Achalasia

Definition

Achalasia most frequently refers to oesophageal achalasia, a motility disorder characterized by failure of the lower oesophageal sphincter to relax. Functional obstruction of the oesophagus leads to its contortion and dilation. Symptoms include dysphagia, regurgitation, chest pain and weight loss. Cough and aspiration of food and liquid can also occur.

Latest Research and Reviews

  • Reviews |

    Peroral endoscopic myotomy (POEM) is a novel treatment for achalasia and other spastic oesophageal motility disorders. Although technically demanding, this technique compares favourably with other therapeutic approaches such as laparoscopic Heller myotomy and pneumatic dilation. In this Review the authors describe the technique, the indications and contraindications, safety and efficacy of POEM.

    • Robert Bechara
    • , Haruo Ikeda
    •  & Haruhiro Inoue
  • Research |

    Johannes Schumacher and colleagues report the results of a genetic association study of idiopathic achalasia, a rare motility disorder of the esophagus. They show that common variation in the HLA-DQ region is strongly associated with achalasia risk, implicating immune-mediated processes in this disorder.

    • Ines Gockel
    • , Jessica Becker
    • , Mira M Wouters
    • , Stefan Niebisch
    • , Henning R Gockel
    • , Timo Hess
    • , David Ramonet
    • , Julian Zimmermann
    • , Ana González Vigo
    • , Gosia Trynka
    • , Antonio Ruiz de León
    • , Julio Pérez de la Serna
    • , Elena Urcelay
    • , Vinod Kumar
    • , Lude Franke
    • , Harm-Jan Westra
    • , Daniel Drescher
    • , Werner Kneist
    • , Jens U Marquardt
    • , Peter R Galle
    • , Manuel Mattheisen
    • , Vito Annese
    • , Anna Latiano
    • , Uberto Fumagalli
    • , Luigi Laghi
    • , Rosario Cuomo
    • , Giovanni Sarnelli
    • , Michaela Müller
    • , Alexander J Eckardt
    • , Jan Tack
    • , Per Hoffmann
    • , Stefan Herms
    • , Elisabeth Mangold
    • , Stefanie Heilmann
    • , Ralf Kiesslich
    • , Burkhard H A von Rahden
    • , Hans-Dieter Allescher
    • , Henning G Schulz
    • , Cisca Wijmenga
    • , Michael T Heneka
    • , Hauke Lang
    • , Karl-Peter Hopfner
    • , Markus M Nöthen
    • , Guy E Boeckxstaens
    • , Paul I W de Bakker
    • , Michael Knapp
    •  & Johannes Schumacher
    Nature Genetics 46, 901–904
  • Reviews |

    Controversy exists with regard to the optimal treatment for achalasia and whether surveillance for early recognition of late complications is indicated. Providing a critical analysis of hot topics within the field, this Review article is an essential update on all aspects of the diagnosis, treatment and management of this rare primary motility disorder. The authors also discuss current and future developments including the value of exciting new endoscopic, radiologic and surgical treatments.

    • Alexander J. Eckardt
    •  & Volker F. Eckardt

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