ASGE guideline on the management of achalasia

Mouen A. Khashab, Marcelo F. Vela, Nirav Thosani, Deepak Agrawal, James L. Buxbaum, Syed M. Abbas Fehmi, Douglas S. Fishman, Suryakanth R. Gurudu, Laith H. Jamil, Terry L. Jue, Bijun Sai Kannadath, Joanna K. Law, Jeffrey K. Lee, Mariam Naveed, Bashar J. Qumseya, Mandeep S. Sawhney, Julie Yang, Sachin Wani

Research output: Contribution to journalArticle

Abstract

Achalasia is a primary esophageal motor disorder of unknown etiology characterized by degeneration of the myenteric plexus, which results in impaired relaxation of the esophagogastric junction (EGJ), along with the loss of organized peristalsis in the esophageal body. The criterion standard for diagnosing achalasia is high-resolution esophageal manometry showing incomplete relaxation of the EGJ coupled with the absence of organized peristalsis. Three achalasia subtypes have been defined based on high-resolution manometry findings in the esophageal body. Treatment of patients with achalasia has evolved in recent years with the introduction of peroral endoscopic myotomy. Other treatment options include botulinum toxin injection, pneumatic dilation, and Heller myotomy. This American Society for Gastrointestinal Endoscopy Standards of Practice Guideline provides evidence-based recommendations for the treatment of achalasia, based on an updated assessment of the individual and comparative effectiveness, adverse effects, and cost of the 4 aforementioned achalasia therapies.

Original languageEnglish (US)
Pages (from-to)213-227.e6
JournalGastrointestinal endoscopy
Volume91
Issue number2
DOIs
StatePublished - Feb 2020

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Khashab, M. A., Vela, M. F., Thosani, N., Agrawal, D., Buxbaum, J. L., Abbas Fehmi, S. M., Fishman, D. S., Gurudu, S. R., Jamil, L. H., Jue, T. L., Kannadath, B. S., Law, J. K., Lee, J. K., Naveed, M., Qumseya, B. J., Sawhney, M. S., Yang, J., & Wani, S. (2020). ASGE guideline on the management of achalasia. Gastrointestinal endoscopy, 91(2), 213-227.e6. https://doi.org/10.1016/j.gie.2019.04.231