Achalasia overview
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Achalasia overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2], Ahmed Younes M.B.B.CH [3]
Overview
Achalasia is a primary esophageal motility disorder of unknown etiology.[1][2]In this disorder, the smooth muscle layer of the esophagus has impaired peristalsis (muscular ability to move food down the esophagus), and the lower esophageal sphincter (LES) fails to relax properly in response to swallowing due to absent enteric neurons.[3] It should be differentiated from pseudoachalasia (caused by neoplastic infiltration of myenteric neurons) and secondary achalasia (caused by extrinsic procedures such as previous fundoplication and gastric banding). Trypanosoma cruzi infection causing Chagas disease can also result in achalasia. It is an incurable chronic condition.[1]
Historical Perspective
Achalasia is Greek for failure to relax and has been known for more than 300 years BC. The first successful esophagomyotomy was done in 1913 while laparoscopic esophagomyotomy was described in 1991.
Classification
Achalasia can be classified according to the pattern of abnormal peristalsis into three types. Different types of achalasia are shown to have different responses to therapies with type II having the best prognosis.
Pathophysiology
Causes
Differentiating Achalasia overview from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
References
- ↑ 1.0 1.1 Vaezi MF, Pandolfino JE, Vela MF (2013). "ACG clinical guideline: diagnosis and management of achalasia". Am J Gastroenterol. 108 (8): 1238–49, quiz 1250. doi:10.1038/ajg.2013.196. PMID 23877351.
- ↑ Kraichely R, Farrugia G (2006). "Achalasia: physiology and etiopathogenesis". Dis Esophagus. 19 (4): 213–23. PMID 16866850.
- ↑ Park W, Vaezi M (2005). "Etiology and pathogenesis of achalasia: the current understanding". Am J Gastroenterol. 100 (6): 1404–14. PMID 15929777.