tess
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In Achalsia, liquid firs; in case of stricture or tumor, it is solid food first? :roll:
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| bozhenka
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in achalasia it's solid and liquid in same rate
in tumor and stricture - is solid food
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| tess
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Thanks, bozhenka, that's what i thought. But please have a look at kaplan surgery page 29 (if you have). It says solids are swallowed with less difficulty than liquids in case of achalasia. :shock:
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| bozhenka
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Sorry, I haven't anyone of kaplan surgery
I read it in LANGE:
"Patients complain of gradual onset of dysphagia for solid foods and, in the majority, of liquids also.
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| lucky
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for tumors solids first.
for achalasia both.
[kaplan int.med.]
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| tess
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yes, i agree also. but why kaplan surgery confuse so much! :shock:
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| Ouli Maty
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I don't think it is a confusion. When I was in med school, I've learned that in akalasia, it is called a paradoxical dysphasia, when liquid stuck more than solid.
I don't remember the explanation though I am guessing it might be because solid weight more, they can overcome the high pressure of the LES, while liquid don't.
That might also be at the beginning since in the end, both don't pass the LES :?: .
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| tess
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Maty, thank you for confirming this. That's the reason I am also thinking about. Just surprised that kaplan surgery says it this way and IM says it in another way! But it is good to know it. thanks. 
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| daira
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My concept:
Achalasia is a motility disorder, not a mechanical disorder. Solids produce stronger peristaltic waves as compared to liquids, so get thru. Liquids produce weaker peristaltic waves so get stuck….paradoxical dysphagia.
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| lucky
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right on spot guest!
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| tess
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Finally there comes the logical explanation! Thanks, guest!
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