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Achalasia Treatments and Diagnosis
Wednesday, October 24, 2018 - 12 Noon (Eastern Time)

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Scott Gabbard, MD

  • Gastroenterologist

Siva Raja, MD, PhD

  • Thoracic Surgeon

Affecting more than 15 million Americans, swallowing and esophageal disorders can range in severity and be chronic concerns that plague daily life. However, disorders such as esophagitis, gastroesophageal reflux disease (GERD), Barrett’s esophagus and achalasia often can be treated successfully before long-term damage occurs. Please join us to have your questions on Achalasia answered by Cleveland Clinic gastroenterologist Scott Gabbard, MD, and Sydell and Arnold Miller Family Heart & Vascular Institute thoracic surgeon Siva Raja, MD, PhD.

The esophagus is a tubular neuro-muscular organ that carries what we eat or drink from the throat into the stomach. This process requires a healthy esophagus which can be affected in many different ways. The esophagus can be damaged from acid reflux, infections, medications, radiation, benign or malignant tumors, surgical procedures, neuromuscular diseases and many other causes. The most common symptoms arising from the esophagus are swallowing difficulties (dysphagia) and painful swallowing among other conditions.

Why esophageal muscles fail to contract normally in people with motility disorders, including achalasia, is unknown. Researchers think it may be linked to a virus, and recent studies show achalasia is caused by nerve cells of the involuntary nervous system within the muscle layers of the esophagus. They are attacked by the patient’s own immune system and slowly degenerate for reasons that are not currently understood.

Slowly, over a number of years, people with achalasia experience an increasing difficulty in eating solid food and in drinking liquids. As their condition advances, achalasia can cause considerable weight loss and malnutrition. People with achalasia also have a small increase in the risk of developing esophageal cancer, particularly if the obstruction has been present for a long time. Your physician may recommend regular endoscopic screenings for the prevention and early detection of esophageal cancer.

Achalasia develops in about 3,000 people in the United States each year. It is typically diagnosed in adults, but can occur in children as well. There is no particular race or ethnic group that is affected, and the condition does not run in families.

Scott Gabbard, MD, is a gastroenterologist who supports our Gastroenterology and Hepatology department under the Digestive Disease & Surgical Institute. Dr. Gabbard completed his undergraduate degree at Dartmouth College and attained his medical degree from Case Western Reserve University School of Medicine. He completed his residency in gastroenterology and hepatology at Dartmouth-Hitchcock Medical Center. Dr. Gabbard’s specialty interests include achalasia, eosinophilic esophagitis, esophagitis, gastroesophageal reflux (GERD), and swallowing disorders.

Siva Raja, MD, PhD, is a thoracic surgeon in the Department of Thoracic and Cardiovascular Surgery at the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic. Dr. Raja has performed more than 3,500 surgeries throughout his career, including 2000 thoracic surgeries. Since 2013, he performed around 100 laparoscopic heller myotomies or POEM procedures to treat patients with achalasia. Dr. Raja has performed more than 1100 surgeries since his Cleveland Clinic appointment in 2012. He specializes in esophageal surgeries including Laparoscopic Heller Myotomy, POEM which is an incision-less technique to treat achalasia. His specialty interests include achalasia, esophageal cancer, lung cancer, hiatal hernia, cancers and tumors of the chest and chest wall, minimally invasive and endoscopic surgery, and general thoracic surgery.

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