Published online Jan 25, 2016. doi: 10.4253/wjge.v8.i2.30
Peer-review started: June 29, 2015
First decision: August 16, 2015
Revised: November 26, 2015
Accepted: December 13, 2015
Article in press: December 15, 2015
Published online: January 25, 2016
Core tip: Achalasia is characterized by dysphagia, regurgitation, chest pain, weight loss and respiratory symptoms. Diagnosis and post-treatment assessment largely rely upon endoscopy, barium swallow study and high resolution esophageal manometry (HRM). Short term improvement in the symptomatology can be achieved with medical therapy or endoscopic botulin toxin injection. Long term relief from dysphagia can be obtained with either laparoscopic Heller myotomy, pneumatic dilatation or per-oral endoscopic myotomy. Age, sex, and manometric subtype by HRM are also predictors of responsiveness to treatment. Self-expandable metallic stents are an alternative in patients non responding to conventional therapies.