The goal of therapy is to obtain relief of difficulty swallowing by opening the lower esophageal sphincter (the valve between the esophagus and the stomach) while preventing GERD.
Several treatments are available to improve the symptoms in patients with achalasia and can be chosen based on a patient’s overall health condition and preferences.
There is no specific therapy that can fix the underlying process (disease of the nerves around the esophagus). None of the treatment options can restore the normal muscle activity of the esophageal body and the lower esophageal sphincter.
All the treatment options are directed to improve the symptoms by relieving the obstruction at the junction between esophagus and stomach to allow the food to pass from the esophagus into the stomach.
Non-surgical treatments include:
The most effective and durable treatment for achalasia is obtained by a myotomy: cutting the muscle of the lower esophageal sphincter (the valve between the esophagus and the stomach) and performing an anti-reflux procedure to prevent reflux following myotomy.
The surgical approaches for myotomy include:
- open transthoracic (incision in the chest)
- transabdominal (Incision in the abdomen)
- thoracoscopic (minimally invasive procedure via small incisions in the chest)
- laparoscopic (minimally invasive procedure via small incisions in the abdomen) techniques
The laparoscopic minimally invasive procedure called Heller myotomy, is the least invasive surgical procedure for treatment of achalasia and is shown to result in great symptomatic relief.