digestive disorders
Achalasia
Treatment of Achalasia
Balloon dilation Myotomy Sometimes botulinum toxin injections No treatment restores peristalsis of the esophagus. The aim of treatment is to relieve symptoms by decreasing pressure in the lower esophageal sphincter. There are two main treatment options for relieving the symptoms of achalasia that are equally effective and have similar outcomes. involves dilating the sphincter mechanically by inflating a large balloon inside it. This procedure is often successful, but repeated dilations may be needed. In very few people, the esophagus ruptures during the dilation procedure. Esophageal rupture leads to severe inflammation in the chest outside the esophagus ( Mediastinitis ) and, in rare cases, is fatal if not treated appropriately. Immediate surgery is needed to close the rupture in the wall of the esophagus. involves surgery to cut the muscle fibers in the lower esophageal sphincter. The procedure is usually done with a Laparoscopy or, less commonly, with a After myotomy, some people have an increased risk of developing a backflow of acid into the esophagus ( Gastroesophageal Reflux Disease (GERD) ). A procedure to prevent backflow of acid from the stomach (called a fundoplication) is usually done at the same time as myotomy. Botulinum toxincan temporarily paralyze muscles, thus doctors sometimes inject botulinum toxin into the lower esophageal sphincter to relax it. This injection is an alternative to balloon dilation or myotomy and is almost as effective. However, the results typically last for only 6 months to 1 year, which is shorter than other treatments last. Certain drugs, such as nitrates or calcium channel blockers, have been studied but have not proved to be effective. 