Comprehensive Review of Achalasia and Esophageal Resection for End-Stage Disease

Achalasia is a chronic esophageal disorder marked by impaired motility, including the loss of peristalsis and incomplete lower esophageal sphincter relaxation, leading to food retention and progressive esophageal dilation. Diagnosis relies on high-resolution manometry, barium swallow, and endoscopy to classify subtypes. Treatment primarily involves minimally invasive myotomy procedures like Heller and per oral endoscopic myotomy. In advanced cases with significant dilation or complications, esophagectomy becomes necessary, utilizing techniques such as gastric pull-up, colon, or jejunal interposition for reconstruction. These surgeries require specialized centers and careful patient selection to optimize outcomes, with research needed to refine management strategies for end-stage achalasia.