Esophageal Achalasia
Esophageal achalasia is an uncommon disorder caused by degeneration of the esophageal nerves. It is characterized primarily by persistent contraction of the lower esophageal sphincter (LES) and reduced esophageal peristalsis. It is also known as cardiospasm or megaesophagus. Typical clinical manifestations include dysphagia, regurgitation, and retrosternal pain. Some patients may also experience heartburn, weight loss, or aspiration pneumonia. In traditional Chinese medicine (TCM), this condition may be classified under “dysphagia and obstruction” (噎膈).
TCM Pattern Identification and Medication Reference
| Common Symptoms
Clinical Description:
A sensation of obstruction or discomfort in the esophagus when swallowing, fullness and distention in the chest and diaphragm area, sometimes with pain. Symptoms may ease when the person feels emotionally at ease and worsen when feeling depressed. Belching, hiccups, vomiting of phlegm and saliva, dry mouth and throat, difficult bowel movements, a red tongue with a thin, slightly greasy coating, and a wiry, slippery pulse.
Plain-Language Explanation:
- A feeling that something is stuck in the esophagus when swallowing, making it difficult to swallow smoothly
- A feeling of tightness in the chest, sometimes with pain
- Symptoms ease when feeling emotionally at ease and worsen when feeling low
- Frequent belching or hiccups
- Phlegm may be vomited
- Dry mouth and throat
- Hard stools that are difficult to pass
- A red tongue with a thin, slightly greasy coating
- A wiry, slippery pulse, traditionally associated with emotional constraint and phlegm-Qi stagnation
| Treatment Approach
Clinical Description:
Direct rebellious Qi downward, transform phlegm, benefit Qi, and harmonize the stomach
Plain-Language Explanation:
- Use methods intended to direct upward-surging Qi downward and transform thick phlegm, making phlegm easier to expectorate and easing discomfort such as chest tightness, phlegm in the throat, upper abdominal fullness, belching, acid regurgitation, hiccups, nausea, and vomiting.
- Also support the body’s Qi and regulate stomach function to improve digestive comfort and address poor appetite, post-meal abdominal bloating, fatigue, reluctance to speak, and loose or unformed stools.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical Description:
Distending pain in the upper abdomen extending to both flanks, often worsening when emotional distress is unresolved; frequent sighing, poor appetite, low mood, restless sleep, a thin white tongue coating, and a wiry, slippery pulse.
Plain-Language Explanation:
- Distending discomfort or pain in the stomach area, sometimes extending to both sides of the ribs
- Symptoms worsen when emotions feel unsettled
- Often sighs to relieve a feeling of chest tightness
- Poor appetite
- Low mood and lack of energy
- Restless sleep
- A thin white tongue coating
- A wiry, slippery pulse, traditionally associated with emotional constraint and liver Qi stagnation
| Treatment Approach
Clinical Description:
Soothe the liver and harmonize the stomach, regulate Qi, and relieve pain
Plain-Language Explanation:
- Use methods intended to relieve liver Qi constraint and regulate the stomach, promoting smoother Qi flow and digestive comfort and easing feelings of fullness and discomfort.
- Use Qi-regulating methods to help disperse stagnation, easing distending or dull pain over time.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical Description:
Obstructed swallowing and pain in the chest and diaphragm area; food does not pass down, and in severe cases even water is difficult to swallow. Food is vomited soon after eating. The complexion may be dark, the skin dry and rough, and the body emaciated. Stools may be as hard as sheep droppings. Vomit or stool may resemble red-bean juice or contain blood. The tongue may be dark purple or red and dry, and the pulse thin and choppy.
Plain-Language Explanation:
- Difficulty swallowing, with a feeling that the throat is blocked
- Chest pain and difficulty swallowing food; in severe cases, even water may be difficult to swallow
- Food is vomited soon after eating
- A dark or dusky complexion
- Dry, dull-looking skin
- Marked weight loss
- Hard stools resembling sheep droppings
- Sometimes vomit resembles red-bean juice, or there is blood in the stool
- The tongue may be dark purple, or red and dry
- A thin, choppy pulse, traditionally associated with impaired Qi and blood flow and a more severe pattern
| Treatment Approach
Clinical Description:
Break up accumulations and move blood stasis; nourish Yin and blood
Plain-Language Explanation:
- Use methods intended to disperse internal accumulations and blood stasis, promoting smoother blood flow and easing distending or stabbing pain, tenderness to pressure, or localized firmness.
