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Coping with achalasia

S C Kadakia1

  • 1Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200.

Postgraduate Medicine
|April 1, 1993
PubMed
Summary

Achalasia is an esophageal motor disorder causing difficulty swallowing and chest pain. Diagnosis involves manometry, and pneumatic dilatation is the primary treatment, with surgery reserved for failures.

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Area of Science:

  • Gastroenterology
  • Esophageal Motility Disorders

Background:

  • Achalasia is a primary esophageal motor disorder.
  • Symptoms include dysphagia, regurgitation, and chest pain.
  • The "bird's beak" sign on imaging suggests the condition.

Purpose of the Study:

  • To summarize the diagnostic and treatment approaches for achalasia.
  • To highlight the importance of excluding pseudo-achalasia.

Main Methods:

  • Diagnostic evaluation includes esophageal manometry and endoscopy.
  • Endoscopy is crucial for excluding pseudo-achalasia.

Main Results:

  • Esophageal manometry confirms achalasia by showing aperistalsis.
  • Pneumatic dilatation is the preferred initial treatment.
  • Surgical myotomy is an option for refractory cases.

Conclusions:

  • Achalasia diagnosis relies on characteristic symptoms and manometric findings.
  • Pneumatic dilatation is the first-line therapy.
  • Management should be tailored, with surgery as a secondary option.

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