Chest Pain and Reappearance of Esophageal Peristalsis in Treated Achalasia

Abstract

The appearance of esophageal peristalsis after forceful dilatation in achalasic patients is frequently associated with persistent or new chest pain.

Timing of surgical intervention does not influence return of esophageal peristalsis or outcome for patients with achalasia

“…Additionally, they demonstrated that these abnormalities were reversible if the outflow obstruction caused by the band was removed. These findings are in part supported by clinical observation of patients treated by either pneumatic dilation or myotomy [7,8,17,18]. Parrilla et al [8] studied 45 patients with achalasia in whom a myotomy had been performed.…”

Return of Esophageal Function after Treatment for Achalasia as Determined by Impedance-Manometry

“…It is, however, unclear why certain patients have been observed to recover esophageal function after treatment as in this study and in other case series, 5,6,22,26 whereas others do not. Variants of achalasia exist in which some peristalsis is observed, including vigorous achalasia, characterized by higher-amplitude simultaneous contractions in the distal esophagus in conjunction with a non-relaxing LES, and short-segment achalasia, in which the proximal esophageal segment retains peristaltic activity.…”

“…Relief of dysphagia after treatment is assumed to be the result of eliminating this functional obstruction of the distal esophagus. However, although the return of peristalsis after both balloon dilation 5 and Heller myotomy 6 has been described, there is little in-depth analysis of the effect of treatments for achalasia on esophageal body function.…”

Short‐ and long‐term effects of balloon dilatation on esophageal motility in achalasia

“…It has been reported that propulsive peristaltic contractions could be restored after dilatation in some achalasia patients 7 . We had observed previously the restoration of peristaltic contractions in two achalasia patients after dilatation (ZF Wang, MY Ke, MW Qin, unpubl.…”