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Achalasia: Symptoms, Diagnosis, and Treatment Options

Learn about Achalasia, a primary motility disorder affecting the esophagus. Explore its pathogenesis, clinical findings, investigations, and treatment options such as pneumatic dilatation and Heller myotomy. Discover the complications and differential diagnosis to effectively manage this condition.

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Achalasia: Symptoms, Diagnosis, and Treatment Options

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  1. Achalasia Prof. Dr. Faisal Ghani Siddiqui

  2. Preamble • Introduction • Pathogenesis • Clinical findings • Investigations • Differential diagnosis • Complications • Treatment

  3. Oesophageal Peristaltic Waves • Primary • Secondary • Tertiary

  4. Oesophageal Motility Disorders Primary • Unknown causes Secondary • Manifestations of systemic diseases

  5. Oesophageal Motility Disorders Primary • Achalasia • Oesophageal spasm • Nutcracker oesophagus • Hypertensive LES Secondary • Diabetes mellitus • Scleroderma • Alcohol • Psychiatric illnesses

  6. Pathogenesis

  7. Achalasia -aetiology

  8. Clinical Findings • Dysphagia • Regurgitation • Heartburn • Chest pain

  9. Dilated proximal Oesophagus Distal Oesophageal narrowing (bird’s beak)

  10. Oesophageal Manometry • Absence of oesophageal peristalsis • Partial or no relaxation of LES

  11. Differential Diagnosis • Benign strictures • Oesophageal carcinoma

  12. Complications • Aspiration | pneumonia • Chronic irritation | carcinoma oesophagus

  13. Treatment • Medical treatment • Endoscopic treatment • Surgical treatment

  14. Intersphincteric Injection of Botulinum Toxin

  15. Pneumatic Dilatation

  16. Heller Myotomy

  17. … in summary • Primary motility disorder • Absence of primary peristaltic waves & hyperactive LES • Dysphagia • Manometry diagnostic • Pneumatic dilatation | Heller myotomy

  18. ?

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