Achalasia

from diagnosis to management

Michael F. Vaezi, Valter N. Felix, Roberto Penagini, Aurelio Mauro, Eduardo Guimarães Hourneaux de Moura, Leonardo Zorrón Cheng Tao Pu, Jan Martínek, Erwin Rieder

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Achalasia is an esophageal motility disorder associated with abnormalities in peristalsis and lower esophageal sphincter (LES) relaxation. The etiology of the disease remains elusive. It is often misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia to solids and liquids but may focus on regurgitation as the primary symptom, leading to the early misdiagnosis. Chest pain, weight loss, and occasional vomiting may be additional symptoms encountered in those with achalasia. The disease may be suspected on the basis of clinical presentation, but diagnosis depends on classic findings using high-resolution manometry, showing either failed or simultaneous contractions with associated normal or high LES pressures with no or incomplete relaxation with swallows. There are no cures for achalasia, and, in most patients, treatments have to be repeated over time. Definitive treatment options in achalasia include pneumatic dilation, surgical myotomy, and the new technique of per-oral endoscopic myotomy. Botulinum toxin (Botox) or other medical therapies are often reserved for those who cannot have definitive therapies owing to comorbid conditions.

Original languageEnglish
Pages (from-to)34-44
Number of pages11
JournalAnnals of the New York Academy of Sciences
Volume1381
Issue number1
DOIs
Publication statusPublished - Oct 1 2016

Fingerprint

Esophageal Achalasia
Lower Esophageal Sphincter
Patient treatment
Diagnostic Errors
Botulinum Toxins
Pneumatics
Esophageal Motility Disorders
Swallows
Peristalsis
Manometry
Therapeutics
Deglutition Disorders
Gastroesophageal Reflux
Chest Pain
Liquids
Vomiting
Weight Loss
Dilatation
Pressure
Therapy

Keywords

  • botulinum toxin
  • pneumatic dilation
  • POEM
  • surgical myotomy

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

Cite this

Vaezi, M. F., Felix, V. N., Penagini, R., Mauro, A., de Moura, E. G. H., Pu, L. Z. C. T., ... Rieder, E. (2016). Achalasia: from diagnosis to management. Annals of the New York Academy of Sciences, 1381(1), 34-44. https://doi.org/10.1111/nyas.13176

Achalasia : from diagnosis to management. / Vaezi, Michael F.; Felix, Valter N.; Penagini, Roberto; Mauro, Aurelio; de Moura, Eduardo Guimarães Hourneaux; Pu, Leonardo Zorrón Cheng Tao; Martínek, Jan; Rieder, Erwin.

In: Annals of the New York Academy of Sciences, Vol. 1381, No. 1, 01.10.2016, p. 34-44.

Research output: Contribution to journalArticle

Vaezi, MF, Felix, VN, Penagini, R, Mauro, A, de Moura, EGH, Pu, LZCT, Martínek, J & Rieder, E 2016, 'Achalasia: from diagnosis to management', Annals of the New York Academy of Sciences, vol. 1381, no. 1, pp. 34-44. https://doi.org/10.1111/nyas.13176
Vaezi MF, Felix VN, Penagini R, Mauro A, de Moura EGH, Pu LZCT et al. Achalasia: from diagnosis to management. Annals of the New York Academy of Sciences. 2016 Oct 1;1381(1):34-44. https://doi.org/10.1111/nyas.13176
Vaezi, Michael F. ; Felix, Valter N. ; Penagini, Roberto ; Mauro, Aurelio ; de Moura, Eduardo Guimarães Hourneaux ; Pu, Leonardo Zorrón Cheng Tao ; Martínek, Jan ; Rieder, Erwin. / Achalasia : from diagnosis to management. In: Annals of the New York Academy of Sciences. 2016 ; Vol. 1381, No. 1. pp. 34-44.
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