Achalasia is an esophageal motility disorder of unknown cause, characterised by aperistalsis of the esophageal body and impaired lower esophageal sphincter relaxation. Patients present at all ages, primarily with dysphagia for solids/liquids and bland regurgitation. The diagnosis is suggested by barium esophagram or endoscopy and confirmed by esophageal manometry. Achalasia cannot be cured. Ins...

background: subjective assessment of primary achalasia is not accurate. we aimed to evaluate surface of barium retention in the objective assessment of these patients. materials and methods: subjective and objective esophageal functions of 99 patients with primary achalasia were evaluated initially and 43 of them were reevaluated one month after balloon dilation. results: predilation: â  9cases...

BACKGROUND/AIMS A new classification of achalasia using high-resolution manometry (HRM) has recently been suggested. Pneumatic dilatation (PD) is a common treatment for primary achalasia. The usefulness of the new classification and HRM for the treatment and follow-up of patients after PD is unknown. The aim of this study was to evaluate the PD effectiveness and the predictive factors of succes...

among the therapeutic options for achalasia are pneumatic dilatation (pd), an appropriate long-term therapy, and botulinum toxin injection (bt) that is a relatively short-term therapy. this study aimed to compare therapeutic effect of repetitive pneumatic dilation with a combined method (botulinum toxin injection and pneumatic dilation) in a group of achalasia patients who are low responder to ...

conclusions our study showed that laparascopic helermyotomy with dor fundoplication result in significant relief of dysphagia. overall clinical symptoms indicate improvement in patient functional status during 18-month follow-up. patients and methods thirty patients who underwent heller myotomy for achalasia via laparoscopy in alzahra hospital isfahan, iran were recorded prospectively (2009 - 2...

In idiopathic achalasia, degeneration of the inhibitory innervation of the esophageal smooth muscle results in absence of primary peristalsis and in incomplete relaxation of the lower esophageal sphincter (LES). All treatments for achalasia aim at reducing the pressure gradient across the LES, thus facilitating esophageal emptying by gravity. Objective evaluation of the response to treatment is...

Generally accepted manometric criteria for the diagnosis of achalasia are absent peristalsis and incomplete lower esophageal sphincter (LES) relaxation. However, in some patients with otherwise typical features of achalasia, esophageal manometry shows complete LES relaxation during swallowing. To establish whether such apparently complete LES relaxations are functionally adequate, we quantified...

Background and study aims  In order to perform peroral endoscopic myotomy (POEM) safely, retained liquid and food debris must be removed before the procedure is started. We developed a novel technique using a super-slim gastroscope, and a gastric tube to remove retained food debris in achalasia patients. In this study, the safety and efficacy of this novel technique were investigated. Patient...

Esophageal achalasia is a primary esophageal motility disorder. Commonly used treatments are botulinum toxin injections, endoscopic balloon dilation and surgical myotomy with or without fundoplication. We are hereby presenting the first case of laproscopic myotomy with fundoplication performed in Croatia. A 32-year old female was admitted to the hospital due to the symptoms of dysphagia, regurg...

OBJECTIVE To compare symptomatic and objective outcomes between HM and POEM. BACKGROUND The surgical gold standard for achalasia is laparoscopic Heller myotomy (HM) and partial fundoplication. Per-oral endoscopic myotomy (POEM) is a less invasive flexible endoscopic alternative. We compare their safety and efficacy. METHODS Data on consecutive HMs and POEMs for achalasia from 2007 to 2012 w...