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Fragebogen 1 von 3 (PHQ-15) Achalasie-Selbsthilfe e.V. Haftungshinweis Impressum Datenschutzerklärung Transparenzerklärung

Dilemma in the decision on achalasia treatment Botox – Dilatation – Heller Myotomy – POEM? What is right for me? Highly complex questions and issues arise in this situation: · Some achalasia patients still experience a sense of unease after consulting their doctor. · What is the balance between the expected improvements and the risks? · Which studies are relevant for me? Studies on this topic have been conducted under highly varied conditions and can be interpreted in different ways. · Operations are irreversible treatments and are decisive cuts in life · How can I orientate myself? · Which doctor do I have sufficient confidence in? · What interests could play a role? · The proximity of the hospital and its treatment options? · What long-term effects can be expected? The route to a decision · Clear diagnosis · Applying specific personal condition as a basis · Detailed patient briefing with the doctor · Addressing personal fears and concerns · Increasing knowledge regarding treatments · Informing yourself about the care landscape · Obtaining a second opinion · Contacting the health insurer · Requesting comparative statements from Achalasie-Selbsthilfe · Finally: Trusting your own gut instinct Zurück Weitere Themen Vergleich zwischen der Heller Myotomie und Dilatation

Neubetroffene Seite 4 von 9 Wie wird Achalasie festgestellt? Typische Untersuchungen: Manometrie Die hochauflösende Manometrie (HRM) ist ein fortschrittliches Verfahren zur Diagnose von Speiseröhrenbeweglichkeitsstörungen, insbesondere Achalasie. Sie wird durchgeführt, indem eine dünne Sonde in die Speiseröhre eingeführt wird, die Druckverhältnisse in Echtzeit misst. Die Untersuchung ist in der Regel nicht schmerzhaft und wird von den meisten Patienten gut toleriert. Die HRM bietet eine genaue Beurteilung des Schluckakts und der Speiseröhrenfunktion, was zu einer präzisen Diagnose und Behandlung führen kann. Breischluck Röntgen mit Kontrastmittel zeigt die Form der Speiseröhre und mögliche Engstellen. Gastroskopie Untersuchung der Schleimhaut, Ausschluss anderer Ursachen. Mit den Ergebnissen kann die Achalasie in Typen (z. B. Typ I, II, III) eingeteilt werden, was wichtig für die Therapieplanung ist. Weiter

Neubetroffene Seite 3 von 9 Typische Symptome der Achalasie Schluckbeschwerden Bei einer Achalasie sind Schluckbeschwerden (Dysphagie) das Hauptsymptom, da der untere Speiseröhrenschließmuskel nicht richtig entspannt. Gewichtsverlust Die Nahrung gelangt nicht mehr richtig in den Magen. In schweren Fällen kann dies zu Mangelernährung führen. Steckenbleiben von Nahrung Die Nahrung wird nicht in den Magen weitergeleitet und bleibt in der Speiseröhre stecken, was zunächst bei fester Nahrung und später auch bei Flüssigkeiten Probleme bereitet. Brustschmerzen Brustschmerzen werden oft als krampfartig beschrieben und treten nach dem Essen oder Trinken auf. Regurgitation (Hochwürgen) Das Hochwürgen von unverdauter Nahrung und Flüssigkeit ist ein typisches Symptom, das durch den gestörten unteren Speiseröhrenschließmuskel verursacht wird. Weiter

