The esophageal motility disorder termed achalasia has been known for many decades and treatment approaches extend at least back to 1674 when Willis reported dilation of the cardiac sphincter with a whale bone (1). The combination of a poorly relaxing lower esophageal sphincter (producing an obstructive component) plus the absence of peristalsis in the smooth muscle portion of the esophagus (pro...

is an idiopathic motility disorder that results from degeneration of the myenteric plexus in the wall of the esophagus and the lower esophageal sphincter (LES). 1 In esopha-geal manometry, achalasia is characterized by impaired relaxation of LES and loss of peristalsis in the body of the esophagus. Achalasia results in severe dysphagia for solids and liquids. Additional symptoms can also develo...

A 38-year-old Caucasian woman, gravida 3 para 2, was admitted at 29 weeks of gestation because of vomiting, dysphagia for solids and liquids, and loss of weight. An enlargement of the anterior left neck region was noted on the palpation of the thyroid gland. An MRI of the neck showed a marked esophageal dilatation with the presence of food remnants along its length and the displacement of the t...

CONTEXT Pneumatic dilatation and surgical (Heller) myotomy are the 2 principal methods for treatment of achalasia. There are no population-based studies comparing outcomes of these 2 treatments in typical practice settings. OBJECTIVE To compare the outcomes of pneumatic dilatation and surgical myotomy for achalasia. DESIGN, SETTING, AND PARTICIPANTS Retrospective longitudinal study using li...

Abnormal eating behaviour among psychiatric patients is associated with several psychiatric conditions, but may also be caused by a comorbid physical condition. Clinical assessment of a psychiatric patient is often challenging, which contributes to an increased rate of undiagnosed medical conditions and an increased mortality rate. We present the clinical case of a 46-year-old woman with a long...