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Current Approach to the Treatment of Achalasia

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Abstract

Achalasia is a primary esophageal motility disorder characterized by aperistalsis and incomplete or absent relaxation of the lower esophageal sphincter (LES). The cause of the disease remains elusive and there is no intervention that improves the esophageal body function. Currently, treatment options focus on palliation of symptoms by reducing the LES pressure. The most effective and well-tolerated treatments continue to be the laparoscopic Heller myotomy and endoscopic pneumatic dilation; however, newer techniques (eg, peroral endoscopic myotomy and self-expanding metal stents) show promise. Botulinum toxin and pharmacologic therapy are reserved for those who are unable to undergo more effective therapies. Treatment options should be tailored to the patient, using current predictors of outcome such as the patient’s age and post-treatment LES pressures. The aim of this article is to highlight current literature and provide an up-to-date approach to the treatment of achalasia.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Acknowledgments

The opinions are solely those of the authors and do not represent an endorsement by the Department of the Defense. There are no restrictions on its use. The authors do not have any commercial or proprietary interest in any drug, device, or equipment mentioned in the manuscript. There are no conflicts of interest, financial disclosures, grant support, or writing assistance.

Conflicts of interest

J.G. Cheatham–none; R.K.H. Wong—none.

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Correspondence to Joseph G. Cheatham.

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Cheatham, J.G., Wong, R.K.H. Current Approach to the Treatment of Achalasia. Curr Gastroenterol Rep 13, 219–225 (2011). https://doi.org/10.1007/s11894-011-0190-z

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