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Achalasia in Geriatric Patients: A Comprehensive Overview
Evgenia Mela1, Orestis Lyros2, Vasileios Charalampakis3
1First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, 11527, Athens, Greece. vemela@hotmail.gr.
Digestive Diseases and Sciences
|February 7, 2026
Summary
Achalasia, an esophageal motility disorder, is increasingly diagnosed in older adults. Advanced age is not a barrier to effective treatment, necessitating age-specific management strategies.
Area of Science:
- Gastroenterology
- Geriatric Medicine
- Esophageal Motility Disorders
Background:
- Achalasia is a rare esophageal motility disorder affecting lower esophageal sphincter relaxation and peristalsis.
- Prevalence is increasing in the elderly due to global population aging.
Purpose of the Study:
- To review clinical presentation, diagnosis, and management of achalasia in geriatric patients.
- To highlight age-related differences in achalasia presentation and outcomes.
Main Methods:
- Literature search focused on age-related differences in symptoms, diagnostics, and treatment outcomes.
- Analysis of current evidence on achalasia management in elderly individuals.
Main Results:
- Geriatric patients often present with less pronounced symptoms, higher risks of malnutrition/aspiration, and advanced disease.
- High-resolution manometry is the gold standard for diagnosis, preceded by endoscopy.
- Treatment options include botulinum toxin, pneumatic dilation, and surgical myotomies.
Conclusions:
- Advanced age should not preclude definitive achalasia treatment, especially with minimally invasive options.
- Development of evidence-based, age-specific recommendations is crucial for optimizing outcomes in elderly achalasia patients.
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