Fragebogen zu favorisierten Behandlungsmethoden der Achalasie Diagnose Achalasie 1. Seit wann ist die Diagnose Achalasie bei Ihnen bekannt? Option wählen 2. Wie lange war der Zeitraum von Beschwerdebeginn bis zur Diagnoseerstellung? Option wählen 3. Nach welchen Vorgehen wurde die Diagnose gestellt? (Mehrfachantworten möglich) * Required Magenspiegelung Röntgenbreischluck Speiseröhrendruckmessung (Manometrie) psychosoziale Faktoren Autoimmunerkrankung genetische Faktoren Eckhard-Score 4. Welche Typ der Achalasie liegt bei Ihnen vor? Option wählen Beratung und Wahl der Behandlungsmethode 5. In welcher Einrichtung wurden Sie über die Behandlungsmöglichkeiten aufgeklärt? Option wählen 6. Wurden Sie über die unterschiedlichen Behandlungsmöglichkeiten aufgeklärt? * Ja Nein 7. Wurden Sie umfassend und ausgewogen über alle Behandlungsmöglichkeiten aufgeklärt? * Ja Nein 8. Welche Behandlungsmethode wurde Ihnen primär empfohlen? Option wählen 9 . Haben Sie den Eindruck, dass der/die aufklärende Arzt/Ärztin eine Behandlungsmethode favorisiert hatte und wenn ja, welche Behandlung? * Ja Nein Welche: Option wählen 9a. Welche Begründung wurde für diese Methode gegeben? 9b. Haben Sie Vergleichsmeinungen eingeholt? Ja Nein 9c. Von wem wurde die Entscheidung getroffen? Option wählen 9d. Würden sie diese Behandlungsmethode nochmal wählen? Ja Nein Gewählte Behandlungsmethode(n) 10. Wie wurden Sie behandelt? (Mehrfachantworten möglich) * Required Medikamente Bougierung Dilatation POEM Operation Psychotherapie 11. In welcher Reihenfolge wurde die Behandlung durchgeführt? (Beispiel: 1. Ballondehnung 2. POEM) Ergebnisse der Behandlung 12. Welche Methode hat am besten geholfen? Option wählen 13. Sind Sie nach Ihrer letzten Behandlung zurzeit beschwerdefrei? * Ja Nein % Besserung welche Behandlung 14. Welche Beschwerden haben Sie zurzeit nach Bougierung? Schluckstörungen Reflux Schmerzen Sonstiges Wie Stark sind die Beschwerden von 0-10? Welche Beschwerden haben Sie zurzeit nach Ballondehnung? Schluckstörungen Reflux Schmerzen Sonstiges Wie Stark sind die Beschwerden von 0-10? Welche Beschwerden haben Sie zurzeit bei POEM? Schluckstörungen Reflux Schmerzen Sonstiges Wie Stark sind die Beschwerden von 0-10? Welche Beschwerden haben Sie zurzeit bei Operation? Schluckstörungen Reflux Schmerzen Sonstiges Wie Stark sind die Beschwerden von 0-10? Nachsorge 15. Erfolgen regelmäßige Nachkontrollen im Rahmen eines Zeitplans? Wenn ja, in welchem Zeitintervall? * Ja Nein Zeitintervall Antworten senden

What is achalasia? In general, the term achalasia describes a malfunctioning of those parts of the smooth muscles of hollow organs (e.g. gullet, stomach, intestines) that have a closing function. What is achalasia of the gullet? In general, this describes the inability of the lower gullet sphincter (oesophagus sphincter or cardia) to sufficiently open for a lump of food to pass into the stomach. In addition to that the motility (peristalsis) of the entire gullet can be negatively affected. Causes and consequences of achalasia - dysphagia - malfunctioning peristaltic of the gullet - malfunctioning relaxation reflex of the lower oesophageal sphincter - malfunction of the upper oesophageal sphincter Sure facts At the cardia the nerve cells (neurons and ganglia) in the plexus (myenteric plexus/Auerbach’s plexus) are degenerated. This causes a tension of the lower gullet sphincter. Swallowing difficulties due to: Impaired mobility (peristalsis) of the oesophagus Impaired swallowing-induced slackening of the lower oesophagus Impaired function of the upper oesophageal sphincter Why? For this question, merely hypotheses can be formulated: autoimmune disorder degeneration and decay of cells, tissues and organs inheritance infection (viral) Symptoms spasmodic pain in the chest difficulties to swallow - with food getting stuck in the gullet regurgitation of undigested food from the gullet digestion problems e.g. bloating weight loss up to 20 kilos malnutrition cough attacks at night due to food reflux Zurück Causes and consequences of achalasia - dysphagia - malfunctioning peristaltic of the gullet - malfunctioning relaxation reflex of the lower oesophageal sphincter - malfunction of the upper oesophageal sphincter Sure facts At the cardia the nerve cells (neurons and ganglia) in the plexus (myenteric plexus/Auerbach’s plexus) are degenerated. This causes a tension of the lower gullet sphincter. Swallowing difficulties due to: Impaired mobility (peristalsis) of the oesophagus Impaired swallowing-induced slackening of the lower oesophagus Impaired function of the upper oesophageal sphincter Why? For this question, merely hypotheses can be formulated: autoimmune disorder degeneration and decay of cells, tissues and organs inheritance infection (viral) Symptoms spasmodic pain in the chest difficulties to swallow - with food getting stuck in the gullet regurgitation of undigested food from the gullet digestion problems e.g. bloating weight loss up to 20 kilos malnutrition cough attacks at night due to food reflux Causes and consequences of achalasia - dysphagia - malfunctioning peristaltic of the gullet - malfunctioning relaxation reflex of the lower oesophageal sphincter - malfunction of the upper oesophageal sphincter Sure facts At the cardia the nerve cells (neurons and ganglia) in the plexus (myenteric plexus/Auerbach’s plexus) are degenerated. This causes a tension of the lower gullet sphincter. Swallowing difficulties due to: Impaired mobility (peristalsis) of the oesophagus Impaired swallowing-induced slackening of the lower oesophagus Impaired function of the upper oesophageal sphincter Why? For this question, merely hypotheses can be formulated: autoimmune disorder degeneration and decay of cells, tissues and organs inheritance infection (viral) Symptoms spasmodic pain in the chest difficulties to swallow - with food getting stuck in the gullet regurgitation of undigested food from the gullet digestion problems e.g. bloating weight loss up to 20 kilos malnutrition cough attacks at night due to food reflux Das Leben mit Achalasie YouTube Video von Nicole Büsching im Interview mit unserer Regionalleiterin NRW Vanessa Kämmerling über das Leben mit Achalasie. Weitere Themen Diagnose & Behandlung Infos für leicht Betroffene Entscheidungshilfen zur Achalasie Behandlung Ernährung Achalasie im Kindesalter Verhaltensempfehlung

