Title:
Achalasia: Review and Assessment of Treatment Options.

Authors:
Charles J. Haddad, M.D., Judella Haddad-Lacle’, M.D., Sofia Muenyi, M.D., Valery Muenyi, M.D., USA

Abstract:

Achalasia is the failure of relaxation of the lower esophageal sphincter causing decrease or inability to pass ingested material from the esophagus to the stomach. It is thought to be caused from progressive degeneration of ganglion cells in the myenteric plexus in the esophageal wall. Achalasia can be associated with esophageal spasm or loss of peristalsis in the distal esophagus.
Symptoms of achalasia may include chest pain, vomiting, inability to pass ingested material, weight loss and heartburn. There are several options of treatment of achalasia, all of which attempt to decrease the resting pressure in the LES, decrease muscular spasm and to allow ingested material to pass into the stomach.
Diagnosis is made via esophageal manometry, esophagram, or Endoluminal functioning lumen imaging probe (EndoFlip). Current treatments of achalasia include pneumatic dilation, botulinum injections, Heller Myotomy, Per Oral Esophageal Myotomy (POEM). Medications to relax the LES may provide temporary symptom relief, but their effectiveness is variable.