Assoc. Dr. Erdem Akbal gave information about digestive system diseases and effective gastrointestinal methods applied in these diseases.
What is achalasia disease?
Achalasia disease causes abnormal functioning of the muscles in the esophagus. It is a disease of unknown cause that results from the destruction of nerve cells. As a result of the damage to the nerve cells, there are no regular muscle contractions in the esophagus that are normally required to push food into the stomach. At the same time, there is a thickening of the esophageal muscles located at the junction of the esophagus and stomach. Due to the lack of contraction of the muscles in the esophagus, the ingested food has difficulty in being pushed down, and the passage of food into the stomach is impaired.
How does the disease develop? What are the symptoms?
Although the disease is a slowly progressing disease, it causes patients to feel stuck in the chest after eating, a feeling of congestion, food coming back from the mouth, and lung infections as a result of it escaping into the lungs. In advanced disease, there is almost no passage of food from the esophagus to the stomach.
How to diagnose achalasia and what examinations should be performed?
Barium radiographs, high-resolution esophagus and Examinations such as pressure measurements of the lower sphincter (High Resolution Manometry-HRM) and computed tomography can be performed.
Which method is used in the treatment of Achalasia Disease?
Peroral endoscopic myotomy procedure. It is an advanced endoscopic treatment method used in achalasia or some esophageal diseases. Endoscopic intervention is made to the muscles in the esophagus affected by achalasia disease, allowing the patient to eat again.
Treatment methods
Digestive system polyps or cancers:Digestive system cancers are one of the most important public health problems in our country and in the world. The earlier the disease is detected, the higher the success rate of treatment. For this reason, it is recommended in National and International guidelines to perform endoscopic screening even in people who have no complaints starting from the age of 45. Certain risk factors and personality Endoscopic screenings are performed at an earlier age depending on the complaints of the patients. Cancers and polyps detected at an early stage during endoscopic screening are removed without surgery by endoscopic mucosal resection and endoscopic submucosal dissection methods.
Gastroesophageal reflux disease and Barret's Esophagus: Endoscopically applied Stretta method is used in reflux disease. . In Barrett's Esophagus, Radiofrequency ablation, endoscopic mucosal resection or endoscopic submucosal resection methods are applied, depending on the size of the lesion and the pathology results.
Unidentified bleeding and small intestine diseases:With standard endoscopes, only a part of the small intestines, which is approximately 4-6 meters long, can be seen. Diagnosis and treatment of small intestine diseases are performed using capsule endoscopy or balloon enteroscopy methods.
Can you tell us about new development methods in endoscopy?
With the introduction of new generation endoscopes. There have been great advances in the identification and treatment of lesions. Many lesions that previously required surgery can now be removed endoscopically.
How are early stage cancers and lesions at risk of cancer diagnosed? Could you give information about its treatment?
Endoscopic mucosal resection (EMR) and Endoscopic Submucosal Dissection are advanced endoscopic methods used to remove early stage tumors or polyps in the esophagus, stomach, small intestine and large intestine. EMR and ESD procedures are performed with devices called endoscopes, equipped with high-resolution video cameras and other devices. By determining the endoscopic appearance, classification and the area to be removed, the entire lesion is removed endoscopically in one piece or in pieces. In this way, early-stage cancers and lesions are treated endoscopically without the need for surgery.
In which diseases is EMR-ESD applied?
- Polyps and polyps in the esophagus in early stage cancers
- Barret's esophagus (in high grade dysplasia and intramucosal cancers)
- Polyp in the stomach or in early stage cancers
- Polyps in the small intestine
- Polyps in the large intestine, in early stage cancers
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