ACG Clinical Guidelines: Diagnosis and Management of Achalasia

Achalasia is an esophageal motility disorder characterized by aberrant peristalsis and insufficient relaxation of the lower esophageal sphincter. Patients most commonly present with dysphagia to solids and liquids, regurgitation, and occasional chest pain with or without weight loss. High-resolution...

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Bibliographic Details
Published in:The American journal of gastroenterology Vol. 115; no. 9; pp. 1393 - 1411
Main Authors: Vaezi, Michael F., Pandolfino, John E., Yadlapati, Rena H., Greer, Katarina B., Kavitt, Robert T.
Format: Journal Article
Language:English
Published: United States Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.09.2020
Subjects:
Accuracy
Barium
Confidence
Disease Management
Dysphagia
Endoscopy
Esophageal Achalasia - diagnosis
Esophageal Achalasia - physiopathology
Esophageal Achalasia - therapy
Esophageal Sphincter, Lower - physiopathology
Esophagus
Gastroenterology
Gastroesophageal reflux
Humans
Manometry
Motility
Peptides
Peristalsis - physiology
Topography
ISSN:0002-9270, 1572-0241, 1572-0241
Online Access:Get full text
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Summary:Achalasia is an esophageal motility disorder characterized by aberrant peristalsis and insufficient relaxation of the lower esophageal sphincter. Patients most commonly present with dysphagia to solids and liquids, regurgitation, and occasional chest pain with or without weight loss. High-resolution manometry has identified 3 subtypes of achalasia distinguished by pressurization and contraction patterns. Endoscopic findings of retained saliva with puckering of the gastroesophageal junction or esophagram findings of a dilated esophagus with bird beaking are important diagnostic clues. In this American College of Gastroenterology guideline, we used the Grading of Recommendations Assessment, Development and Evaluation process to provide clinical guidance on how best to diagnose and treat patients with achalasia.
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ISSN:0002-9270
1572-0241
1572-0241
DOI:10.14309/ajg.0000000000000731