Achalasia, characterised by the absence of peristalsis and failure of relaxation of the lower oesophageal sphincter, is an uncommon degenerative condition that results in dysphagia. If left untreated it can lead to aspiration, oesophageal perforation, oesophagitis and malnutrition. It has a range of immune, allergic, viral and genetic aetiological causes. Successful diagnosis relies on the use of oesophagogastroduodenoscopy, barium swallow and oesophageal manometry to characterise the severity of the disease and to rule out underlying malignancy. Although no treatment can reverse the degenerative process, therapeutic strategies including lifestyle modification, medication, endoscopic and operative intervention can help to reduce symptoms. This article reviews the latest methods used to investigate and manage achalasia.
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Objectives: Achalasia is an esophageal motility disorder of unknown etiology. However, no studies have determined the populations in which sleep problems occur and whether they are improved by peroral endoscopic myotomy (POEM). We investigated the rate of sleep problems assessed by GERD-Q (AGQ) in achalasia patients, evaluated whether POEM improves these issues, and identified factors associated with sleep improvement after POEM.
View Article and Find Full Text PDFEffectiveness and safety of full-thickness versus circular muscle myotomy in peroral endoscopic myotomy: a retrospective single-center analysis of 152 patients.
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Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu, 610083, Sichuan, China.
Background: Achalasia is a primary esophageal motility disorder, which shows impaired relaxation of the lower esophageal sphincter (LES) and the absence of peristalsis, leading to dysphagia, weight loss, and chest pain. In recent years, peroral endoscopic myotomy (POEM) has become a popular method for treating achalasia. However, the effectiveness and safety of full-thickness myotomy (FTM) versus circular muscle myotomy (CMM) in POEM require further investigation.
View Article and Find Full Text PDFGastrointestinal (GI) motility is regulated in a large part by the cells of the enteric nervous system (ENS), suggesting that ENS dysfunctions either associate with, or drive GI dysmotility in patients. However, except for select diseases such as Hirschsprung's Disease or Achalasia that show a significant loss of all neurons or a subset of neurons, our understanding of human ENS histopathology is extremely limited. Recent endoscopic advances allow biopsying patient's full thickness gut tissues, which makes capturing ENS tissues simpler than biopsying other neuronal tissues, such as the brain.
View Article and Find Full Text PDFPersistent body-weight change on achalasia and peroral endoscopic myotomy: a multicenter cohort study.
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Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan.
Background: The distribution of body weight in patients with achalasia and after peroral endoscopic myotomy (POEM) has not been investigated. The role of body weight assessment after treatment remains unclear.
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Exploring the relaxation effects of Coptis chinensis and berberine on the lower esophageal sphincter: potential strategies for LES motility disorders.
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Article Synopsis
- Esophageal achalasia is a condition that affects the lower esophageal sphincter (LES), leading to symptoms like difficulty swallowing, chest pain, and weight loss, with traditional treatments providing limited relief.
- This study investigates the effectiveness of Traditional Chinese Medicine, specifically Coptis chinensis and its active component berberine, in promoting LES relaxation as a potential alternative treatment.
- Results indicate that both C. chinensis extract and berberine significantly relax the LES by activating potassium channels, suggesting further research is warranted for their therapeutic use in esophageal disorders like achalasia.
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