Clinical management of pediatric achalasia

Marinde van Lennep, Michiel P. van Wijk, Taher I.M. Omari, Marc A. Benninga, Maartje M.J. Singendonk*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Introduction: Achalasia is a rare esophageal motility disorder. Much of the literature is based on the adult population. In adults, guidance of therapeutic approach by manometric findings has led to improvement in patient outcome. Promising results have been achieved with novel therapies such as PerOral Endoscopic Myotomy (POEM). Areas covered: In this review, we provide an overview of the novel diagnostic and therapeutic tools for achalasia management and in what way they will relate to the future management of pediatric achalasia. We performed a PubMed and EMBASE search of English literature on achalasia using the keywords ‘children’, ‘achalasia’, ‘pneumatic dilation’, ‘myotomy’ and ‘POEM’. Cohort studies < 10 cases and studies describing patients ≥ 20 years were excluded. Data regarding patient characteristics, treatment outcome and adverse events were extracted and presented descriptively, or pooled when possible. Expert commentary: Available data report that pneumatic dilation and laparoscopic Heller’s myotomy are effective in children, with certain studies suggesting lower success rates in pneumatic dilation. POEM is increasingly used in the pediatric setting with promising short-term results. Gastro-esophageal reflux disease (GERD) may occur post-achalasia intervention due to disruption of the LES and therefore requires diligent follow-up, especially in children treated with POEM.

Original languageEnglish
Pages (from-to)391-404
Number of pages14
JournalExpert Review of Gastroenterology and Hepatology
Volume12
Issue number4
DOIs
Publication statusPublished - 3 Apr 2018

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