Times of India
23 August 2010
Kolkata, India

Eight–year–old Tashmia Mahboob has never had a peaceful meal in her life. After every meal she would throw up. Trips to several doctors across the country didn’t help. Finally, a test at a Kolkata hospital revealed that the girl, weighing barely 15 kg, was suffering from achalasia cardia, a condition rare in children. After a surgery on Thursday, Tashmia left for her home in Asansol on Sunday afternoon.

"Around 40 such cases have been treated laparoscopically since 1995 in the US and UK. In one lakh children, one to two patients may get this condition. Very rarely is it genetic. Usually, a viral infection damages the nerves in the esophagus and there is no movement of food," explained Subhashish Saha, pediatric surgeon who operated on the girl.

This is the second surgery that we have done with the minimal invasive method. Last year we had got a similar case, where the child, like Tashmia, was thought to be having a psychological problem. But it turned out to be achalasia cardia," Saha added.

Achalasia cardia is caused by blockage in the lower portion of the food pipe. Those suffering with the problem suffer from chest pain and regular vomiting. There is a contraction in the muscles and increases pressure. The patient can’t eat at all.

"She couldn’t digest anything. We took her to several doctors and hospitals. No one could detect the problem. We were told that she had some psychological problem. We had lost all hope," said Mahboob Khan, Tashmia’s father.

About a month back, Mahboob and his wife Musharrat Jahan took her to a city–based gastroenterologist, Sujit Chaudhuri. "When I saw her symptoms, I found it to be those similar to achalasia cardia. The suspicion was confirmed after a esophageal manometry test was done," said Chaudhuri.

Twenty days back, the child was referred to Saha, pediatric surgeon at Calcutta Medical Research Institute.

The condition also occurs in some elderly patients. It is treated with either medicines, open surgery or with endoscopy. "The open surgery leaves a scar. Also administering painkillers is a problem in case of children. If treated endoscopically, possibilities of recurrence is very high," Saha said.

Saha, with anaesthetist S Basu Thakur and specialists Ajay Mondal and Hiralal Konar, opted for the laparoscopy that took 90 minutes. "For three weeks she will be on soft diet. After that, she can eat normally," Saha said.