Optimal Initial Therapy for Achalasia

Achalasia is an esophageal dysmotility disorder for which many initial therapy options exist. In this chapter we reviewed recent literature and clinical practice guidelines to help guide physicians and surgeons on the appropriate initial management of achalasia. Evaluation of the data suggests that POEM is an appropriate initial management for properly selected patients with achalasia, however it is important to consider the patient’s medical, surgical, endoscopic, and radiological history prior to selecting appropriate therapy.