Endoscopic Management of Achalasia


Diagnosis and treatment of achalasia are performed endoscopically, which uses a fibre-optic wire equipped with a camera. An endoscopy is performed in order to determine the severity of the condition in the lower esophagus. Treatment may involve an endoscopic or laparoscopic myotomy, during which the lower esophagus is cut to loosen the muscles, making it easier to swallow/digest foods.

What is it?

This procedure is performed to loosen or weaken the lower esophageal sphincter. One method of loosening the esophageal sphincter through pneumatic balloon dilation, which inserts a balloon into the sphincter and inflates enough for waste to pass through. The second most common endoscopic treatment is a botulinum toxin injection.

What should I do to prepare?

When preparing for any endoscopic management of achalasia, it is important for a patient to contact the doctor and discuss any medications currently being taken. It is important that the patient does not consume any food or liquids within 24 hours before the procedure. Finally, it is important that the patient makes transportation accommodations for after the procedure because the anesthesia impairs one’s ability to drive.

What happens during the process?

During a pneumatic balloon dilation, the doctor inserts a catheter through the mouth of the patient. It is then placed in the lower esophagus sphincter where it inflates. When a patient gets a botulinum toxin injection, the patient will have an upper endoscopy and will already have a tube with a camera in his or her throat. A catheter with a needle is then inserted into the injection site, the esophageal lining.

What are the risks and potential complications?

Endoscopic management of achalasia comes with associated risks, that include, but are not limited to bleeding, puncturing of involved and surrounding anatomy, and infection.


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