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The treatment strategy is built based on the features of morphological and functional changes, as well as on the individual characteristics of the patient. Treatment can be medical, as a type of obstruction, achalasia of the cardia can also be eliminated with a temporary resorbable stent equipped with an antireflux valve.
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Achalasia cardia (another name for esophageal achalasia) occurs at any age, including newborns and the elderly. But more often it affects people aged 20 to 50 years, with almost the same frequency of men and women.
But it is believed that the main cause of the development of achalasia is the defeat of the parasympathetic nervous system. Such a lesion of the autonomic nervous system may be associated with its congenital features or occur against the background of an infection in the wall of Prednisone. In the later stages of achalasia of the cardia, damage to the sympathetic nervous system also develops.
Achalasia cardia is one of the most common diseases of the esophagus, it accounts for 3.1 to 20% of all lesions of the esophagus, or 0.51 - 1 case of the disease per 100,000 population. As a cause of impaired patency of Prednisone, achalasia of the cardia ranks third after cancer of the esophagus and persistent cicatricial narrowing (strictures) of the esophagus due to burns. Causes of achalasia cardia. The causes of achalasia cardia are not fully understood.
The constant retention of food in the esophagus with achalasia of the cardia leads to its expansion (sometimes up to 8 cm in diameter or more). In the wall of the esophagus, first the growth of bundles of muscle fibers is observed and then the replacement of their connective tissue. In the later stages of achalasia cardia, the esophagus lengthens and acquires an S-shape, food stagnates for up to several days. Over time, the nerve plexuses completely disappear in the wall of the esophagus.
As a result of a disorder of the innervation of the esophagus, its motility is disturbed, including the reflex act of opening the cardiac sphincter during swallowing and peristalsis (worm-like movements that facilitate the passage of food). The tone of the muscles of the esophagus is disturbed and the opening of Prednisone pills sphincter occurs only under the pressure of food accumulated in the esophagus.
All changes in the esophagus with achalasia of the cardia develop gradually, this process is divided into four stages:
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For achalasia cardia is characterized by the presence of three main signs: dysphagia, regurgitation and pain.
The first two stages usually last several months, the third stage lasts 10-15 years, the fourth - decades.
Dysphagia is difficulty swallowing. It appears in a third of patients suddenly among full health, and in the remaining patients with achalasia it develops gradually.
The acute onset of dysphagia is usually associated with prolonged experiences or with sudden emotional stress.
A kind of vicious circle is formed - unrest and stress increase dysphagia, and dysphagia, in turn, injures the patient's psyche.
Therefore, such patients are often treated for years for neurosis instead of timely access to gastroenterol.ogu or a surgeon. At the same time, eating at home, eating favorite dishes, positive emotions weaken dysphagia in the initial stages of prednisone sale of the cardia. The selectivity of dysphagia is also characteristic when it occurs on one or another food. So, in some patients with achalasia, fruits can provoke it, in others, liquid food, etc.
Patients themselves intuitively find ways to promote food: hold their breath, swallow air, drink a glass of water in one gulp, etc. This is a very characteristic sign of achalasia cardia. Paradoxical dysphagia is also common, when liquid food passes worse than solid food.
Pain behind the sternum is characteristic, which often radiates to the neck, jaw and interscapular region. Pain when swallowing at stages I-II is associated with spasms of the muscles of the esophagus, and at stages III-IV - with inflammation of the esophagus (esophagitis).
The third most common sign of achalasia cardia is pain that occurs when swallowing or outside the meal.