- Use methods intended to moisten the body and nourish the blood, helping restore nourishment and address dry mouth and throat, irritability, dizziness, fatigue, and a pale complexion.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical Description:
Food is obstructed during swallowing and does not pass down; it is vomited soon after eating. There may be no vomiting at first, followed later by an inability to swallow. Dull or mildly burning pain in the upper abdomen, a gnawing sensation like hunger despite little desire to eat, dry mouth without thirst, dry throat and lips, constipation or difficulty passing stool. The tongue is thin, delicate, and red, with little or no coating; the pulse is thin and rapid.
Plain-Language Explanation:
- Food is difficult to swallow and is often vomited soon after eating
- Symptoms may be subtle at first; later, swallowing may become completely difficult
- Dull pain or a burning sensation in the upper abdomen
- A gnawing feeling in the stomach, as if hungry, but with little desire to eat
- Dry mouth without a desire to drink; dryness in the throat and lips
- Hard stools or difficulty passing stool
- A small, thin tongue that is delicate and red, with little or no coating
- A thin, somewhat rapid pulse, traditionally associated with depleted Yin fluids and internal deficiency heat
| Treatment Approach
Clinical Description:
Nourish Yin and clear heat
Plain-Language Explanation:
- Use nourishing and moisturizing methods to replenish the body’s fluids, helping ease dry mouth and throat, irritability, poor sleep or vivid dreams, and dry skin.
- Also address “deficiency heat” associated with insufficient Yin fluids, which may include episodes of warmth in the afternoon or at night, heat in the palms and soles, night sweats, flushed cheeks, dry or sore throat, and a dry cough with little phlegm.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical Description:
Long-term difficulty swallowing and eating; a pale, lusterless complexion, fatigue, feeling cold, shortness of breath, facial and foot swelling, bringing up clear fluids, abdominal bloating and loose stools, a pale tongue with a white coating, and a thin, weak pulse.
Plain-Language Explanation:
- Long-term difficulty swallowing, making it hard to eat
- A pale, dull complexion
- Low energy and easy fatigue
- Feeling cold and short of breath
- Swelling in the face and feet
- Frequent bringing up of clear, watery phlegm or saliva
- Abdominal fullness and loose stools
- A pale tongue with a white coating
- A thin, weak pulse, traditionally associated with spleen-kidney Yang deficiency and a cold constitution
| Treatment Approach
Clinical Description:
Warm and tonify the spleen and kidneys, benefit Qi, and restore Yang
Plain-Language Explanation:
- Use warming methods intended to support spleen and kidney Yang and improve digestive function, addressing discomfort such as feeling cold, cold hands and feet, sore or weak lower back and knees, poor appetite, and fatigue.
- Also support the body’s vital Qi and restore depleted Yang, with the aim of gradually addressing a pale complexion, shortness of breath, reluctance to speak, palpitations, feeling cold, and cold extremities.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical Description:
Difficulty swallowing and regurgitation of food; eating a little more may provoke vomiting. Symptoms come and go, and food is difficult to digest. Retrosternal pain, aversion to cold and preference for warmth, loose stools, a pale tongue with a white coating, and a soft, weak pulse.
Plain-Language Explanation:
- Difficulty swallowing, with food prone to coming back up
- Feeling like vomiting after eating even a little more than usual
- Symptoms fluctuate
- Food seems difficult to digest after reaching the stomach
- Pain behind the breastbone
- Easily chilled and prefers warmth
- Loose, unformed stools
- A pale tongue with a white coating
- A soft, weak pulse, traditionally associated with spleen-stomach deficiency-cold and impaired digestive function
| Treatment Approach
Clinical Description:
Warm the middle and strengthen the spleen, harmonize the stomach, and direct rebellious Qi downward
Plain-Language Explanation:
- Use methods intended to warm the middle and support spleen function, helping improve digestion and ease discomfort such as feeling cold, abdominal chill, post-meal bloating, poor appetite, loose stools, and fatigue.
- Also regulate stomach function and direct upward-surging Qi downward, addressing upper abdominal fullness, belching, acid regurgitation, hiccups, nausea, and vomiting.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
References
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