Esophageal Achalasia: Evaluation and Treatment of Recurrent Symptoms

Background Esophageal achalasia is a primary esophageal motility disorder of unknown origin. Treatment is palliative and its goal is to decrease the resistance posed by a non-relaxing and often hypertensive lower esophageal sphincter. This goal can be accomplished by different treatment modalities such as pneumatic dilatation, laparoscopic myotomy or peroral endoscopic myotomy. In some patients, however, symptoms tend to recur overtime. Methods A comprehensive literature search was performed on PubMed focused on the management of recurrent achalasia. Results The available treatment modalities can be used, alone or in combination. The goal of treatment is to resolve/improve symptoms, avoiding an esophagectomy, an operation linked to significant morbidity. Conclusions The treatment of these patients is often very challenging, and the best results are obtained in centers where a multidisciplinary team—radiologists, gastroenterologists, and surgeons—is present.