liquids like any other normal person with no swallowing difficulty. With imaging tests confirming there were no leaks or complications, he was discharged from the hospital with guidance on his diet and physical activity.

Vishal thanked the medical staff, saying, "I was able to eat and drink normally and enjoy meals without hesitation or discomfort for the first time in years."

Vishal's experience serves us as a reminder that, with early diagnosis, even complicated GI problems can be effectively treated with both open and minimally invasive procedures.

Sometimes the body whispers before it begins to scream. Enduring, seemingly minor or manageable symptoms frequently serve as early indicators of more serious health issues. Vishal’s experience illustrates that timely assistance can not only address a problem but also restore confidence, comfort, and overall quality of life.