What are the types of treatment and the pros and cons of each?
Achalasia is not a curable disease yet. However, there are a variety of treatments available that can effectively relieve symptoms and help patients resume a relatively normal lifestyle. The most important cause of symptoms in achalasia appears to be the lower esophageal sphincter- this is a ring of muscle at the junction of the esophagus and the stomach that normally opens with swallowing to allow material to pass into the stomach. In achalasia, this muscle stays shut and therefore causes food to get held up and eventually start backing up into the throat. All present therapies for achalasia seek to lower the pressure in this ring of muscle, thereby overcoming the resistance to the passage of food (see figure). This can be done by one of the following means: 1. Traditional drugs: these act directly on the muscle, causing it to relax. Examples include nitroglycerin (also used for heart problems) and nifedipine. 2. Balloon (also known as pneumatic) dilation. This involves the insertion
