الفهرس 
Anatomy of Esophagus and Gastroesophageal junctionOnly 14 pages are availabe for public view
 |  | from | 107 |  |  |
| | | from | 107 | | |
Abstract
Esophageal achalasia is a rare motility disorder characterized by impaired peristalsis and incomplete Lower esophageal sphincter relaxation. The disease has a significant effect on the patients’ quality of life. Loss of the myenteric inhibitory neurons in the wall of the esophagus is the pathological hallmark of the disease. No definite cause has been found to lead to this loss. Diagnosis of Achalasia is suggested by endoscopy and barium esophagram, however, the gold standard in the diagnosis is manometry. Multiple therapeutic options are available, with the most effective being surgical myotomy, which was performed through an open approach initially. Thoracoscopic and Laparoscopic modified Heller’s myotomy were described as minimally invasive approaches to this procedure. Studies comparing these two approaches have concluded that the Laparoscopic modified Heller’s myotomy with fundoplication is the surgical treatment of choice in Achalasia of the cardia.
Various modalities of treatments have been described for achalasia. Pharmacotherapy with nitrates and calcium channel blockers offer little benefit because of its weak and short-lived action and unfavorable side effects. With botulinum toxin, the relapse rate is 50% after 1 year. Endoscopic pneumatic dilatation affords substantial relief of dysphagia after 1 year. However, repeated dilatation is often necessary.