title: [Primary esophageal motility disorders; especially about esophageal achalasia].
abstract: Esophageal motility disorders are classified primary and secondary, and primary esophageal motility disorders are classified esophageal achalasia and other diseases by manometry. An esophageal emptying disorder associated with insufficient relaxation of the lower esophageal sphincter (LES) and elimination of peristaltic waves on the esophageal body is the major abnormality of achalasia. Esophagogram, endoscopy, and manometry are used for diagnosis. As pharmacological therapy, administration of a calcium channel blocker or nitrate is useful. The pharmacological therapy is not recommended as long-term basic therapy but as a temporary treatment. At 1st, the balloon dilation method is chosen in treatment of achalasia Surgical treatment is indicated in the following cases: (1) Patients uneffected by balloon dilation, (2) Flask type with grade II to III dilation, and sigmoid type, (3) the gradual progression to the pathophysiological stage, (4) young patients, (5) complicated with esophageal cancer. Laparoscopic Heller-Dor procedure is the most popular surgical procedure, recently. It is somewhat difficult to perform surgical treatment for this functional disease. We should select the most suitable individualized treatment with efficient comprehension of the pathophysiological situation.
authors.affiliation: Department of General Surgical Science, Gunma University, Maebashi, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakai
authors.forename: Naritaka
authors.initials: N
authors.lastname: Tanaka
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takehiko
authors.initials: T
authors.lastname: Yokobori
authors.forename: Takanori
authors.initials: T
authors.lastname: Inose
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Motoyasu
authors.initials: M
authors.lastname: Kusano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult