Before removing the diverticula (running suture for mucosa, interrupted stitches for the esophageal wall with resorbable material) a myotomy of the upper sphincter (pars inf. of the crycopharyngeal) muscle should be performed to restore the preoperative insufficient relaxation of the upper sphincter. The diffuse spasm shows a normal function of the LES; painful attacks can be treated by calcium antagonists or nitroglycerin. The achalasia can be treated either by endoscopic dilatation or myotomy to reduce the LES-pressure and restore the insufficient relaxation of the LES.
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