జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Achalasia Cardia Recent Advances in Diagnosis and Endoscopic Management

Zaheer Nabi, Duvvur Nageshwar Reddy

Achalasia Cardia is a rare neurodegenerative disorder of esophagus resulting in defective peristalsis and impaired relaxation of lower esophageal sphincter. The exact etiopathogenesis of achalasia is not known. Achalasia is associated with significant morbidity and impaired quality of life. The standard of care in patients with achalasia has been pneumatic balloon dilatation and laparoscopic heller's myotomy. Recent advancements in the diagnosis and endoscopic management have greatly improved the outcomes of this disorder. Subtyping of esophageal motility disorders with high resolution manometry has served to predict treatment outcomes and plan appropriate treatment. Per oral endoscopic myotomy (POEM) is an novel minimally invasive treatment option for all types of achalasia cardia. Short and mid term efficacy are excellent. Randomized trials are required to confirm its superiority over the currently established treatment modalities.