Peroral endoscopic myotomy for treatment of Guillain-Barre syndrome-associated achalasia: A rare case

Guillain-Barre syndrome(GBS)-associated achalasia is a very rare disease of uncertain cause. We report the case of a patient diagnosed with GBS-associated type Ⅰ achalasia who was successfully treated with peroral endoscopic myotomy(POEM). A 30-year-old man who was diagnosed with GBS 3 mo before was referred to our department with dysphagia and mealrelated regurgitation. The results of esophagography, endoscopy, and high-resolution manometry(HRM) revealed type Ⅰ achalasia. POEM that utilized a submucosal tunneling technique was performed to treat the GBS-associated type Ⅰ achalasia. After POEM, smooth passage of a contrast agent into the stomach was shown in follow-up esophagography, and followup HRM revealed a decrease in the mean integrated relaxation pressure 22.9 mm Hg to 9.6 mm Hg. The patient remained without dysphagia for 7 mo, even though the patient’s neurological problems were not fully resolved. POEM may be a safe and effective treatment for GBS-associated type Ⅰ achalasia.