A Case Report on Management of Patient With Achalasia

Abstract

A peristalsis of the tubular esophagus in combination with a poorly relaxing and occasionally hypertensive lower esophageal sphincter characterizes esophageal achalasia, a primary smooth muscle motility disorder (LES). The breakdown of the neuronal network that coordinates esophageal peristalsis and LES relaxation causes these alterations (plexus myentericus). The amount of information available on segmental esophageal involvement in adults is minimal. We discuss the case of a 54-year-old man who had total aperistalsis localized to the distal esophagus at first. The patient relapsed two years after a satisfactory response to BoTox-infiltration of the distal esophagus. The manometric recordings revealed that the condition had progressed, with a weakly relaxing hypertensive lower esophageal sphincter and complete tubular esophageal aperistalsis (type III achalasia according to the Chicago 3.0 classification system). Clinical findings: After physical examination and investigation doctor diagnosed a case of achalasia with patient was treated analgesics, antibiotic drug to reduce pain. Antipyretic drugs gives to reduce fever. Therapeutic intervention:- Present case took the medical management with achalsia , antipyretics given such Tab. Paracetamol 500 mg (BD), Inj. Ceftriaxone 1gm IV (BD), Inj. Pantaprozole 40 Mg iv (OD), Inj. Ondesetron 4MG iv (TDS) for 7 days. Outcome:-  Patient was taken medications as per doctor order such as paracetamol to reduce their fever. And also patient condition was good with the medical treatment. Now patient’s symptoms reduced and he had in better condition. Nursing perspectives:- Administered fluid replacement ie.DNS and RL. Monitor vital signs and Check BP per hourly. Maintained intake and output chart and provided adequate rest and sleep to the patient. Administered  medications according to doctor’s order. Hydrotherapy given because patient had fever. Conclusion:- The patient was admitted in A.V.B.R.H. with chief complaint Researchers suspect it may be caused by a loss of nerve cells in the esophagus. There are theories about what causes this, but viral infection or autoimmune responses have been suspected. Very rarely, achalasia may be caused by an inherited genetic disorder patient taken all treatment with proper medication . The patient’s  condition was improved.