Achalasia an Autoimmune Disease?

I was made aware of an illness on my husbands side of the family this week. An 18 year old suffering greatly from Achalasia. The online definition through Google is “a condition in which the muscles of the lower part of the esophagus fail to relax, preventing food from passing into the stomach.” My very first thought as I read the prayer request and what this young man was going through, currently fighting for his life, was “Man, this sounds autoimmune in nature”. Thus the nature of this post….

Image from article “Who is at Risk of Achalasia?”   http://www.bestonlinemd.com/achalasia/

The young man suffering can’t get anything into his stomach. He’s lost so much weight and been on so many medications. I began to dig around online and I found the connection I initially thought must be there, ‘autoimmune in nature’. I found the article “Mysterious esophagus disease is autoimmune after all“. Research shows that many suspected  this but that there were no studies yet completed to state for sure… until July 2014. That was only 6 months ago.

I wondered if my husband’s cousin and ill son knew this or if the doctors even knew this. Sadly many doctors don’t look for an autoimmune connection because as far as they are concerned it makes no difference in your care. Instead of seeking out the cause of the inflammation and removing it or minimizing it, they ignore it and push down the immune system instead with extremely strong drugs that have equally as miserable side effects is the disease they are suppose to be relieving. Sound counter productive? Yeah, I agree.

I decided to do some research and here’s what I found. [I am not a doctor, I am just sharing what is available on the internet and comparing it to what I’ve studied for my own wellness with an my autoimmune disease, hashimoto’s.]

Below is almost all of the article explaining this new direct link to autoimmunity. It’s a bit technical but worth the read!

Mysterious esophagus disease is autoimmune after all

http://www.sciencedaily.com/releases/2014/07/140729073644.htm
July 29, 2014
KU Leuven
Achalasia is a rare disease – it affects 1 in 100,000 people – characterized by a loss of nerve cells in the esophageal wall. While its cause remains unknown, a new study confirms for the first time that achalasia is autoimmune in origin.
Achalasia is a rare disease — it affects 1 in 100,000 people — characterized by a loss of nerve cells in the esophageal wall. While its cause remains unknown, a new study by a team of researchers at KU Leuven in Belgium, the University of Bonn in Germany and other European institutions confirms for the first time that achalasia is autoimmune in origin. The study, published on 6 July in Nature Genetics, is an important step towards unraveling the mysterious disease.

When we swallow, a sphincter in the lower esophagus opens, allowing food to enter the stomach. Nerve cells in the esophageal wall control the opening and closing of this sphincter, but in people with achalasia, these nerve cells gradually disappear. Without these cells, the esophageal sphincter fails to relax, causing food to accumulate in the esophagus. This results in swallowing problems, regurgitation, vomiting, nighttime coughing, chest pain and weight loss.
Because so little is known about achalasia, current treatments are limited to stretching the esophageal sphincter endoscopically with a balloon or surgically cutting the sphincter. But while these treatments can help alleviate the disease’s symptoms, they do not address its cause.
Researchers have long suspected that an autoimmune response lies at the root of the disease, but an explanation for why the immune system of people with achalasia responds as it does remains elusive.
One possible explanation is that esophageal nerve cells are targeted by the body’s defenses due to a miscued immune response to an earlier viral infection — the immune system mistakes the nerve cells for the virus and attacks them.
…….
Story Source:
The above story is based on materials provided by KU Leuven. Note: Materials may be edited for content and length.
[Please see the original article for all the specific contributors to this research listed at the end of the article.]

Reading this I was really not surprised. Sadly I understand all to well the statement “current treatments… do not address the cause”.

There are some many things that are infiltrating our bodies daily that were never around even 100 years ago. The body is facing new virus’ at an alarming rate. With achalasia there is a possible connection to the patients with the disease and a past serious viral infection. So in this autoimmune situation it looks like a virus is what the body starts attacking which then gets confused into attacking the neurons in the sphincter tissue causing it’s state of tonus, or relaxation, to be increasingly less relaxed.

The virus’ we are attacked by are mutating very quickly to survive vaccines and medicines so the body has to quickly recognize this brand new invader and create a game plan for removing it. Sometimes that game plan leaks over into killing anything that looks similar, and the body may have proteins that look similar and mistakenly are attacked in the process. After the immune system has marked the body as an invader it doesn’t forget, or go “Oops! My bad! Your with us!”. Instead, from then on out, when the immune system is sent out, the body protein tagged by accident again becomes a target.

