Gastro-Oesophageal Inflammation and Peptic Ulceration

• Describe achalasia

due to impaired smooth muscle relaxation, can be the cause of oesophageal obstruction.

Achalasia triad

incomplete Lower oesophageal sphincter (LES) relaxation

Increased LES tone

Aperistalsis of the oesophagus (lack of propulsion of food)

it can be a primary achalasia or secondary, it is more commonly secondary but in rare familial genetic cases it is primary

Primary Achalasia

Caused by Neuronal, ganglion cell degeneration (Vagus N) – occurs in rare familiar cases

Secondary Achalasia

causes inc the following

• Chagas disease (Trypanosoma cruzi infection) – destruction of myenteric plexuses
• Diabetic autonomic neuropathy, amyloidosis, sarcoidosis, polio, Down syndrome
• Herpes simplex infection