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Achalasia.

Saleem Islam1

  • 1Division of Pediatric Surgery, University of Florida College of Medicine, 1600 SW Archer Rd, PO Box 100119, Gainesville, Florida 32610.

Seminars in Pediatric Surgery
|May 29, 2017
PubMed
Summary

Pediatric achalasia, a rare esophageal disorder, causes difficulty swallowing and weight loss. Management is evolving, with newer techniques and ongoing debates in pediatric care.

Area of Science:

  • Gastroenterology
  • Pediatric Motility Disorders
  • Esophageal Diseases

Background:

  • Achalasia is a rare neurogenic esophageal motility disorder affecting children, characterized by aperistalsis, hypertensive lower esophageal sphincter (LES), and impaired LES relaxation.
  • Symptoms include progressive dysphagia, weight loss, and regurgitation, significantly impacting children's quality of life.
  • Current management strategies are often based on adult data, highlighting a need for pediatric-specific insights.

Purpose of the Study:

  • To review the current understanding of achalasia pathogenesis in children.
  • To discuss advancements in therapeutic techniques for pediatric achalasia.
  • To explore existing controversies in the management of this condition.

Main Methods:

  • Literature review of pediatric achalasia studies.
Keywords:
Endoscopic therapyEsophageal achalasiaFundoplicationHeller myotomyManometry

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  • Analysis of evolving treatment modalities, including surgical and endoscopic options.
  • Discussion of clinical data extrapolation from adult to pediatric populations.

    • Main Results:

    • Achalasia pathogenesis involves complex neurogenic factors affecting esophageal motility.
    • Treatment options have progressed from less invasive methods to minimally invasive surgeries and endoscopic myotomies.
    • Significant variations exist in management approaches, with ongoing debate regarding optimal pediatric care.

    Conclusions:

    • A comprehensive understanding of pediatric achalasia pathogenesis is crucial for effective management.
    • Emerging therapeutic techniques offer promising alternatives, but require further pediatric-specific validation.
    • Addressing management controversies is essential for optimizing outcomes in children with achalasia.