Achalasia is an incurable condition of the esophagus involving the inflammation and degeneration of inhibitory neurons of the lower esophageal sphincter (LES) resulting in failure of the LES to relax. Typical symptoms of achalasia are dysphagia, retrosternal chest pain, regurgitation, and weight loss. Three studies are typically required for the diagnosis of achalasia: barium swallow, high-resolution esophageal manometry, and esophagogastroduodenoscopy. Differential diagnosis includes gastroesophageal reflux disease, pseudoachalasia, neoplasm, and nonachalasia esophageal motility disorders such as scleroderma, jackhammer esophagus, distal esophageal spasm, and nutcracker esophagus.
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http://dx.doi.org/10.1016/j.suc.2024.06.011 | DOI Listing |
Cureus
December 2024
Department of Surgery, Zen Hospital, Mumbai, IND.
Achalasia cardia is a primary motility disorder of the esophagus marked by the absence of peristalsis and the failure of the lower esophageal sphincter (LES) to relax during swallowing. The preferred surgical approach is laparoscopic Heller's cardiomyotomy with Dor's fundoplication. Given the significant risks of mucosal perforation and the possibility of incomplete myotomy, which can lead to symptom recurrence, it is essential to ensure both the completeness of the myotomy and the preservation of the mucosal integrity.
View Article and Find Full Text PDFJ Clin Gastroenterol
February 2025
Digestive Disease and Surgery Institute, Cleveland Clinic London, UK.
Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible.
View Article and Find Full Text PDFACG Case Rep J
January 2025
Departamento de Gastroenterología, Clínica Reina Sofía, Clínica Colsanitas, Grupo Keralty, Bogotá, Colombia.
Achalasia is a rare esophageal motor disorder characterized by incomplete relaxation of the lower esophageal sphincter and ineffective contraction of the esophageal body. This condition is not often associated with obesity; however, in recent years, cases of achalasia after bariatric surgery have been described. We describe the case of a 30-year-old female patient with a history of gastric sleeve surgery in 2018, which, 4 years after the intervention, presented with dysphagia, regurgitation, and weight loss.
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 PDFJ Gastroenterol
December 2024
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.
Methods: Using the multicenter achalasia cohort, the frequency of underweight (body mass index [BMI] < 18.
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