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Q. Am I suffering from achalasia or GERD?

 

Hi doctor,

I am a 31 year old male. I recently had a severe chest pain like heartburn and visited a gastroenterologist doctor. I am also suffering from swallowing disorder for the past seven to eight months, especially solid foods and sometime liquids too. It feels that whenever I eat food it stuck somewhere in the chest at the level of the lower esophagus. I need to drink water to take down that food in the stomach. My doctor told me that I am suffering from mild antral gastritis and esophageal candidiasis as per endoscopy. Also, the endoscopy finding says that esophagus shows white curdy precipitate with erythema at GE junction and large dilated esophagus. Now, he has suggested for manometry test. I want to know the actual problem with me. Am I suffering from achalasia with GERD? What are the treatment options? The medication I am going through is Nexpro-L, Nexpro 40 and Torfix 400 mg. Can it be treated with medication or require surgery?

 

Dr. Happykumar Kagathara
MBBS., MS (GENERAL SURGERY)., FELLOWSHIP IN SURGICAL GASTROENTEROLOGY., FELLOWSHIP IN HPB SURGERY
Medical Gastroenterology, Surgical Gastroenterology

Hello,

Welcome to icliniq.com.

  • Your primary diagnosis is esophageal candidiasis and antral gastritis. These are medical conditions and managed with medical treatment only. Although, treatment for esophageal candidiasis lasts little long duration.
  • The esophageal manometry test is not required for these conditions and neither for GERD.
  • The esophageal manometry test is to confirm esophageal motility disorder in which esophageal dilatation is common. Also, these disorders have a common presentation like you, difficulty in swallowing.
  • In contrast to the above mentioned conditions, achalasia is a surgical condition and requires surgery.
  • Yes, you require manometry test in suspicion of dilated esophagus. But, do this test after completion of treatment for esophageal candidiasis for at least after 15 to 20 days.

  • Investigations to be done:

    Upper GI endoscopy and esophageal manometry.

  • Probable diagnosis:

    1. Achalasia cardia.
    2. Esophageal dysmotility syndrome.

  • Regarding follow up:

    For further information consult a medical gastroenterologist online.---> https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

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