Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2016; 22(39): 8670-8683
Published online Oct 21, 2016. doi: 10.3748/wjg.v22.i39.8670
Published online Oct 21, 2016. doi: 10.3748/wjg.v22.i39.8670
Update on the endoscopic treatments for achalasia
Dushant S Uppal, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA 22908, United States
Author contributions: Uppal DS and Wang AY contributed equally to this manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest, financial or otherwise, to report with respect to this manuscript. Dr. Wang discloses that he has received research funding from Cook Medical on the topic of metal biliary stents.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Andrew Y Wang, MD, AGAF, FACG, FASGE, Associate Professor of Medicine, Section Chief of Interventional Endoscopy, Division of Gastroenterology and Hepatology, University of Virginia Health System, Box 800708, Charlottesville, VA 22908, United States. ayw7d@virginia.edu
Telephone: +1-434-9241653 Fax: +1-434-2447590
Received: March 28, 2016
Peer-review started: March 29, 2016
First decision: May 12, 2016
Revised: August 20, 2016
Accepted: September 14, 2016
Article in press: September 14, 2016
Published online: October 21, 2016
Peer-review started: March 29, 2016
First decision: May 12, 2016
Revised: August 20, 2016
Accepted: September 14, 2016
Article in press: September 14, 2016
Published online: October 21, 2016
Core Tip
Core tip: Achalasia can be classified into three subtypes based on high-resolution manometry, with type 2 being the most responsive to therapy. Since no cure for achalasia exists, early diagnosis and treatment of the disease are critical. Pre-treatment counseling is paramount, as the goal of therapy is to improve swallowing and prevent late manifestations of the disease, rather than to restore normal swallowing and function. Pneumatic dilation and surgical or endoscopic myotomy are efficacious and reasonable first-line treatment options in appropriate candidates. In instances of therapeutic failure or symptom recurrence, different treatment modalities might need to be applied.