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Achalasia is a condition characterized by difficulty swallowing due to the failure of the muscles in the lower esophagus to relax. Treatment options have evolved over time, initially including medications, botulinum toxin (Botox) injections, dilation, and surgical methods. Currently, due to the numerous side effects of drug therapies and the need for Botox applications to be repeated every 4 to 6 months, these methods are generally no longer the primary choice.
Today, the most commonly applied methods for achalasia treatment are endoscopic dilation (balloon expansion) and surgery. Endoscopic dilation involves expanding the narrowed lower part of the esophagus with a balloon. Although its success rate is slightly lower than surgery, it is often considered the first-choice treatment due to advantages such as shorter procedure time, no surgical incision, and quicker return to normal life for the patient. However, since the effectiveness of this treatment method is not as high as surgery, multiple sessions may often be required. In pediatric patients under 9-10 years of age, surgery is frequently the preferred initial treatment.
The Heller Esophagocardiomyotomy operation, defined approximately a hundred years ago, continues to be the most effective surgical treatment option for achalasia today, with various modifications. This surgery can be performed via the abdomen or chest, either openly or laparoscopically (minimally invasively). During the operation, the unrelaxed muscles at the lower end of the esophagus are incised or separated to reduce lower esophageal pressure, thereby correcting the difficulty in swallowing. The success rate of this surgery has been determined to be over 85-90%. Since gastroesophageal reflux disease (GERD) is commonly observed after these operations, many surgeons also add anti-reflux procedures to achalasia surgery. Patients are typically discharged within an average of 3-4 days after laparoscopic surgeries and 6-7 days after open surgeries.
What is the treatment for achalasia (difficulty swallowing)?
Today, the most commonly applied methods for achalasia treatment are endoscopic dilation (balloon expansion) and surgery. Endoscopic dilation involves expanding the narrowed lower part of the esophagus with a balloon. Although its success rate is slightly lower than surgery, it is often considered the first-choice treatment due to advantages such as shorter procedure time, no surgical incision, and quicker return to normal life for the patient. However, since the effectiveness of this treatment method is not as high as surgery, multiple sessions may often be required. In pediatric patients under 9-10 years of age, surgery is frequently the preferred initial treatment.
The Heller Esophagocardiomyotomy operation, defined approximately a hundred years ago, continues to be the most effective surgical treatment option for achalasia today, with various modifications. This surgery can be performed via the abdomen or chest, either openly or laparoscopically (minimally invasively). During the operation, the unrelaxed muscles at the lower end of the esophagus are incised or separated to reduce lower esophageal pressure, thereby correcting the difficulty in swallowing. The success rate of this surgery has been determined to be over 85-90%. Since gastroesophageal reflux disease (GERD) is commonly observed after these operations, many surgeons also add anti-reflux procedures to achalasia surgery. Patients are typically discharged within an average of 3-4 days after laparoscopic surgeries and 6-7 days after open surgeries.