Achalasia - An Update
Journal of Neurogastroenterology and Motility
;
: 232-242, 2010.
Article
in English
| WPRIM
| ID: wpr-103882
ABSTRACT
Achalasia is an esophageal motility disorder of unknown cause, characterized by aperistalsis of the esophageal body and impaired lower esophageal sphincter relaxation. Patients present at all ages, primarily with dysphagia for solids/liquids and bland regurgitation. The diagnosis is suggested by barium esophagram and confirmed by esophageal manometry. Achalasia cannot be cured. Instead, our goal is to relieve symptoms, improve esophageal emptying and prevent the development of megaesophagus. The most successful therapies are pneumatic dilation and surgical myotomy. The overall success rate of graded pneumatic dilation is 78%, with women and older patients responding best. Laparoscopic myotomy, usually combined with a partial fundoplication, has an overall success rate of 87%. Young patients, especially men, are the best candidates for surgical myotomy. Botulinum toxin injection into the lower esophageal sphincter and smooth muscle relaxants are usually reserved for older patients or those with co-morbid illness. The prognosis for achalasia patients to return to near normal swallowing is good, but the disease is rarely "cured" with a single procedure and intermittent touch-up procedures may be required.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Relaxation
/
Barium
/
Botulinum Toxins
/
Esophageal Motility Disorders
/
Deglutition Disorders
/
Esophageal Achalasia
/
Fundoplication
/
Deglutition
/
Esophageal Sphincter, Lower
Type of study:
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Journal of Neurogastroenterology and Motility
Year:
2010
Type:
Article
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