Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 8: What Do People Do For The Treatment Of Achalasia These Days? Does It Matter If The Symptoms Are Severe Or If The Patient Is Elderly? (continued)

Drew Ingram, MD; Joseph Leung, MD, FRCP, FACP, FASGE, MACG

Achalasia is an esophageal motility disorder characterized by the absence of esophageal peristalsis and ineffective lower esophageal sphincter (LES) relaxation. It is an uncommon disorder that affects both sexes and all races equally. Onset can occur in any decade of life but is rare before adolescence. Although the cause remains unknown, achalasia is thought to develop secondary to inflammation of the myenteric plexus, which thereby disrupts LES relaxation. Acetylcholine is the neurotransmitter that causes contraction of the smooth muscle of the lower esophagus, whereas nitric oxide and…