Achalasia Overview

Front

What is achalasia?

Back

Achalasia is absent or ineffective peristalsis of the distal esophagus accompanied by failure of the esophageal sphincter to relax in response to swallowing.

Front

What are the main symptoms of achalasia?

Back

The main symptom is dysphagia, particularly difficulty with solid food, and a sensation of food sticking in the lower esophagus. Other symptoms may include regurgitation, noncardiac chest pain, and pyrosis.

Front

What diagnostic findings are associated with achalasia?

Back

X-ray studies show esophageal dilation above the narrowing at the lower gastrosophageal sphincter, known as a birds beak deformity. High-resolution manometry confirms the diagnosis.

Front

What management strategies are recommended for achalasia?

Back

Patients are instructed to eat slowly and drink fluids with meals. Treatment options include botulinum toxin injections, pneumatic dilation, and surgical options like esophagomyotomy.

Front

What is the purpose of pneumatic dilation in achalasia treatment?

Back

Pneumatic dilation is used to stretch the narrowed area of the esophagus and has a high success rate, although it may require multiple procedures.

Front

What is a Heller myotomy?

Back

A Heller myotomy is a surgical procedure that involves cutting the esophageal muscle fibers to treat achalasia.

Front

What is the risk associated with botulinum toxin injections for achalasia?

Back

The benefits of botulinum toxin injections fade over time, and there is a risk of submucosal fibrosis.

Front

What is the newer technique for treating achalasia mentioned in the text?

Back

The newer technique is an endoscopic myotomy, also known as per-oral endoscopic myotomy (POEM).