Inventi Rapid: Gastroenterology

Inventi:hrgst/31462/21

The Primary Esophageal Motor Disorder- Achalasia

Achalasia is a primary esophageal disorder involving the body of the esophagus and lower esophageal sphincter. It occurs at any age in both genders. Normal individuals have a lower esophageal high-pressure zone, which completely relaxes with initiation of a swallow. In achalasia, residual pressures in the LES remain well above normal after swallowing; resulting in a functional outflow obstruction at the gastroesophageal junction. Etiology was idiopathic, pathophysiologic mechanism involves the destruction of the myenteric plexus responsible for esophageal peristalsis. Achalasia is a slowly progressive disease. As a consequence, patients often present late in the course of this disease, when their symptoms and anatomic abnormalities have become prominent. It is a progressive disease that presents with symptoms of dysphagia both for liquid and solid food, regurgitation as well as chest pain with but also long after meals. Esophageal manometry is the gold standard to diagnose achalasia. Treatment options like laparoscopic myotomy and pneumatic balloon dilatations of the lower esophageal sphincter are considered definitive treatments for achalasia. Recognizing the clinical presentation of achalasia is important in order to refer patients for appropriate diagnostic procedures and treatment early in the course of the disease....