Bougienage, Forceful Dilatation, and Surgery in Treatment of Achalasia

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Abstract
A study of the literature has disclosed that most authors have been prejudiced either in favor of bougienage or surgery in the treatment of achalasia. Eighty-eight cases of achalasia were studied to give an unprejudiced opinion on the best treatment of this disease. Results of various types of therapy administered to the patients under study were compared. This study concluded that esophagoscopy, followed by simple mercury bougienage, should be done first to rule out other diseases of the esophagus. If this procedure does not prove satisfactory, the next step is use of the Browne-McHardy bougie passed under fluoroscopic guidance. A Heller esophagocardiomyotomy should be recommended only if other methods fail.

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