Achalasia: Difference between revisions
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==Background== | ==Background== | ||
*Inability of LES to relax and loss of normal peristalsis | *Inability of LES to relax and loss of normal peristalsis <ref>Krill JT, Naik RD, Vaezi MF. Clinical management of achalasia: current state | ||
of the art. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831602/ Clin Exp Gastroenterol. 2016 Apr 4;9:71-82.] | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 20:51, 9 August 2016
Background
- Inability of LES to relax and loss of normal peristalsis <ref>Krill JT, Naik RD, Vaezi MF. Clinical management of achalasia: current state
of the art. Clin Exp Gastroenterol. 2016 Apr 4;9:71-82.
Clinical Features
- Dysphagia
- Regurgitation
- Chest pain
- Esophageal spasm can be eight, crushing retrosternal much like ACS
Differential Diagnosis
Evaluation
- Upper GI
- Esophageal dilatation
- Birds beak sign
- Esophageal Manometry
Management
- Trial of antispasmodic for Esophageal Spasm
- Nifedipine
- Surgical intervention
- Baloon dilatation
- Botulinum toxin injection
- Myomectomy
- Consider gastrostomy for frail and older patients
- Patients need to eat upright at all times.
- Treatment may improve dysphagia, but there is no cure and swallowing never completely normalizes