Achalasia is a swallowing disorder in which the lower end of the food pipe does not relax properly. Food and liquids may remain in the oesophagus instead of passing smoothly into the stomach. Over time, patients may adapt by eating slowly, drinking water with meals or avoiding certain foods, but the underlying obstruction can continue.
Dr Hemant Chhajed evaluates swallowing difficulty carefully because achalasia can resemble reflux disease or other oesophageal conditions. The laparoscopic Heller procedure, also called Heller cardiomyotomy, is one treatment used to reduce this functional blockage.
Why Achalasia Causes Swallowing Problems
The oesophagus normally uses coordinated muscular contractions to push swallowed food toward the stomach. A muscular valve at its lower end then relaxes to allow food to pass.
In achalasia, the valve does not relax adequately, and normal movement of the oesophagus may also be reduced. Common symptoms include:
- Difficulty swallowing solids and liquids
- Regurgitation of undigested food
- Chest discomfort
- Coughing, especially at night
- Unintentional weight loss
- A feeling that food is stuck
- Repeated episodes mistaken for acidity
Night-time regurgitation can also allow food or liquid to enter the airway, making timely assessment important.
How the Laparoscopic Heller Procedure Works
During the procedure, the surgeon divides selected muscle fibres at the lower oesophagus and upper stomach. This is called a myotomy. Releasing these tight muscle fibres makes it easier for food and liquids to enter the stomach.
The operation is performed through small abdominal incisions using a camera and specialised instruments. A partial fundoplication may be added because weakening the lower oesophageal valve can increase the possibility of acid reflux. The fundoplication creates a partial wrap using the upper stomach to provide some reflux protection without making swallowing unnecessarily tight.
Assessment Before Cardiomyotomy in Nagpur
Patients being assessed for cardiomyotomy in Nagpur, Maharashtra, may require several investigations before treatment is planned. These can include upper gastrointestinal endoscopy, a barium swallow study and oesophageal manometry.
Each test answers a different question:
- Endoscopy examines the inner lining and helps exclude a physical blockage.
- Barium swallow shows how material moves through the oesophagus.
- Manometry measures pressure and muscle coordination.
These findings help confirm achalasia, identify its subtype and distinguish it from other causes of swallowing difficulty.
What Recovery May Involve
After surgery, patients are usually guided through a gradual diet progression. Clear liquids may be followed by thicker liquids, soft foods and eventually a more regular diet as healing progresses.
Practical recovery measures may include:
- Eating small portions slowly.
- Chewing food thoroughly.
- Avoiding large meals during early recovery.
- Following the prescribed diet stages.
- Taking medicines as directed.
- Avoiding strenuous activity until medically cleared.
Temporary bloating, mild swallowing discomfort or soreness around the incisions may occur. Persistent vomiting, fever, severe chest or abdominal pain, breathing difficulty or inability to swallow requires immediate medical attention.
What the Procedure Can and Cannot Do
Heller cardiomyotomy reduces resistance at the lower end of the oesophagus, but it does not restore damaged oesophageal nerves or normal muscle movement. Some patients may continue to need careful eating habits, and follow-up remains important for monitoring swallowing and reflux symptoms.
The laparoscopic Heller procedure can provide meaningful improvement for properly selected patients with achalasia. Accurate diagnosis, appropriate surgical planning and disciplined dietary progression are central to a safer recovery and better long-term symptom control.