For me and my hashimoto’s the cells I accidentally have marked as the enemy are my thyroid cells. So when my immune system is inflamed my thyroid is also under attack, from me. Ugh!

With achalasia they aren’t exactly sure what protein is marked. Below in the quotes you will see the higher occurrence of antibodies against certain neurons in the esophagus that may be the answer to that question. Once it’s discovered it will be much easier to diagnose, although until doctors address the immune system in illnesses, it will only help the patient help themselves by minimizing the things setting off their immune system. Sadly, as of right now, this discovery likely won’t change how western medicine treats the patient.

There are many many more things that are protein based that the body mimics besides virus’ like bacteria, gluten, GMO foods and now bugs (yup, they are considering releasing genetically altered mosquitoes in the Florida Keys), and toxins that are in the air, water, and soil, and so much more.

Also, the little butterfly organ located very nearby [the thyroid] when it’s sick it’s often due to an autoimmune disease (Grave’s or Hashimoto’s) so the stretch to the throat is not so far….. Here is another article I found describing this connection:

Achalasia and thyroid disease: possible autoimmune connection?
SUMMARY
Many cases have been published showing a co-existence of autoimmune thyroid diseases (AITDs) and other autoimmune diseases. About a quarter of patients with achalasia have a concurrent thyroid disease, most commonly associated with hypothyroidism. Although relatively rare, the association of achalasia and hyperthyroidism requires attention. The physiopathology of Grave’s Disease (GD) involves B- and T-mediator lymphocytes, which have an affinity for known thyroid antigens: thyroglobulin, thyroid-peroxidase, and thyrotrophin receptor. Currently, however, the real physiopathogenesis of achalasia continues to be unknown. Some important findings are suggestive of an autoimmune mechanism: significant infiltration of the myoenteric plexus by monocytes, presence of the class II-Human Histocompatibility Complex DQwl antigen and antibodies to myoenteric neurons. The present case reports a patient who, despite testing negative for Chagas’ disease, had achalasia, progressed to developing significant wasting and worsening of his quality of life, was later diagnosed with hyperthyroidism. After endoscopic esophageal dilatation and radioiodine ablation of the thyroid gland, there was great improvement in the patient clinical condition. Arq Bras
What I gathered from the article is that there is a recurring finding of autoimmune thyroid disease as well as Sjogren Syndrome, pernicious anemia, primary biliary cirrhosis, vitiligo, and type 1 diabetes mellitus with achalasia. Often once the body attacks one protein of itself, it’s easier for it to do that again with a different protein. Often autoimmune suffers have several autoimmune diseases.

Kraichely and cols. demonstrated that 25.7% of the patients with primary achalasia had one or more neural autoantibodies: skeletal muscle AChR or striational neuronal voltagegated cation channel (potassium channel or N-type calcium channel) or glutamic acid decarboxylase-65 antibody (GAD65).

FromAchalasia and thyroid disease: possible autoimmune connection?

This is saying that just over a quarter of the patients with achalasia had one or more antibodies that were neural(ogical) in nature. Neurological cells had been marked as the enemy by the immune system and it was attacking them. It lists the very neuron’s that the body had marked as an invader that are in fact our own body, not an invading virus at all.

The pathophysiology of achalasia involves the progressive degeneration of intrinsic neurons found in the esophageal wall,…

FromAchalasia and thyroid disease: possible autoimmune connection?

The neurons in the esophageal wall are the neurons being attacked. They have been marked by the body as outsider invading cells instead of our own cells that we need in order to serve a function. This attack, if the immune system isn’t calmed (not suppressed by drugs, but calmed through removing things that cause it to be inflamed), stays constant and breaks down the ability of the esophagus to function properly. Over time it gets worse and worse and worse…..

…this inflammatory degradation involves mainly nitric oxide-producing inhibitory neurons, consequently affecting the relaxation capacity of the smooth muscle of LES; while the involvement of cholinergic neurons results in an abnormally high resting tonus, making it progressively difficult for physiologic contraction to occur.

FromAchalasia and thyroid disease: possible autoimmune connection?

 

The Neurons being attacked effect the smooth muscle that needs to relax in order for you to swallow. Over time this constant attack results in a high resting tonus, meaning the relaxation amount is really less and less relaxed, it becomes increasingly tight.

