Published online Sep 16, 2014. doi: 10.4253/wjge.v6.i9.407
Revised: July 8, 2014
Accepted: July 18, 2014
Published online: September 16, 2014
Core tip: No definitive treatments of achalasia are currently available. Palliative treatment options aims to relieve symptoms and to help patients for food and liquid intake. Endoscopic approach to achalasia is directed to disrupt or weaken the lower esophageal sphincter. On the other hand, intra-sphincteric injection of botulinum toxin is reserved for elderly or severely ill patients. Pneumatic dilation provides better results than botulinum toxin injection and a clinical benefit comparable to surgery. Per oral endoscopic myotomy is a promising option but it requires increased experience and further objective and long-term follow up.