Information for sufferers with a mild form of achalasia and for those in the early stages of the disease This article is intended to address individuals who are suspected of having achalasia or who are dealing with difficulties that are typical of the early stages of the disease. Likewise those who are affected by a milder form of the disease and who therefore have their own personal questions. Achalasia does not begin with a sudden and unambiguous event, but usually develops gradually over the course of weeks, months or even years. Sometimes other simultaneous health events, occupational and family strains, etc., can be registered as suspected triggers. A long time often passes from the moment the swallowing disorder is personally perceived to the point of diagnosis. During this phase of uncertainty, some individuals attempt to repress the symptoms, make various assumptions, try to make changes to their eating and drinking habits, observe and change some aspects of everyday life, communicate with relatives, with professionals and much more besides. With a bit of luck, the doctor’s consultation quickly leads to a clear diagnosis, although sometimes also to misdiagnosis and incorrect treatment. In addition to the treatment recommendations from a specialist, personal body awareness is always the focus of a new life experience. It is very difficult to realistically assess the effects that this rare disease has on oneself, because there are - strictly speaking - many different forms. As a natural consequence, many sufferers experience a mixture of emotions, which can vary greatly in composition: Worry about the unknown limitations, fear of painful treatment, fear of aggravation, concern about existence, concern about a reduction in the quality of life - but also positive attitudes, optimism regarding improvement, resilience, confidence in appropriate help, confidence in support within the family, hope for improved healthcare and hope that things will not actually be that bad after all. Depending on their life situation and personality, each individual is required to deal with their own personal feelings and emotions. Some individuals are able to compensate for minor swallowing disorders with their own tricks and personally devised methods, and somehow live with them. Those who inform themselves about the clinical picture and the typical progression of the disease will come across a widely diverse range of views and representations. Many hospitals report on achalasia and describe their diagnostic and therapeutic possibilities. Research shows that hospitals apply a variety of different strategies. However, in general only the three most important types of achalasia are mentioned according to the Chicago Classification. The serious progressions of achalasia are then described, where clinical help is indeed essential. Milder progressions of the disease are not classified and described or differentiated anywhere. Furthermore, clinical studies do not make any assertions regarding the ratio of mild to moderate and severe disease progressions. As an affected individual, you may also be concerned that information on the internet could be influenced by specific interests (e.g. economic factors). Even leading members of Achalasie-Selbsthilfe only have a limited perspective of the ratio of mild to severe disease progression: Those who are able to cope with minor limitations caused by the disease usually do not contact the Achalasie-Selbsthilfe (it would be nice if they did...). Nonetheless, Achalasie-Selbsthilfe has accumulated knowledge gained from many years of experience. Every member is able to recall the time when the disease first appeared and is also happy to pass on this experience to new sufferers who submit inquiries via the website. The needs of sufferers of achalasia in its early stages, during the diagnosis phase and the search for suitable treatment for mild forms of the disease are addressed in the following. 1. The confusion that comes with unclear and indefinable symptoms can be countered by open communication with relatives and medical professionals. Although it may appear preferable to keep some embarrassing situations hidden away (e.g. from colleagues), openness is the best strategy. Few people possess knowledge of rare diseases, but finding someone with experience is still helpful. At the same time, everyone learns to describe their complaints in a more differentiated way. 2. A comparison with other disease courses involving swallowing disorders can lead to an approximate diagnosis. Looking at therapeutic methods is frequently unhelpful, and likewise the presumption of psychosomatic causes is of little use. 3. The inevitably arising fears and apprehensions form part of the reality. Understanding dialogue partners are helpful here. The information gathering steps that lead to possible diagnoses and prognoses provide further assurance. 