An Update on Current Management Strategies for Achalasia and Future Perspectives

Ioana Smith, Michel Kahaleh

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

The last decade has seen growing insight into the pathophysiology of Achalasia, and current treatments decreasing the resting pressure in the lower esophageal sphincter by endoscopic (botulinum toxin injection, pneumatic dilation, peroral endoscopic myotomy) or surgical means (Heller myotomy). Manometry is considered the gold standard to confirm the diagnosis of Achalasia. Pneumatic dilation and laparoscopic Heller myotomy have similar effectiveness and are both more successful in patients with type II Achalasia. Laparoscopic myotomy when combined with partial fundoplication is an effective surgical technique and has been considered the operative procedure of choice until recently. Peroral endoscopic myotomy is an emerging therapy with promising results since it offers a minimally invasive and efficacious option especially in type III Achalasia. However, it remains to be determined if peroral endoscopic myotomy offers long-term efficacy.

Original languageEnglish (US)
Pages (from-to)277-286
Number of pages10
JournalJournal of Clinical Gastroenterology
Volume52
Issue number4
DOIs
StatePublished - Jan 1 2018

Keywords

  • Achalasia
  • Heller myotomy
  • management of Achalasia
  • peroral endoscopic myotomy
  • pneumatic dilation

ASJC Scopus subject areas

  • Gastroenterology

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