Achalasia: Difference between revisions
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==Management== | ==Management== | ||
*Trial of antispasmodic for [[Esophageal Spasm]] | *Trial of antispasmodic for [[Esophageal Spasm]] | ||
**Nifedipine | **Nifedipine | ||
*Surgical intervention | *Surgical intervention | ||
**Baloon dilatation | **Baloon dilatation | ||
**Botulinum toxin injection | **Botulinum toxin injection <ref>Nassri A, Ramzan Z. Pharmacotherapy for the management of achalasia: Current status, challenges and future directions. World J Gastrointest Pharmacol Ther. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635155/ 2015 Nov 6;6(4):145-55.]</ref> | ||
**Myomectomy | **Myomectomy | ||
**Consider gastrostomy for frail and older patients | **Consider gastrostomy for frail and older patients | ||
Revision as of 20:56, 9 August 2016
Background
- Inability of LES to relax and loss of normal peristalsis [1]
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 [2]
- 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
Disposition
See Also
External Links
References
- ↑ Krill JT, Naik RD, Vaezi MF. Clinical management of achalasia: current state of the art. Clin Exp Gastroenterol. 2016 Apr 4;9:71-82.
- ↑ Nassri A, Ramzan Z. Pharmacotherapy for the management of achalasia: Current status, challenges and future directions. World J Gastrointest Pharmacol Ther. 2015 Nov 6;6(4):145-55.