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Management of Achalasia

  • Anthony R. Tascone
  • Caitlin A. HalbertEmail author
Chapter

Abstract

Achalasia is a rare disorder of the esophagus caused by inflammation and subsequent degeneration of the ganglion cells of the myenteric plexus of the esophageal wall. This results in failure of the lower esophageal sphincter to relax with a loss of functional peristalsis in the lower esophagus. Achalasia is diagnosed by clinical symptoms, imaging, endoscopy, and manometric findings. For good surgical candidates, laparoscopic esophageal myotomy is the preferred therapeutic intervention. Patients can also be given the option of pneumatic dilation. Pharmacologic therapies are reserved for high-risk surgical candidates, in the form of endoscopic injections of botulinum toxin or oral medications, including calcium channel blockers, long-acting nitrates, or the phosphodiesterase-5 inhibitor, sildenafil.

Keywords

Achalasia Esophageal aperistalsis Corkscrew esophagus Esophageal myotomy Heller myotomy Pneumatic dilation 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of General SurgerySaint Luke’s Health SystemKansas CityUSA
  2. 2.Advanced GI and Bariatric Surgery, Department of General SurgeryChristiana Care Health SystemNewarkUSA

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