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Achalasia

Summary Achalasia is a rare motility disorder of the oesophagus characterised by loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower oesophageal sphincter. Although its cause remains largely unknown, ganglionitis resulting from an aberrant immune response t... Full description

Journal Title: The Lancet 2014, Vol.383 (9911), p.83-93
Main Author: Boeckxstaens, Guy E, Prof
Other Authors: Zaninotto, Giovanni, Prof , Richter, Joel E, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier Ltd
ID: ISSN: 0140-6736
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recordid: cdi_proquest_miscellaneous_1514420606
title: Achalasia
format: Article
creator:
  • Boeckxstaens, Guy E, Prof
  • Zaninotto, Giovanni, Prof
  • Richter, Joel E, Prof
subjects:
  • Achalasia
  • Autoimmune diseases
  • Biological and medical sciences
  • Care and treatment
  • Cytokines
  • Diagnosis
  • Dilatation - methods
  • Disease
  • Dysphagia
  • Early Detection of Cancer - methods
  • Epidemiology
  • Esophageal Achalasia - diagnosis
  • Esophageal Achalasia - epidemiology
  • Esophageal Achalasia - therapy
  • Esophageal Neoplasms - diagnosis
  • Esophagoscopy - methods
  • Esophagus
  • Food
  • Gastroenterology. Liver. Pancreas. Abdomen
  • Gastroesophageal reflux
  • Gastrointestinal diseases
  • General aspects
  • Health aspects
  • Humans
  • Internal Medicine
  • Malformations
  • Manometry - methods
  • Medical colleges
  • Medical research
  • Medical sciences
  • Medical treatment
  • Medicine(all)
  • Medicine, Experimental
  • Minimally Invasive Surgical Procedures - methods
  • Mortality
  • Motility
  • Myotomy
  • Pain
  • Patient outcomes
  • Precancerous Conditions - diagnosis
  • Recurrence
  • Rodents
  • Studies
  • Virus diseases
ispartof: The Lancet, 2014, Vol.383 (9911), p.83-93
description: Summary Achalasia is a rare motility disorder of the oesophagus characterised by loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower oesophageal sphincter. Although its cause remains largely unknown, ganglionitis resulting from an aberrant immune response triggered by a viral infection has been proposed to underlie the loss of oesophageal neurons, particularly in genetically susceptible individuals. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of oesophageal carcinoma. At present, pneumatic dilatation and Heller myotomy combined with an anti-reflux procedure are the treatments of choice and have comparable success rates. Per-oral endoscopic myotomy has recently been introduced as a new minimally invasive treatment for achalasia, but there have not yet been any randomised clinical trials comparing this option with pneumatic dilatation and Heller myotomy.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionSummary Achalasia is a rare motility disorder of the oesophagus characterised by loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower oesophageal sphincter. Although its cause remains largely unknown, ganglionitis resulting from an aberrant immune response triggered by a viral infection has been proposed to underlie the loss of oesophageal neurons, particularly in genetically susceptible individuals. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of oesophageal carcinoma. At present, pneumatic dilatation and Heller myotomy combined with an anti-reflux procedure are the treatments of choice and have comparable success rates. Per-oral endoscopic myotomy has recently been introduced as a new minimally invasive treatment for achalasia, but there have not yet been any randomised clinical trials comparing this option with pneumatic dilatation and Heller myotomy.
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subjectAchalasia ; Autoimmune diseases ; Biological and medical sciences ; Care and treatment ; Cytokines ; Diagnosis ; Dilatation - methods ; Disease ; Dysphagia ; Early Detection of Cancer - methods ; Epidemiology ; Esophageal Achalasia - diagnosis ; Esophageal Achalasia - epidemiology ; Esophageal Achalasia - therapy ; Esophageal Neoplasms - diagnosis ; Esophagoscopy - methods ; Esophagus ; Food ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastroesophageal reflux ; Gastrointestinal diseases ; General aspects ; Health aspects ; Humans ; Internal Medicine ; Malformations ; Manometry - methods ; Medical colleges ; Medical research ; Medical sciences ; Medical treatment ; Medicine(all) ; Medicine, Experimental ; Minimally Invasive Surgical Procedures - methods ; Mortality ; Motility ; Myotomy ; Pain ; Patient outcomes ; Precancerous Conditions - diagnosis ; Recurrence ; Rodents ; Studies ; Virus diseases
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descriptionSummary Achalasia is a rare motility disorder of the oesophagus characterised by loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower oesophageal sphincter. Although its cause remains largely unknown, ganglionitis resulting from an aberrant immune response triggered by a viral infection has been proposed to underlie the loss of oesophageal neurons, particularly in genetically susceptible individuals. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of oesophageal carcinoma. At present, pneumatic dilatation and Heller myotomy combined with an anti-reflux procedure are the treatments of choice and have comparable success rates. Per-oral endoscopic myotomy has recently been introduced as a new minimally invasive treatment for achalasia, but there have not yet been any randomised clinical trials comparing this option with pneumatic dilatation and Heller myotomy.
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1Autoimmune diseases
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9Early Detection of Cancer - methods
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26Manometry - methods
27Medical colleges
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34Mortality
35Motility
36Myotomy
37Pain
38Patient outcomes
39Precancerous Conditions - diagnosis
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41Rodents
42Studies
43Virus diseases
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9Early Detection of Cancer - methods
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abstractSummary Achalasia is a rare motility disorder of the oesophagus characterised by loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower oesophageal sphincter. Although its cause remains largely unknown, ganglionitis resulting from an aberrant immune response triggered by a viral infection has been proposed to underlie the loss of oesophageal neurons, particularly in genetically susceptible individuals. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of oesophageal carcinoma. At present, pneumatic dilatation and Heller myotomy combined with an anti-reflux procedure are the treatments of choice and have comparable success rates. Per-oral endoscopic myotomy has recently been introduced as a new minimally invasive treatment for achalasia, but there have not yet been any randomised clinical trials comparing this option with pneumatic dilatation and Heller myotomy.
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pmid23871090
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