Thinking out loud

[Guest guest]

It helps me to dream of ways that science and technology could one day fix A, or

at least help make it much more manageable. I am not a doctor, and some of this

is probably in the far future, but I thought it wouldn't hurt to discuss the

topic since having hope is important.

1) Stem cells. Possibly the ultimate solution? A fully customised new E,

obediently listening to the brain's swallowing instructions, just like before A.

True, even the massive opposition to stem cell research from some quarters pales

into insignificance compared to the medical and technical obstacles, but we've

all probably read the articles about stem cells already demonstrating some

neuron-like abilities in tests. If not the whole E, then at least the nerves

which control it, so that normal-ish swallowing could resume.

2) A bionic E, fully peristaltic, even though it is a mechanical piece of kit.

How do you power something implanted so deeply over long periods of time, and in

all sorts of locations?

3) A bionic LES, wrapped around the myotomically severed LES of an A sufferer,

powered by an induction coil mechanism whenever the " user " brings to their chest

a specialised corresponding plate whose job it is to transfer energy - and

perhaps charge batteries - without wires. The " charging plate " technology is

already being used for the likes of mobile phone docks. No need to plug the

phone in - just let it rest on or near its charging plate. Perhaps such a bionic

LES could remain dormant in an achalasia-like almost closed state most of the

time, only to dilate and allow the GEJ to pass food only when the person

" energises " the LES through a (discreet?) charging plate. Move the plate away,

and the bionic sphincter closes again, sealing the gap to prevent acid reflux.

Obviously, reliability would be of paramount importance, since nobody wants to

get cut up just to remove a bit of malfunctioning equipment, but there are other

similar sphincters in the rest of the body too, and achalasians would be far

from the only beneficiaries.

4) An implanted device to electically stimulate the muscles of the real LES - a

clump of artificial neurons. I gather the problem is more mechanical than

electrical, in the sense that electric currents close muscles, not open them,

but perhaps the implanted bio-neurons could be made to secrete the chemicals

needed to open the (non-HM) LES. This feels like a very remote possibility, even

by the standards of this list.

Any others?

Hang in there. Medical help is coming. It's only a matter of time.

All the best,

Andre

[Guest guest]

> I think there is hope long down the road to come. The problem I see is

> that some people would put off treatment that exists today in hope that

> some new treatment will be here tomorrow. In the meantime they may be

> suffering and doing damage to their esophagi needlessly.

>

> Lets be hopeful but not give in to false hope. Sometimes the best hope

> now is on things you can actually do today.

>

> notan

Thanks notan. I agree completely.

For what it's worth, everything I've read tells me that surgery (a myotomy) is

the best way to slow the progression, and I would therefore encourage anyone

reading this who may be holding off in the hope that future tech will come soon

to our rescue to instead reconsider once more and book the surgery.

I'm getting mine done within weeks. Future tech will find me post-myotomy.

Another thought - some sort of external, enveloping support for the esophagus,

made from material sufficiently inert to minimize rejection? The function of the

new pipe would be to provide a barrier to further dilation, and even to

straighten an otherwise sigmoid esophagus.

Andre