Related Experiment Videos
Achalasia: diagnosis and management
1Center for Swallowing and Esophageal Disorders, Cleveland Clinic Foundation, OH 44195, USA.
Seminars in Gastrointestinal Disease
|August 6, 1999
Summary
Achalasia treatment has advanced, offering patients effective options like pneumatic dilation and laparoscopic surgery. These methods improve esophageal emptying and relieve symptoms like dysphagia and chest pain.
Area of Science:
- Gastroenterology
- Esophageal Motility Disorders
Background:
- Achalasia is a primary esophageal motor disorder causing dysphagia, regurgitation, and chest pain.
- Current treatments aim to reduce lower esophageal sphincter (LES) pressure for improved esophageal emptying.
Observation:
- Calcium channel blockers and nitrates are now secondary treatments for achalasia.
- Modern pneumatic dilation with graded Rigiflex balloons (3.0-4.0 cm) is highly effective, improving symptoms in up to 90% of patients.
Findings:
- Laparoscopic surgical myotomy offers comparable efficacy to open surgery with reduced morbidity and hospitalization.
- Both pneumatic dilation and laparoscopic myotomy are equally effective treatment options for achalasia.
Implications:
- Patients with achalasia now have effective, minimally invasive treatment choices.
- Botulinum toxin injection is reserved for patients unsuitable for dilation or surgery.