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Updated: Sep 26, 2025

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[Achalasia Update].

Ulrich Klaus Fetzner1,2, Martha Trujillo3, Ioannis Dimopoulos1

  • 1Klinik für Allgemeinchirurgie, Viszeral-, Thorax-, Kinder- und Endokrine Chirurgie, Johannes Wesling Klinikum, Universitätsklinikum der Ruhr Universität Bochum, Minden, Deutschland.

Therapeutische Umschau. Revue Therapeutique
|April 20, 2022
PubMed
Summary
This summary is machine-generated.

Achalasia is a neurodegenerative esophageal disease causing significant patient suffering due to impaired swallowing and peristalsis. While incurable, treatments like medications, endoscopic procedures, and surgery can alleviate symptoms.

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Area of Science:

  • Gastroenterology
  • Neurogastroenterology
  • Esophageal Disorders

Background:

  • Achalasia is the second most common functional esophageal disorder after reflux disease.
  • This neurodegenerative condition causes significant patient distress.
  • Pathophysiology involves impaired lower esophageal sphincter relaxation and esophageal peristalsis.

Purpose of the Study:

  • To provide an update on the diagnosis and management of achalasia.
  • To highlight the current understanding of achalasia's pathophysiology.
  • To summarize the available treatment options for symptom alleviation.

Main Methods:

  • High-resolution manometry is the gold standard for diagnosis.
  • Review of current literature on achalasia pathophysiology and treatment.
  • Analysis of therapeutic interventions including pharmaceutical, endoscopic, and surgical options.

Main Results:

  • Achalasia is characterized by a lack of swallowing-induced relaxation at the gastric entrance.
  • Disturbed peristalsis in the tubular esophagus is a key feature.
  • High-resolution manometry is crucial for accurate diagnosis.

Conclusions:

  • Achalasia is an incurable neurodegenerative esophageal disease.
  • A range of treatments exist to manage symptoms and improve patient quality of life.
  • Multimodal therapeutic approaches are often necessary.