4. The individual’s own personality is greatly influential during this orientation phase. Some individuals become a whirlwind of activity, searching intensively and almost desperately for every available opinion, to avoid making the wrong decision. The contrasting approach of others is to remain still and wait, in the hope that they will become confident of the right decision. Each individual can and should be allowed to develop his or her own very personal attitude when it comes to proximity and distance to the illness. 5. Little knowledge exists regarding the possible consequences of not treating mild achalasia. 6. Often, as the narrowing of the stomach entrance becomes more pronounced, there is a need for dilatation. It is not possible to definitively identify the right moment for this procedure on the basis of a gastroscopy. Furthermore, a barium swallow does not provide clear findings for the right moment either. Instead, it is the patient's subjective feeling that the impaired transport of the food bolus and the associated pain have become unbearable that gastroenterologists also rely on. 7. Some of the newly afflicted persons wish to avoid the treatment offered by the visceral medicine in hospitals, if possible and initially seek naturopathy therapies. Some good outcomes have been experienced with osteopathy and relaxation techniques. Trying these out can be worthwhile. Unfortunately, no systematic evaluations currently exist regarding proof of efficacy that are meaningful for achalasia. 8. Furthermore, there are unfortunately no targeted studies regarding the long-term progression of achalasia. No systematic research has been conducted to determine whether the dynamics of the oesophagus or the behaviour of surgical scars change with age. 9. Achalasia is considered a benign disease. However, medical experts primarily describe the treatment options for more severe courses of the disease. Only isolated personal reports of positive courses of the disease exist, where the constriction has regressed or come to a tolerable stop. It is however likely that there are some individuals, who are able to live quite well with a minor form of the disease. An unknown number of achalasia patients also exists, who can lead a reasonably normal life after one or more dilatations and do not require surgery. 10. As only insufficient epidemiological evaluations are carried out for rare diseases such as achalasia, many questions remain unanswered, in particular for those newly affected. Currently, the Achalasie Selbsthilfe e.V. is distinguishing itself by the introduction of empirical questionnaires. In addition, information from the sharing of experiences at regional meetings is evaluated. This creates a large pool of helpful data. It would be extremely useful if reports of experiences with healing progressions, also courses with minor problems, and inventive interventions could be sent to the association which then could subsequently be made available to all those seekking such information. We hereby kindly request that such reports be sent to us. Anonymity is guaranteed. This will hopefully help to close the existing information gaps described. Weitere Themen Tipps für die Seele Leben mit Achalasie - Resilienz Ernährung Roehrenpost 41.pdf

Diagnosis and Treatment Diagnostic Methods thorough evaluation of the disease (diagnosis) barium swallow (gastro-intestinal-passage) gastroscopy/endoscopy manometry (pressure monitoring within the gullet) ph (acid) monitoring within the gullet isotope analysis (scintigraphy) of the gullet computer tomography CT Therapy The treatment of achalasia cannot solve the actual cause. Following therapies can be applied to treat the symptoms: botulinum toxin injections into the muscle of the lower oesophagus sphincter by using an endoscope endoscopic dilatation of the lower oesophagus sphincter surgery of the lower oesophagus sphincter (key-hole or open surgery) medication of accessory symptoms like the inflammation of the gullet, heartburn, cardiac arrhythmia (irregular heartbeat), indigestion there is not yet much experience with alternative medicine. Weitere Themen Schmerzmedikation Infoblatt Vergleich zwischen Myotomie und Dilatation

Help - swallowing difficulties!" In case the food does not slide properly