4.6 Review

Achalasia

Related references

Note: Only part of the references are listed.
Review Gastroenterology & Hepatology

Systematic Review: esophageal motility patterns in patients with eosinophilic esophagitis

Pierfrancesco Visaggi et al.

Summary: Esophageal motor abnormalities are common in patients with eosinophilic esophagitis (EoE) and may contribute to symptoms. Eosinophils influence esophageal motility, and some motility abnormalities can be improved after medical treatment.

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Epidemiologic and Economic Burden of Achalasia in the United States

Charles E. Gaber et al.

Summary: This study estimated the incidence, prevalence, and direct medical costs of achalasia in the United States. The results showed that achalasia has a higher epidemiologic and economic burden in the US than previously suggested, with a particularly increasing diagnosis in older patients.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Autoimmune and viral risk factors are associated with achalasia: A case-control study

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Summary: This study suggests that achalasia may be associated with autoimmune conditions and viral infections. Autoimmune diseases and certain viral infections may increase the risk of achalasia.

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Achalasia and Obstructive Motor Disorders Are Not Uncommon in Patients With Eosinophilic Esophagitis

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Summary: Achalasia and obstructive motor disorders were found in almost 15% of patients with EoE, suggesting that esophageal eosinophilia might be causing these disorders. Patients who do not respond to standard treatments may require targeted muscle disruption.

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Per-oral Endoscopic Myotomy Biopsies of Achalasia Patients Reveal Schwann Cell Depletion in the Muscularis Propria

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Comparison of Short Versus Long Esophageal Myotomy in Cases With Idiopathic Achalasia: A Randomized Controlled Trial

Zaheer Nabi et al.

Summary: The study indicates that in patients with achalasia, short esophageal myotomy is comparable to long myotomy in terms of clinical success, operative time, and GERD. Short esophageal myotomy can reduce operating duration efficiently.

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Gastroesophageal reflux after per-oral endoscopic myotomy is frequently asymptomatic, but leads to more severe esophagitis: A case-control study

Arun Karyampudi et al.

Summary: In patients with pH positive GERD after POEM, symptoms are milder and reflux-symptom association is poor despite more severe esophagitis compared with controls.

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Risk of Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus in Patients With Achalasia: A Long-Term Prospective Cohort Study in Italy

Rocco Maurizio Zagari et al.

Summary: This long-term prospective cohort study found that patients with achalasia have a higher risk of developing both squamous cell carcinoma and adenocarcinoma of the esophagus compared to the general population, with men having a higher risk. However, the annual incidence rate of esophageal cancer is relatively low, which may have implications for endoscopic surveillance of patients with achalasia.

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Duration of symptoms and manometric parameters offer clues to diagnosis of pseudoachalasia

Mate Gergely et al.

Summary: Pseudoachalasia is characterized by a shorter history, greater weight loss, and incomplete high-resolution manometry patterns compared to achalasia.

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Samuel Slone et al.

Summary: The study confirmed that ASQ and Eckardt scores are valid and reliable tools to assess symptom severity in achalasia patients, accurately classifying treatment successes versus failures, with a high correlation between the two instruments.

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Summary: This study describes a classification of esophageal motility using FLIP panometry and compares it with HRM and CCv4.0. The results suggest that FLIP has the potential to evaluate esophageal motility disorders and aligns with the information provided by HRM and CCv4.0.

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Lower esophageal sphincter muscle of patients with achalasia exhibits profound mast cell degranulation

Melissa Nelson et al.

Summary: The study found striking mast cell degranulation in the LES muscle of patients with achalasia or EGJOO, with different manometric phenotypes exhibiting different patterns of gene expression for Ca2+ handling and muscle contraction. These findings support the hypothesis that achalasia may be allergy-driven.

NEUROGASTROENTEROLOGY AND MOTILITY (2021)

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Xing Yue Wu et al.

Summary: Accumulating evidence supports the involvement of an autoimmune component in esophageal achalasia, with immune-mediated inflammation playing a crucial role. Viral infections may trigger autoimmune reactions, while specific human leukocyte antigen gene variations define susceptible populations.

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NEUROGASTROENTEROLOGY AND MOTILITY (2021)

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Roberto Oliveira Dantas

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Summary: Peroral endoscopic myotomy (POEM) is highly safe and effective in long-term follow-up, with a clinical success rate of over 90% at >= 5 years, and only 2% of patients lacking follow-up assessments.

