Megaesophagus

Achalasia is the most common primary motor disturbance of the oesophagus, whose prevalence is 1 patient for every 10.000, and its aetiology remains unknown. It is classified in 3 types, according to the contraction pattern of the oesophageal body; in its more extreme type, there is no oesophageal contraction at all. It may present with progressive and incapacitating dysphagia, regurgitation of non-digested foods, nocturnal cough, aspiration pneumonia, thoracic pain or weight loss. First line treatment comprises of endoscopic dilation, local botulinum toxin injection or Heller myotomy. In the end-stage achalasia, after failure of first line treatments, oesophageal resection may become the best alternative.