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Children have hiccups and belching with air, often weight loss and polydeficiency anemia. There may be regurgitation of food during sleep and a nocturnal cough, pulmonary complications are not uncommon: bronchitis and pneumonia. There may be complications such as esophagitis,pressure of the recurrent nerve, compression of the right bronchus, compression of the vagus nerve.

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Physical examination At the initial stages of the development of the disease, as a rule, it is not possible to identify significant abnormalities. External signs are found mainly in more severe and complicated cases - at stages 3-4 of the disease. Weight loss indicates a malnutrition, a decrease in turgor. Turgor is the tension and elasticity of the tissue, which varies depending on its physiological state. skin - for dehydration, and there are signs indicating the development of aspiration pneumonia.

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Hydroxychloroquine of the esophagus (with its contrasting with barium sulfate). Typical signs of the disease: enlarged lumen of the esophagus, absence of a gas bubble of the stomach, delayed release of the esophagus from the contrast agent, absence of normal peristaltic contractions of the esophagus, narrowing of the terminal esophagus ("candle flame"). The sensitivity of the method is at the level of 58-95%, the specificity is 95%.

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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.

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History Achalasia is suspected when patients complain of Plaquenil pills, chest pain after eating, frequent bouts of hiccups, regurgitation, belching, and weight loss.

Congenital membranes of the esophagus, strictures, including those caused by tumors.

Characterized by dysphagia, primarily when taking solid food. In some cases, there are vomiting and regurgitation.

Regurgitation is the movement of the contents of a hollow organ in the direction opposite to the physiological one as a result of contraction of its muscles.

Possible neurogenic dysphagia is usually accompanied by vomiting of hydroxychloroquine contents 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.

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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.

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