Abstract

ORGAZ GALLEGO, Mª Pilar. Achalasia: a not so rare esophageal motility disorder. Rev Clin Med Fam [online]. 2009, vol.2, n.6, pp.305-308. ISSN 2386-8201.

Achalasia is a rare motility disorder of the distal esophagus, of unknown etiology. The irreversible destruction of esophageal myenteric plexus neurons is causes aperistalsis and the failure of lower esophageal sphincter to relaxduring deglutition. Consequently, the food bolus stops at the level of the cardia producing disphagia and others symptoms such as regurgitation, chest pain, heartburn and weight loss. With a thorough medical history, upper GI endoscopy and barium swallow X-ray a diagnosis of achalasia can be suspected and later confirmed by esophagueal manometry. Others diseases, especially malignant diseases, can imitate the clinical symptoms. Pneumatic balloon dilatation is the first choice treatment for achalasia, but Heller myiotomy is now becoming the treatment of choice in many hospitals because it is significantly less invasive and costly. Heller myotomy together with laparoscopic fundoplication in order to prevent reflux should be offered when dilatation therapy fails, especially in younger patients. I present two cases of achalasia, demonstrating that, although the incidence is approximately 1 per 100,.000 people per year, it is not so infrequent in clinical practice as one would think.

Keywords : Achalasia; Deglutition Disorders; Dysphagia.

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