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Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
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Direct-acting cholinergic agonists, such as synthetic choline esters and naturally occurring alkaloids, exert their effects by enhancing the actions of acetylcholine and stimulating the parasympathetic nervous system. Synthetic choline esters share structural similarities with acetylcholine. For example, they have a positively charged quaternary ammonium or onium group, contributing to their hydrophilic characteristics. As a result, they are poorly absorbed in the body through oral...
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Direct-Acting Cholinergic Agonists: Pharmacological Actions00:59

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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Pharmacological management
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Achalasia: current therapeutic options.

Zubin Arora1, Prashanthi N Thota1, Madhusudhan R Sanaka2

  • 1Department of Gastroenterology and Hepatology, Cleveland Clinic, OH, USA.

Therapeutic Advances in Chronic Disease
|July 19, 2017
PubMed
Summary
This summary is machine-generated.

Achalasia is a rare esophageal motility disorder. This review examines current and emerging treatments, focusing on peroral endoscopic myotomy (POEM) for symptom relief.

Keywords:
Heller myotomyachalasiadysphagiamanometryperoral endoscopic myotomypneumatic dilation

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Area of Science:

  • Gastroenterology
  • Esophageal Motility Disorders
  • Surgical Innovation

Background:

  • Achalasia is a chronic, incurable esophageal motility disorder affecting lower esophageal sphincter relaxation and peristalsis.
  • It is the most common primary esophageal motility disorder, with significant patient impact including dysphagia and weight loss.
  • Current management focuses on symptomatic relief by improving esophageal outflow due to unclear etiology and lack of curative treatment.

Purpose of the Study:

  • To review current and emerging treatment options for achalasia.
  • To emphasize the evidence and growing role of peroral endoscopic myotomy (POEM) in achalasia management.
  • To provide an overview of therapeutic strategies for this rare esophageal disorder.

Main Methods:

  • Literature review of current and emerging achalasia treatments.
  • Focus on evidence supporting peroral endoscopic myotomy (POEM).
  • Analysis of treatment efficacy for symptom relief in achalasia patients.

Main Results:

  • Pneumatic dilation, Heller myotomy, and POEM are effective treatments for achalasia.
  • Peroral endoscopic myotomy (POEM) is increasingly recognized as a primary treatment option.
  • Management strategies aim to alleviate symptoms like dysphagia and regurgitation.

Conclusions:

  • No curative treatment exists for achalasia, necessitating management focused on symptom relief.
  • Peroral endoscopic myotomy (POEM) represents a significant advancement in achalasia treatment.
  • Further research into POEM and other therapies is crucial for improving patient outcomes.