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Etiology and treatment of achalasia in the pediatric age group

V M Piñeiro-Carrero1, C A Sullivan, P L Rogers

  • 1Division of Pediatric Gastroenterology and Nutrition, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-4799, USA. vpineiro@usuhs.mie

Gastrointestinal Endoscopy Clinics of North America
|April 25, 2001
PubMed

Insights

Pneumatic dilation is the primary definitive therapy for pediatric achalasia, offering safe and effective treatment. Heller myotomy serves as a safe surgical option for cases unresponsive to dilation.

Area of Science:

  • Pediatric Gastroenterology
  • Esophageal Motility Disorders

Background:

  • Achalasia in children shares clinical features and therapeutic approaches with adult cases.
  • Pharmacologic treatments offer only temporary symptom relief in pediatric achalasia.
  • Botulinum toxin injections provide short-term, safe symptom palliation.

Purpose of the Study:

  • To review the safety and effectiveness of pneumatic dilation for pediatric achalasia.
  • To establish pneumatic dilation as the primary definitive therapy for achalasia in children.
  • To identify effective alternative treatments for refractory pediatric achalasia.

Main Methods:

  • Review of safety and effectiveness data for pneumatic dilation in pediatric achalasia.
  • Evaluation of outcomes for graduated pneumatic dilation protocols.
  • Assessment of Heller myotomy as a secondary treatment option.

Main Results:

  • Pneumatic dilation is a safe and effective definitive therapy for pediatric achalasia.
  • Graduated pneumatic dilation achieves satisfactory results in most pediatric patients.
  • Heller myotomy is a safe and effective surgical treatment for children who do not respond to pneumatic dilation.

Conclusions:

  • Pneumatic dilation should be considered the primary definitive treatment for pediatric achalasia.
  • Heller myotomy is a viable and effective surgical option for refractory pediatric achalasia cases.

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