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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Veröffentlicht in:The American journal of gastroenterology Jg. 115; H. 9; S. 1393 - 1411
Hauptverfasser: Vaezi, Michael F., Pandolfino, John E., Yadlapati, Rena H., Greer, Katarina B., Kavitt, Robert T.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.09.2020
Schlagworte:
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-Zugang:Volltext
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Abstract 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.
AbstractList 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.
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.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.
Author Greer, Katarina B.
Pandolfino, John E.
Yadlapati, Rena H.
Vaezi, Michael F.
Kavitt, Robert T.
Author_xml – sequence: 1
  givenname: Michael F.
  surname: Vaezi
  fullname: Vaezi, Michael F.
  organization: Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
– sequence: 2
  givenname: John E.
  surname: Pandolfino
  fullname: Pandolfino, John E.
  organization: Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
– sequence: 3
  givenname: Rena H.
  surname: Yadlapati
  fullname: Yadlapati, Rena H.
  organization: Division of Gastroenterology, University of California San Diego School of Medicine, San Diego, California, USA
– sequence: 4
  givenname: Katarina B.
  surname: Greer
  fullname: Greer, Katarina B.
  organization: Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
– sequence: 5
  givenname: Robert T.
  surname: Kavitt
  fullname: Kavitt, Robert T.
  organization: Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medicine, Chicago, Illinois, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32773454$$D View this record in MEDLINE/PubMed
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Snippet Achalasia is an esophageal motility disorder characterized by aberrant peristalsis and insufficient relaxation of the lower esophageal sphincter. Patients most...
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StartPage 1393
SubjectTerms 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
Title ACG Clinical Guidelines: Diagnosis and Management of Achalasia
URI https://www.ncbi.nlm.nih.gov/pubmed/32773454
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