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Esophageal achalasia diagnosed in people previously diagnosed with an eating disorder: Epidemiological study using record-linkage

Michael Goldacre et al.

Summary: The study found that patients with anorexia nervosa and bulimia nervosa were more likely to be diagnosed with esophageal achalasia than expected by chance alone. Clinicians should be aware of the potential associations with achalasia as the treatment for eating disorders and achalasia differs.

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Esophagogastric junction outflow obstruction

Albert J. Bredenoord et al.

Summary: EGJOO is defined as an elevated IRP and IBP during wet swallows and persistently elevated IRP in the upright position according to CCv4. A conclusive diagnosis requires a manometric diagnosis of EGJOO and associated symptoms supported by additional investigations, with history and endoscopic evaluation being crucial for excluding secondary causes. Proposed changes in CC4.0 aim to improve specificity of diagnosis and reduce clinically irrelevant diagnoses.

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Antony Delliturri et al.

Summary: The field of endoscopic esophageal surgery is based on the concept of NOTES, allowing for decreased morbidity and equivalent outcomes for patients. POEM is an effective method for managing achalasia by directly dividing the circular muscular layer of the esophagus without destroying surrounding structures. The innovations in endoscopic surgery have focused on the management of achalasia over the last 10 years, revolutionizing the use of flexible technology and mucosal closure methods.

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Achalasia Is Associated With Atopy in Patients Younger Than 40 Years of Age

Dominic King et al.

Summary: The study indicates that there is an association between achalasia and autoimmune conditions as well as atopic conditions, particularly in patients under 40 years of age. These findings support an autoimmune etiology in achalasia and also suggest a potential atopic etiology, especially in younger subjects.

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Long-term clinical results of per-oral endoscopic myotomy (POEM) for achalasia: First report of more than 10-year patient experience as assessed with a questionnaire-based survey

Manabu Onimaru et al.

Summary: This study aimed to present the long-term clinical results of per-oral endoscopic myotomy (POEM) over 10 years and evaluate the technique and outcomes at the institution where it was first used in clinical settings. The results showed favorable clinical outcomes of POEM over 10 years, suggesting that POEM plays a significant role in the treatment of achalasia, even in patients who required additional treatments.

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ASGE guideline on the management of achalasia

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European Guideline on Achalasia - UEG and ESNM recommendations

R. A. B. Oude Nijhuis et al.

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2019 Seoul Consensus on Esophageal Achalasia Guidelines

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Short-term outcome after singular hydraulic EsoFLIP dilation in patients with achalasia: A feasibility study

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ACG Clinical Guidelines: Diagnosis and Management of Achalasia

Michael F. Vaezi et al.

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ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing

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Effects of laparoscopic myotomy on the esophageal motility pattern of esophageal achalasia as measured by high-resolution manometry

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Histopathologic patterns among achalasia subtypes

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Longitudinal Muscle Dysfunction in Achalasia Esophagus and Its Relevance

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Multiple rapid swallow responses segregate achalasia subtypes on high-resolution manometry

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Achalasia With Dense Eosinophilic Infiltrate Responds to Steroid Therapy

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Pneumatic Dilation versus Laparoscopic Heller's Myotomy for Idiopathic Achalasia

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Achalasia Cardia Subtyping by High-Resolution Manometry Predicts the Therapeutic Outcome of Pneumatic Balloon Dilatation

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Long-Term Esophageal Cancer Risk in Patients With Primary Achalasia: A Prospective Study

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Multiple rapid swallowing: a complementary test during standard oesophageal manometry

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Achalasia: Virus-induced euthanasia of neurons?

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T cells in the myenteric plexus of achalasia patients show a skewed TCR repertoire and react to HSV-1 antigens

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Life expectancy, complications, and causes of death in patients with achalasia: results of a 33-year follow-up investigation

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Multiple rapid swallowing in idiopathic achalasia:: evidence for patients' heterogeneity

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Intramuscular interstitial cells of Cajal associated with mast cells survive nitrergic nerves in achalasia

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Timed barium esophagogram in the assessment of patients with achalasia: Reproducibility and observer variation

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Esophageal achalasia: Is the herpes simplex virus really innocent?

I Castagliuolo et al.

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Myenteric antiplexus antibodies and class IIHLA in achalasia

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The nature of the myenteric infiltrate in achalasia - An immunohistochemical analysis

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AMERICAN JOURNAL OF SURGICAL PATHOLOGY (2000)

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Effects of sildenafil on esophageal motility of patients with idiopathic achalasia

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GASTROENTEROLOGY (2000)