Professor Ran OrenGastroenterologist
Modern methods for treating achalasia of the cardia in Israel combine precise diagnostics and gentle surgical interventions. At the Ichilov clinic, minimally invasive technologies are used to restore esophageal patency with minimal discomfort for the patient. A team of specialized professionals develops a personalized therapy plan aimed at alleviating symptoms and preventing recurrence. This approach ensures rapid improvement in condition.
During treatment, patients are accommodated in comfortable rooms resembling hotel conditions. The care of the medical staff is felt from the first moments — attention to detail, warm attitude, and constant monitoring make the stay as calm as possible. A personal coordinator accompanies patients at all stages – from consultations to everyday matters, helping them focus solely on what matters – their own recovery.
About the Disease
Esophageal achalasia is a chronic condition in which the lower esophageal sphincter fails to relax during swallowing, leading to difficulty in the passage of food from the esophagus to the stomach.
Causes
- Hereditary predisposition
- Autoimmune processes
- Infectious lesions (e.g., viral)
- Degeneration of nerve endings in the esophagus
Symptoms
- Difficulties swallowing (dysphagia)
- Regurgitation (reverse flow of food)
- Pain or discomfort behind the sternum
- Weight loss
- Heartburn
- Cough, especially at night
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Treatment Methods for Esophageal Achalasia
The choice of treatment method for esophageal achalasia depends on the stage of the disease, the patient's age, accompanying pathologies, and the technical capabilities of the clinic. Preference is given to minimally invasive endoscopic methods, and if they are ineffective, surgical interventions are applied.
Medication Therapy
In the early stages of the disease, doctors often recommend conservative treatment. Experienced gastroenterologists select an individual regimen of medications that help safely relieve the spasm of the lower esophageal sphincter and ease swallowing. Calcium channel blockers and prolonged nitrates act gently but effectively, while myotropic antispasmodics and anticholinergic agents enhance the overall effect. With the correct treatment regimen, patients return to normal eating without pain and discomfort within the first weeks.
Botulinum Therapy
This minimally invasive method is especially relevant for patients who require rapid relief without surgery. Botulinum toxin type A is injected precisely into the muscle fibers of the sphincter using a thin needle under ultrasound or X-ray control. Doctors use a well-established injection technique at 4-8 key points, ensuring even relaxation of the muscle and restoration of esophageal patency. The procedure takes only a few minutes, is performed on an outpatient basis, and can be repeated if necessary.
Pneumatic Balloon Dilation
This is one of the most effective non-surgical methods for restoring esophageal patency. Under X-ray control, the doctor introduces a special balloon with a diameter of 30-40 mm into the sphincter area, which gently expands the narrowed area. Thanks to markers on the balloon, millimeter precision in positioning is achieved, and the controlled pressure only disrupts the pathologically altered muscle fibers. The effect of the procedure often lasts for years, especially with careful monitoring and timely control.
Peroral Endoscopic Myotomy (POEM)
A modern endoscopic technique that does not require external incisions. A thin flexible endoscope is introduced through the mouth into the esophagus, through which the doctor creates a submucosal tunnel and precisely cuts the spastic muscle fibers of the sphincter. The procedure is performed using carbon dioxide, which provides good visualization and safety. Thanks to the high qualifications of the surgeons and modern equipment, recovery is rapid, and the results are long-lasting.
Laparoscopic Heller Myotomy
The gold standard for surgical treatment of achalasia, combining effectiveness and minimal invasiveness. Through 4-5 small punctures in the abdominal wall, the surgeon gains access to the esophagus, carefully cutting the muscle fibers of the sphincter over a length of 5-6 cm while simultaneously forming an anti-reflux cuff (usually using the Dor or Toupet technique). The operation is performed under general anesthesia, using ultrasonic scissors and coagulators, and after it, the patient quickly returns to their usual lifestyle.
Open Heller Myotomy
In cases of complex anatomical features or advanced forms of the disease, open surgery may be required. It is performed through laparotomy or thoracotomy access and provides the surgeon with a wide view. It allows for a more extensive myotomy (up to 10 cm) and the formation of reliable anti-reflux protection. This technique has been used for decades, and thanks to the high qualifications of surgeons, it remains one of the most reliable methods for restoring esophageal function.
Resection Operations
In the most severe cases, especially with malignant tumors or severe scarring changes, doctors perform subtotal resection of the affected area of the esophagus with simultaneous reconstruction. A portion of the stomach or colon may be used as a graft. Modern equipment allows for the formation of airtight sutures and their verification using intraoperative endoscopy. The operation is performed by a team of experienced surgeons and oncologists, and after it, the patient has a chance for complete recovery and return to an active life.
Diagnostic Methods for the Disease
All diagnostic procedures at the Ichilov clinic for treating achalasia of the cardia are planned in advance and are typically completed within three days. This approach allows for the rapid and efficient collection of complete clinical information for accurate diagnosis and selection of optimal therapy.
First Day
Upon arrival at the clinic, the patient undergoes a consultation with the attending physician. The doctor collects a detailed medical history, conducts an examination, and provides recommendations for necessary studies that will help obtain a complete picture of the patient's condition.
Second Day
For comprehensive diagnostics, the following studies are assigned to the patient:
- laboratory blood tests
- esophageal manometry
- abdominal ultrasound
- X-ray with contrast (series of barium images)
- esophagoscopy
- impedance measurement
- esophageal pH monitoring
Third Day
Based on the examination results, an individual therapeutic plan is developed. The gastroenterologist, surgeon, anesthesiologist, and other specialists participate in its development. A multidisciplinary approach ensures a comprehensive review of the disease and allows for the selection of the most effective and safe treatment for each patient.
How Much Does Treatment Cost in Israel
The cost of treatment depends on the method of treatment (endoscopic or surgical), the severity of the disease, the required length of hospital stay, the medications used, and consumables.
To get an accurate price calculation for your case, contact the consultant at the phone number listed on the website. They will provide preliminary costs, detailed explanations of what is included, information about possible additional expenses, and answer all your questions.
Advantages of Treatment in Israel
- Treatment by leading doctors, experts in esophageal diseases.
- Use of advanced diagnostic and therapeutic technologies of the latest generation.
- Comprehensive patient management by a team of leading specialists from related fields.
- Personalized selection of therapeutic protocols based on molecular genetic analysis.
- First-class support services, including personal assistance and document translation.
Even before arriving at the Israeli clinic, the patient can order an online consultation with the necessary specialist. As a result, they will receive professional recommendations, answers to all questions, and confidence in the correctness of further steps.