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Achalasia

Achalasia - How to prevent?

Achalasia - Causes and Risk Factors

Achalasia - Treatments

If left untreated, achalasia can result in severe weight loss due to malnutrition, and even recurrent lung infections due to aspiration of food. The main treatment options are:


A) Per oral endoscopic myotomy (POEM)
  • This is a newer endoscopic technique that cuts the lower oesophageal muscle fibres using the endoscope.
B) Surgical cardiomyotomy and fundoplication
  • This is performed via laparoscopic techniques (key-hole surgery) and involves cutting the lower oesophageal muscle fibres.
  • A fundoplication procedure (wrapping of the top part of the stomach around the lower oesophagus) may be added to minimise risk of reflux (GERD).

Second line treatment options may be recommended under certain circumstances (i.e. when the patient is not fit for general anaesthesia). These treatments include:


(a) Endoscopic balloon dilatation
  • This procedure is used to stretch or break the lower oesophageal sphincter muscle fibres.
  • The effect is temporary but longer-lasting compared to medication.
  • Repeated treatment is required

(b) Medications/Pharmacological therapy
  • Medication such as nitrate drugs or Botox is used to relax the lower oesophageal sphincter (LES) .
  • The treatment effect is temporary, and usually lasts about 6-12 months depending on the medication used.

(c) Surgical oesophagectomy (removal of the oesophagus)
  • This is reserved for patients with severe, end-stage achalasia where the oesophagus is very distended and filled with food

The type of treatment offered will depend on the type of achalasia. Our team of doctors will discuss for your treatment options in further detail with you.

Achalasia - Other Information

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