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ACHALASIA AND PERORAL ENDOSCOPIC MYOTOMY POEM
4
Figure 1.
Manometry of a healthy person (left) and patient with achalasia type I (right)
Figure 2.
Barium swallow with a typical “bird’s beak”- or corkscrew pattern in a patient with achalasia
THERAPY
Causal treatment of achalasia is not possible. Altogether, there are four treatment options:
medication, injection of botulinum toxin into the LOS, pneumatic dilatation of the LOS, and
(surgical) myotomy.
Medication
Drugs that can reduce the pressure in the LOS are calcium channel blockers, nitrates, and
phosphodiesterase inhibitors. Evidence based data is missing, but treatment with these
agents is rarely successful and therefore not usually performed.