As with any medical condition, there are risks in relation to treatments, and indeed in not having treatment.
Some of these risks are outlined to help you understand the situation better:
Because achalasia has no cure as such, only the possibility of treatment to help with the symptoms, you should bear in mind that the untreated condition will be unlikely to improve on its own. The longer you leave it untreated, the more problems you are likely to have with accumulated food blocking your oesophagus. This in time may stretch the oesophagus until it gets ‘baggy’. This may cause it to lose its natural shape and its ability to funnel food through to your stomach. This would result in any surgery being more extensive.
Seeing a specialist for an assessment of your achalasia will help decide the best way forward.
Your ability to swallow to that food readily reaches your stomach will have an effect on the speed at which you can eat and the quantity you can take in. This may result in loss of weight and malnutrition in serious cases.
Avoiding certain types of food, and having food which is soft and easily digestible will mitigate this risk. Nutrition drinks like Fortisip can help to maintain vitamin levels.
Linked to malnutrition, the ability to undertake sports or physical activity may be compromised because of lack of nutritional intake.
A loss of quality of life around food, and problems of eating with others for instance, can be dispiriting. There will inevitably some anxiety about whether you will be able to digest what you eat. Stress and tension can make swallowing more difficult, and can increase the likelihood of painful spasms.
Persistent reflux can be a significant health risk. Reflux is more likely after a POEM procedure, or sometimes after LHM myotomy surgery. Reflux can sometimes get into your lungs (aspiration) which brings a risk of pneumonia.
The fundoplication part of LHM surgery is designed to reduce reflux. Medication can be taken to reduce reflux.
Adjusting your bed to sleep with your head and shoulders raised can help against reflux at night.
Pneumatic dilatation can result in the lower oesophageal sphincter being stretched so as to allow food to pass through more easily, and this will be appropriate treatment for many people. Sometimes this procedure is repeated after a relatively short interval. Inevitably, however, this process does damage the tissue surrounding the LOS and it will tend to make later surgery more difficult.
Be careful about repeated dilatations, and consider the case for definitive long term treatment at the earliest stage, compatible with your own overall medical situation.