Treatment of Achalasia — From Whalebone to Botulinum Toxin

Publisher Website
Google Scholar
Abstract
Achalasia, described by Thomas Willis in 1674, was initially treated by dilation of the lower esophagus with a whalebone. The forceful disruption of the lower esophagus by this means relieved dysphagia and other obstructive symptoms. Current procedures, pneumatic balloon dilation and surgical myotomy of the lower esophageal sphincter, mimic this earlier approach. The relative merits of these treatments have been debated without resolution for more than 40 years. Pneumatic dilation and myotomy result in long-term relief of dysphagia in 70 and 85 percent of patients, respectively.1 In 5 percent of patients, pneumatic dilation causes esophageal perforation, requiring subsequent thoracic surgical . . .