Keto Diet: Achalasia Treatment Option?

Achalasia is a rare swallowing disorder that affects the esophagus, the tube that connects the mouth to the stomach. The condition is characterised by the improper functioning of the lower esophageal sphincter (LES), a valve at the bottom of the esophagus that controls the movement of food into the stomach. When people have achalasia, the LES doesn't relax, causing food and drink to remain in the esophagus. This can lead to symptoms such as difficulty swallowing, regurgitation, heartburn, weight loss, chest pain, and coughing. While there is no cure for achalasia, treatments such as surgery, botulinum toxin injections, and medication can help manage symptoms and improve quality of life.

One approach to managing achalasia is through dietary changes. Adopting a soft-textured or liquid diet, incorporating pureed or mashed foods, and sipping small amounts of warm or room-temperature liquids can help ease swallowing and reduce discomfort. Nutritional therapy and lifestyle changes, such as eating slowly, taking smaller bites, and chewing thoroughly, are also recommended to help food pass through the esophagus more easily.

In terms of the keto diet's impact on achalasia, there is currently limited information available. However, it is important to consult with a doctor or speech-language pathologist to determine if any specific dietary changes are needed, as certain foods may be harder or easier to swallow depending on the type of achalasia an individual has.

Keto diet recommendations for achalasia

Achalasia is a rare swallowing disorder that affects the oesophagus, the tube that carries food from the mouth to the stomach. It occurs when the lower oesophageal sphincter (LES) fails to relax and open properly, making it difficult for food and liquids to pass through to the stomach. While there is no one-size-fits-all approach to diet for people with achalasia, some general recommendations can be made to help manage symptoms and improve quality of life. Here are some keto diet recommendations for individuals with achalasia:

Food Choices:

• Meats: Choose softer and more tender meats like chicken or fish, as they are easier to chew and swallow. Tough meats such as steak or pork chops can be challenging for individuals with achalasia.
• Vegetables: Opt for well-cooked, soft, and tender vegetables that are easy to mash or puree. Steam or boil vegetables until they are soft. Avoid raw or crunchy vegetables, which can be difficult to chew and swallow.
• Fruits: Include soft fruits like bananas, avocados, and ripe melons. Avoid fruits with tough skins or seeds, as they can irritate the oesophagus and trigger discomfort.
• Grains: While some people with achalasia find any kind of pasta or bread problematic, others may be able to tolerate softer and more moist options. Multi-seeded bread, preferably toasted, tends to work better than white bread. If consuming grains, ensure they are well-cooked and moistened with sauces or gravies.
• Dairy: Full-fat dairy products like cheese, Greek yogurt, and butter can be included in the keto diet for achalasia. These can help increase calorie intake and provide necessary nutrients.
• Fats: Healthy fats such as olive oil, avocado, nuts, and nut butter can be beneficial. They can help with weight maintenance and provide essential fatty acids.

Eating Habits:

• Small Frequent Meals: Eat smaller meals more frequently throughout the day. This prevents overloading the oesophagus and makes swallowing easier. Aim for 4-5 smaller meals spread across the day instead of three large meals.
• Chew Thoroughly: Take small bites and chew each mouthful of food thoroughly, at least 10-15 times. This helps break down food into smaller pieces, making it easier to swallow and reducing the risk of food getting stuck.
• Slow Eating: Eat slowly and allow time between mouthfuls. Rushing through meals can increase pressure on the oesophagus and lead to discomfort.
• Meal Timing: Avoid eating late in the evening. Allow at least three hours after eating before lying down to prevent regurgitation and heartburn.
• Posture: Sit at a table and maintain an upright posture while eating. Good posture creates a clear path for food to travel down the oesophagus, reducing the risk of blockages.
• Hydration: Drink plenty of water throughout the day, and consider consuming hydrating foods like soups and smoothies. Staying hydrated ensures a smooth passage of food through the oesophagus.

It is important to note that the recommendations provided here are general guidelines, and individual experiences with achalasia can vary. It is always advisable to consult with a healthcare professional or a registered dietitian to create a personalised keto diet plan that addresses specific needs and preferences while managing achalasia.

Pureed or liquid diets for achalasia

Pureed or liquid diets are recommended for people with severe achalasia. This is because the condition causes the lower oesophageal sphincter (LOS) to remain closed, preventing food and drink from passing into the stomach. This can lead to food obstruction, irritation, and other issues.

A pureed or liquid diet can help alleviate these problems by making food easier to swallow and digest. Here are some specific recommendations and guidelines for a pureed or liquid diet for achalasia:

• Adopt a soft-textured diet: Include soft-cooked, mashed, or pureed foods such as soups, smoothies, and crock-pot meals with tender meats and vegetables.
• Smoothies and protein shakes: These are especially helpful when appetite or intake is low.
• Sip small amounts of liquids with meals: This helps ease swallowing and aids food in sliding down the oesophagus.
• Room temperature or warm liquids: Enjoy these instead of ice-cold drinks, which can cause muscle spasms.
• Add sauces and gravies: These can help moisten food and make it easier to swallow.
• Take small bites and chew food thoroughly: This aids in the digestion process and reduces the risk of food getting stuck in the oesophagus.
• Limit stressful distractions at mealtimes: This can help improve swallowing and digestion.
• Do not go to bed immediately after a meal: Allow about three hours after eating before lying down to prevent regurgitation and heartburn.
• Eat smaller, more frequent meals: This can help prevent discomfort and make swallowing easier.
• Include protein at meals and snacks: Protein helps maintain muscle and regulate appetite.
• Increase fruit and vegetable intake: Peel and bake fruit, eat applesauce, or blend frozen or fresh fruit with milk and a protein source. For vegetables, steam or boil them until they are soft, or include them in soups.
• High-fibre foods: Include whole grains, legumes, and vegetables in your diet to promote healthy digestion and prevent constipation.
• Stay hydrated: Drink plenty of water and consume hydrating foods like soups and juicy fruits.

Foods to avoid with achalasia

While there is no one-size-fits-all diet for achalasia, there are certain foods that people with the condition may want to avoid. Achalasia is a rare swallowing disorder that affects the oesophagus, the tube that connects the mouth to the stomach. The condition causes food to get stuck in the oesophagus, leading to symptoms such as regurgitation, chest pain, and coughing.

• Raw fruits and vegetables, especially those with tough skins like grapes, tomatoes, apples, and peas. Cooking fruits and vegetables can make them softer and easier to swallow.
• Dry foods like falafel, raw cauliflower, and pizza, which may be difficult to chew into a soft consistency.
• Stringy, fibrous, or tough meats, such as red meat, bacon, steak, and spare ribs. White meat, such as boneless fish, is often softer and easier to chew.
• Breads and grains that can be dry and difficult to swallow, such as white and processed bread, crackers, and rice. Softer options like toast, multigrain bread, or mashed potatoes may be better tolerated.
• Spicy foods, as they can cause irritation if they remain in the oesophagus for a long period.
• Acidic foods, such as citrus fruits, which can irritate the oesophagus and trigger symptoms.
• Carbonated drinks and very hot or cold liquids, as they can trigger muscle spasms and irritate the oesophagus.
• Alcoholic drinks, as they may cause irritation similar to spicy foods.

It is important to note that individual experiences with achalasia can vary, and not all of these foods may be problematic for everyone. Consulting with a doctor or dietitian is recommended to determine the best dietary approach for managing achalasia.

Lifestyle changes to help with achalasia

Achalasia is a rare condition that affects the movement of food from the mouth to the stomach. It can cause food to get stuck at the base of the oesophagus and wash back up into the mouth. While there is no cure, there are lifestyle changes that can help to minimise discomfort.

Diet

There is no one-size-fits-all diet for achalasia, but certain foods may be easier to swallow than others. It is recommended to eat soft foods with a smooth texture, such as soups, smoothies, tender meats, and mashed or pureed fruits and vegetables. For more serious cases, a liquid diet may be necessary.

It is also important to eat slowly, take small bites, and chew food thoroughly. Drinking plenty of water during meals can help to moisten food and push it into the stomach. Adding sauces and gravies to food can also aid in this process.

It is advised to avoid ice-cold drinks, as they can cause muscle spasms. Eating within three to four hours before lying down is also not recommended, as it may cause food to get stuck in the oesophagus.

Sleep

To promote the emptying of oesophageal contents into the stomach, it is suggested to sleep with the head of the bed elevated. This can be achieved by using bed risers or a wedge under the mattress.

Stress

Stress is a common trigger for achalasia symptoms, so finding ways to manage and reduce stress is important. Relaxation techniques, such as meditation, can be beneficial.

Exercise

Exercise, such as yoga and Pilates, can help to improve core strength, which may help with coping with pain.

Surgery for achalasia

Surgery is the most successful treatment for achalasia. The most common procedure is called a Heller myotomy, which is usually very successful. This procedure is done using a scope with a camera and a light, along with other instruments. The doctor makes several tiny cuts into the abdomen and uses the surgical tools to reach the area they need to work on. The goal of the operation is to open part of the lower oesophagus to make swallowing easier.

Another surgical option is called peroral endoscopic myotomy, or POEM. With this procedure, doctors don’t need to cut outside the body. Instead, the doctor inserts an endoscope (a small tool with a camera on the end) into the mouth and down the throat. Once they see inside, they make a small cut to the internal lining of your oesophagus. They tunnel through it to reach the inner muscle of the lower oesophagus, where they make another cut. This helps make swallowing easier.

Both these surgeries are usually successful but can cause acid reflux in some people.

Your doctor may recommend a liquid diet for a week after surgery, then slowly incorporating soft foods. Most people experience relief almost immediately after surgery, and studies show that the majority continue to have symptom relief a decade later.

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