title: Recent trends in endoscopic management of achalasia.
abstract: Esophageal achalasia is a chronic and progressive motility disorder characterized by absence of esophageal body peristalsis associated with an impaired relaxation of lower esophageal sphincter (LES) and usually with an elevated LES pressure, leading to an altered passage of bolus through the esophago-gastric junction. A definitive cure for achalasia is currently unavailable. Palliative treatment options provide only food and liquid bolus intake and relief of symptoms. Endoscopic therapy for achalasia aims to disrupt or weaken the lower esophageal sphincter. Intra-sphincteric injection of botulinum toxin is reserved for elderly or severely ill patients. Pneumatic dilation provides superior results than botulinum toxin injection and a similar medium-term efficacy almost comparable to that attained after surgery. Per oral endoscopic myotomy is a promising option for treating achalasia, but it requires increased experience and further objective and long-term follow up. This article will review different endoscopic treatments in achalasia, and summarize the short-term and long-term outcomes.
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tolone
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Limongelli
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Gianmattia
authors.initials: G
authors.lastname: Del Genio
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Brusciano
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cipriano
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Terribile
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ruggiero
authors.affiliation: Salvatore Tolone, Paolo Limongelli, Gianmattia del Genio, Luigi Brusciano, Antonio Russo, Lorenzo Cipriano, Marco Terribile, Giovanni Docimo, Roberto Ruggiero, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Docimo
keywords: Achalasia; Botulinum toxin injection; Dysphagia; Endoscopy; High resolution manometry; Per oral endoscopic myotomy; Pneumatic dilation