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      Management of achalasia cardia: Expert consensus statements : Expert consensus: Achalsia cardia

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          Abstract

          Achalasia cardia (AC) is a frequently encountered motility disorder of the esophagus resulting from an irreversible degeneration of neurons. Treatment modalities are palliative in nature, and there is no curative treatment available for AC as of now. Significant advancements have been made in the management of AC over last decade. The introduction of high resolution manometry and per-oral endoscopic myotomy (POEM) has strengthened the diagnostic and therapeutic armamentarium of AC. High resolution manometry allows for the characterization of the type of achalasia, which in turn has important therapeutic implications. The endoscopic management of AC has been reinforced with the introduction of POEM that has been found to be highly effective and safe in palliating the symptoms in short-term to mid-term follow-up studies. POEM is less invasive than Heller's myotomy and provides the endoscopist with the opportunity of adjusting the length and orientation of esophageal myotomy according to the type of AC. The management of achalasia needs to be tailored for each patient, and the role of pneumatic balloon dilatation, POEM, or Heller's myotomy needs to be revisited. In this review, we discuss the important aspects of diagnosis as well as management of AC. The statements presented in the manuscript reflect the cumulative efforts of an expert consensus group.

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          Author and article information

          Journal
          Journal of Gastroenterology and Hepatology
          Journal of Gastroenterology and Hepatology
          Wiley
          08159319
          August 2018
          August 2018
          July 11 2018
          : 33
          : 8
          : 1436-1444
          Affiliations
          [1 ]Department of Gastroenterology; Asian Institute of Gastroenterology; Hyderabad Telangana India
          [2 ]Department of Digestive Diseases and Endoscopy; Deenanath Mangeshkar Hospital and Research Center; Pune Maharashtra India
          [3 ]Department of Gastroenterology; Seth G S Medical College and KEM Hospital; Mumbai Maharashtra India
          [4 ]Department of Gastroenterology; Vedanta Institute of Medical Sciences; Ahmedabad Gujarat India
          [5 ]Department of Gastroenterology; Bhatia General Hospital; Mumbai Maharashtra India
          [6 ]Department of Surgical Gastroenterology; Medanta The Medicity; Gurgaon Haryana India
          [7 ]Department of Gastroenterology; SGPGI; Lucknow Uttar Pradesh India
          [8 ]Gastroenterology; PVS Memorial Hospital; Ernakulam Kerala India
          [9 ]Department of Internal Medicine; Evangelical Hospital Düsseldorf; Dusseldorf Nordrhein-Westfalen Germany
          [10 ]Department of Gastroenterology; Erasmus Hospital; Bruxelles Belgium
          [11 ]Digestive Disease Center; Showa University Koto-Toyosu Hospital; Tokyo Japan
          Article
          10.1111/jgh.14097
          29377271
          cc7aaaaa-6ecc-458c-b181-e2652b162b29
          © 2018

          http://doi.wiley.com/10.1002/tdm_license_1.1

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