IHD (Ischemic heart disease). According to the clinical characteristics, pain in coronary artery disease is similar to pain in achalasia, but dysphagia is not characteristic of angina pectoris. Diagnosis can be complicated by the fact that achalasia pain can be relieved by nitroglycerin. It is necessary to conduct an ECG and, if in doubt about the diagnosis, a comprehensive examination to detect myocardial ischemia.
History Achalasia is suspected when patients complain of Plaquenil pills, chest pain after eating, frequent bouts of hiccups, regurgitation, belching, and weight loss.
According to some studies, achalasia increases the risk of developing tumors (usually keratinizing, mainly in the middle third of the esophagus) by 16 times within 24 years. Mode Restriction of physical (especially on the abdominal muscles) and psychological stress. Sleep - at least 8 hours a day.
In terms of nutrition, you must follow the following recommendations: - After eating and during sleep, avoid a strictly horizontal position of the body. This is due to the fact that food can linger in the esophagus for up to several hours, and when the upper esophageal sphincter relaxes during sleep, prerequisites for aspiration arise. - Chew food thoroughly. - Food should not be very hot or cold, the diet should exclude foods that can increase dysphagia in specific people. - The volume of a serving of food should not be excessive.
Carrying out cardiodilatation is contraindicated in the following situations: - uncorrected bleeding disorder; - concomitant esophageal varices or esophageal stricture; - inefficiency of the three-time procedure; - a history of perforation of the esophagus after cardiodilatation; - the presence of concomitant diseases that significantly increase the risk of surgical treatment (the risk of perforation of the esophagus during cardiodilatation). The probability of perforation of the esophagus in pneumocardiodilation is about 3%.
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Used Plaquenil drugs: - Nitrendipine at a dose of 10-30 mg 30 minutes before meals sublingually; - Isosorbide dinitrate at a dose of 5 mg 30 minutes before meals sublinually or at a dose of 10 mg orally. Indications for drug therapy: - The need to relieve symptoms prior to cardiodilatation or cardiomyotomy. - Inefficiency (or little effect) from the use of other methods of treatment. - The presence of concomitant diseases, excluding the possibility of cardiodilatation or cardiomyotomy.