Achalasia is an esophageal motility disorder that is due to degeneration of the myenteric plexus; it results in failure of the lower esophageal sphincter to relax and a lack of normal esophageal peristalsis. Patients typically present with dysphagia to solids and liquids, along with regurgitation. Diagnosis is established by high-resolution manometry. Upper endoscopy is performed to rule out malignancy as a cause. Barium swallow study helps evaluate the esophageal morphology. Management options include pneumatic balloon dilation, surgical myotomy, and botulinum toxin injection. Choice of treatment is dependent on the type of achalasia and surgical risk. Medications are available for those who fail initial intervention, but they provide the least benefit.
Last updated: Feb 16, 2023
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