Update on therapeutic interventions for the management of achalasia

J Gastroenterol Hepatol. 2016 Aug;31(8):1422-8. doi: 10.1111/jgh.13408.

Abstract

Achalasia is a primary esophageal motility disorder. It is the absence of peristalsis in the esophageal body and inability of the lower esophageal sphincter to relax, which characterizes this rare condition. Its features typically include dysphagia, regurgitation, chest pain, and weight loss. The ultimate goal in treating achalasia is to relieve the patient's symptoms, improve esophageal emptying, and prevent further dilatation of the esophagus. Current treatment modalities targeted at achalasia include pharmacological therapy, endoscopic therapy, and surgery. This review focuses on the current therapeutic options and explores the role of peroral endoscopic myotomy in the management armamentarium.

Keywords: POEM; achalasia; laparoscopic Heller myotomy; peroral endoscopic myotomy.

Publication types

  • Review

MeSH terms

  • Dilatation
  • Esophageal Achalasia / complications
  • Esophageal Achalasia / diagnosis
  • Esophageal Achalasia / physiopathology
  • Esophageal Achalasia / therapy*
  • Esophageal Sphincter, Lower / physiopathology
  • Esophageal Sphincter, Lower / surgery
  • Esophagoscopy / adverse effects
  • Esophagoscopy / methods*
  • Esophagus / physiopathology
  • Esophagus / surgery*
  • Gastrointestinal Agents / therapeutic use
  • Gastrointestinal Motility*
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Recovery of Function
  • Treatment Outcome

Substances

  • Gastrointestinal Agents