Mission
Weight loss is observed in persons with significant difficulty in swallowing, as well as in patients with severe signs of neurosis. Such patients often refuse food (psychogenic anorexia). Percussion and auscultation usually do not reveal any specific signs in the lungs. It is possible to buy motilium online the sound of splashing liquid in the stomach after taking a sip of water, but this symptom is not constant.
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Leukocytosis and increased ESR are diagnosed late, mainly with complications - periesophagitis or aspiration pneumonia.
X-ray examination reveals a delay in the contrast mass in the esophagus, a significantly dilated esophagus, which contains fluid, mucus and food debris. The delay area is usually funnel-shaped, but the edges of the esophagus are smooth. Above food retention, kinks and deformities of the distended esophagus can be detected. The contrasting mass on top assumes a horizontal level. Above it is a gas bubble. If the esophageal patency is restored, you can see how the contrast agent enters the stomach in a thin stream or a wide stream. It is also possible to observe regurgitation of the contents of the esophagus into the oral cavity.
Esophagoscopy allows you to visually detect a number of important diagnostic features. The device is inserted into the esophagus easily, since its upper part is stretched. The mucosa is noted to be pale, atrophic or thickened, in places with leukoplakia. The esophagus usually contains liquid, mucus, and food debris. The area of the esophageal-gastric communication can be bent in an S-shape. The abundance of folds makes it difficult to move the esophagoscope into the stomach. It passes through the narrowing site, as through a muscle pulp. Sometimes there is quite a lot of resistance. In some cases, in order to overcome the spasm, it is necessary to apply atropine or papaverine, or to buy domperidone pills out bougienage.
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Pharmacological tests (performed under x-ray control) make it easier in unclear cases to differentiate esophageal achalasia from cancer, as well as to determine the stage of the disease. Basically, a test is done with nitroglycerin or acetylcholine, less often with atropine.
The diagnosis of the disease is based on the history and clinical data (signs of food regurgitation), X-ray or esophagoscopy. If gastric cancer is suspected, a gastroscopy is performed. The assumption of cancer of the lung or pericardium appears if there are signs of domperidone, fever, pericarditis. Such patients undergo a comprehensive x-ray examination. Radiographs are performed in direct and oblique projections. If necessary, tomograms are made. Esophagoscopy helps to differentiate esophageal ulcer from achalasia.
In severe cases of achalasia, cachexia, anemia, and signs of hypovitaminosis develop. Patients become withdrawn, avoid society, take food in solitude.
The course of the disease can be long and slowly progressive. Swallowing gradually worsens, esophagospasm develops, the patient's nutrition decreases, resistance to infection weakens. Severe complications are aspiration pneumonia, periesophagitis, mediastinitis. In some patients, prolonged inflammation of the esophagus contributes to carcinogenesis. Achalasia should be considered as a precancerous condition. Periodine from the formation of a cancerous tumor is not captured. It is detected late when metastases, signs of intoxication, fever, etc.
- There are signs of severe neurosis with vegetative disorders.
- Treatment of functional disorders of the esophagus and achalasia.
- The dietary regimen of motilium for the period of treatment is based on the principle of sparing.
- This mode is indicated primarily for patients with severe signs of esophageal achalasia and esophagitis.
- However, a sparing diet (No. 1, 5) should be short-lived. Nutrition is recommended fractional, food is warm, fortified.
- Drug treatment is carried out in the following direction.