The neuromuscular mechanisms that maintain tonic or reflex contraction of these sphincters are essential for their antireflux behavior. Impairment of these mechanisms promotes gastroesophageal reflux (GER).
From the article: Sphincter mechanisms at the lower end of the esophagus Ravinder K. Mittal, M.D. and Raj K. Goyal, M.D.

 

 

It is well known that the resting tonus of the LES is regulated by excitatory (acetylcholine, Substance P, among others), as well as inhibitory neurotransmitters (nitric oxide). Therefore, patients with achalasia have a significant imbalance between the excitatory and inhibitory pathways, resulting in hypertensive LES. Currently, the real physiopathogenesis of achalasia continues to be unknown.
However, some important findings are suggestive of an autoimmune mechanism: significant infiltration of the myoenteric plexus by monocytes, presence of the class II-Human Histocompatibility Complex DQwl antigen and antibodies to myoenteric neurons. Specifically, higher genotypic frequency of the human leukocyte antigen (HLA)-DQw1, DQA1*0101, DQA1*103, DQB1*0602, and DQB1*0603 alleles were observed in achalasia patients compared with controls (7,8,10-13).]

from the articleAchalasia and thyroid disease: possible autoimmune connection?

This excerpt details the markers found that are leaning this illness in the autoimmune direction. These are the antigens (the markers the immune system creates to remember invaders that need to be constantly attacked) to myoenteric neurons, an integral part of the esophageal sphincter.

This case report the disease history of a patient who had achalasia, and was later diagnosed with hyperthyroidism due to GD.

From: Achalasia and thyroid disease: possible autoimmune connection?

The connection to thyroid disease just makes me more determined to help people recognize and address the autoimmune disease closest to my heart, hashimoto’s.

Doctors very rarely address autoimmune diseases from the perspective of calming the immune response, as I mentioned earlier. However, as more and more patients are discovering that the drugs and help they are getting form there doctors isn’t really working, they are searching out alternatives. If you feel this way concerning any autoimmune diagnosis I highly recommend the books I have in references to get you started as well as making an appointment with a functional medicine doctor who’s goal is to seek out your wellness, not kill off your immune system, which you need!

We were never meant to be bombarded with chemicals and toxins, and mutating virus’ and bacteria. As the attack heightens we need to remember that we are directed to take care of our temples, our bodies.

1 Corinthians 6:19&20
Or do you not know that your body is a temple of the Holy Spirit who is in you, whom you have from God, and that you are not your own? For you have been bought with a price: therefore glorify God in your body.

We need to take care of our bodies. We glorify God when we take care of ourselves! Isn’t that amazing?

We need to rest when we are exhausted and get 8 hours of sleep a night and eat food full of essential nutrients and vitamins and healthy fats and fiber. We need to take the time to find out what our body is telling us when we get sick many times in a row. Don’t have time for 8 hours of sleep and live on donuts and coffee because it’s quick? Well, a debilitating autoimmune disease will force you to slow down, or even make you stop altogether. It’s much easier to make the conscious effort to be better to our bodies now then after we are forced to, and after we lose so much.

If you already have a diagnosis and are trying to find relief there is good news if you diligently take care of your temple and listen to what it’s telling you. Like if you swell up eating anything with refined sugar, stop eating it! or if you go for a run one day but then can’t move and hurt for days or weeks afterwards like you were in a major car accident, then running is not something you can do yet, do yoga and palates instead. God gave us these bodies to get us around here on Earth, we need to listen and take note of what it is telling us.

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There is a new book I just finished reading that walks you through all the things that set off your immune system and how to get those things out of your life. I HIGHLY recommend it to anyone searching for relief. It will take dedication on your part because it took you your life up to now to get it here, reversing it and getting your system to heal will not be overnight, nor will it be with a pill. But the great new is that we are ‘fearfully and wonderfully made’ (Psalms 139:14) and our bodies can heal, and can heal fairly quickly. I’m significantly better now 3 years out from taking on the challenge of reducing my immune response yet it took me 33 years to get it to this place; 3 years versus 33 is extremely fast!

It will be well worth it, you’ll have your life back! And you don’t have to do it alone. Ask the Lord to walk this difficult but rewarding journey with you and He’ll stay right by your side!
Take the first step to a healthier you!

The Autoimmune Solution by Amy Myers MD.

Thank you for your time and God bless!

 

 

 

 

 

 

 

 

 

About Mel Phipps

I'm a work-a-holic turned wife and mom who struggled for years only to discover that hashimoto's was what I was dealing with. I'm a wellness advocate and blogger helping those through my journey and discoveries.

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