Endoscopic Treatment for Achalasia
Achalasia develops from the functional disturbance of inhibitory neurons in the lower esophagus. Imbalance between excitatory neurons and inhibitory neurons induces impaired relaxation of the lower esophageal sphincter (LES). Achalasia is classified into three subtypes according to the Chicago Classification Ver. 3.0. The main treatment modalities of endoscopic treatment for achalasia include pneumatic balloon dilation (PBD) and peroral endoscopic myotomy (POEM). POEM has revealed more favorable results in type III achalasia. Since the introduction of POEM, many centers have been available to perform POEM for the patients with achalasia. This chapter shows the techniques of endoscopic treatment for achalasia.