Korean Journal of Gastrointestinal Endoscopy 2011;42(6): 341-348.
Endoscopic Treatment of Primary Esophageal Motility Disorders
Joon Seong Lee, M.D., Ph.D.
Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea
Abstract
Treatment of primary esophageal motility disorders, particularly achalasia, has
developed enormously. The proven treatments for these patients include mostly
endoscopic methods. Currently, pneumatic dilatation and laparoscopic myotomy
with partial fundoplication are both useful for treating achalasia. A young man with
high lower esophageal sphincter pressure might be best indicated for a laparoscopic
myotomy with fundoplication, whereas an older patient with a high risk for
surgery or vigorous achalasia may for a candidate for an endoscopic botulinum
toxin injection. Pneumatic balloon dilatation is the choice of treatment for other
cases of achalasia. The best treatment option for a nonachalasia spastic motor
disorder of the esophagus may be endoscopic injection of botulinum toxin. In the
future, endoscopic injection of neuronal stem cells could be the best treatment
option for achalasia.
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