We read with interest the article by Eckardt et al regarding the long term results of pneumatic dilatation in achalasia (Gut 2004;53:629–33). Fifty four patients were followed up for a median of 14 years after a single pneumatic dilatation using the Browne-McHardy dilator. Five and 10 year remission rates were 40% and 36%, respectively, and repeated dilatations only mildly improved the clinical...

BACKGROUND Pneumatic dilatation or intrasphincteric botulinum toxin injection provide effective symptom relief for patients with achalasia. Although intrasphincteric botulinum toxin injection is simple and safe, its efficacy may be short-lived. Pneumatic dilatation lasts longer, but esophageal perforation is a risk. We compared treatment costs for pneumatic dilatation and intrasphincteric botul...

BACKGROUND and aims: In this prospective study, we determined the long term clinical course of patients with achalasia who were treated by pneumatic dilation using the Browne-McHardy dilator, and determined whether previously described predictors of outcome remain significant after prolonged follow up. METHODS Between 1981 and 1991, 54 consecutive patients were treated by pneumatic dilation a...

BACKGROUND Symptom relief post pneumatic dilation is traditionally used to assess treatment success in achalasia patients. Recently, we showed that symptom relief and objective oesophageal emptying are concordant in about 70% of patients, while up to 30% of achalasia patients report near complete symptom relief despite poor oesophageal emptying of barium. AIMS We now report the results of lon...

achalasia is a primary motor disorder of the esophagus, in which esophageal emptying is impaired. diagnosis of achalasia is based on clinical findings and confirmed by radiologic, endoscopic and manometric evaluations. several treatments for achalasia have been introduced. we searched the pubmed database for original articles and meta-analyses about achalasia to summarize the current knowledge ...

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...

Between 1993-1996 seventy-three consecutive patients (33 M, 40 F, mean age 35.4) with newly diagnosed achalasia underwent one or more pneumatic dilatations with the Rigiflex balloon using a protocol of graded dilatation with a fixed inflation pressure of 10 psi and constant duration of 30 seconds for all patients without using fluoroscopy. Using Vantrappen's classification for assessment of...