Lewy Bodies, Achalasia
Achalasia cardiae; Cardiospasm; Esophageal achalasia; Esophageal aperistalsis; Megaesophagus
Achalasia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter (LES).
Though the disease was first described more than 300 years ago (Willis 1674), its exact pathogenesis still remains poorly understood. Pathophysiologically, achalasia is caused by loss of inhibitory ganglion in the myenteric plexus of the esophagus. In the initial stage, degeneration of inhibitory nerves in the esophagus results in unopposed action of excitatory neurotransmitters, such as acetylcholine, resulting in high amplitude non-peristaltic contractions (vigorous achalasia). Progressive loss of cholinergic neurons over the time results in dilation and low-amplitude simultaneous contractions in the esophageal body (classical achalasia).
The most common form of achalasia is primary, which has no underlying cause. Since the initial...
References and Further Reading
- Giuli R, McCallum R. W., & Skinner, D. B. (1991). Primary motility disorders of the esophagus. Achalasia (hypomotility) is the best known entity.http://www.hon.ch/OESO/vol_4_Prim_Motility/400_chapters.html
- Willis, T. (1674). Pharmaceutice Rationalis Sive Diatribe de Medicamentorum Operationibus in Human Corpore. London, England: Hagae Comitis.Google Scholar