Medical and Endoscopic Management of Achalasia

ABSTRACT

Achalasia is a rare primary esophageal motility disorder. Because its etiology is uncertain, treatment is focused on palliation of symptoms or for decreasing lower esophageal sphincter pressure. Treatment options include pharmacological, endoscopic and surgical methods. Various medications including nitrates, calcium channel blockers, and nitric oxide donors (sildenafil) are available, but their effectiveness is inconsistent. Endoscopic options include pneumatic balloon dilation, injection of botulinum toxin, temporary self-expandable metal stent placement, and peroral endoscopic myotomy. Laparoscopic or open myotomy can be a surgical option. We reviewed the treatment options focusing on medical and endoscopic management of achalasia.