Per Oral Endoscopic Myotomy and Prolonged Dilatation as Additional Endoscopic Treatment Options for Achalasia and Other Esophageal Motility Disorders

What this Trial Is About

Achalasia is a disorder affecting the movement of the esophagus, causing symptoms like difficulty swallowing, regurgitation, chest pain, and weight loss. This research evaluates the long-term effectiveness of four different treatments for achalasia and related esophageal motility disorders. The study aims to compare newer endoscopic options with conventional treatments to find the best approaches for individualized care. The treatments being studied include Per Oral Endoscopic Myotomy (POEM), which is an endoscopic procedure to cut muscles in the esophagus; Prolonged Dilatation (PRD) involving the temporary placement of large stents fixed to the esophageal wall; conventional balloon dilatation; and laparoscopic Heller myotomy surgery. These interventions are performed as initial treatments and may also be options after previous treatments have failed. Participants will be monitored closely with evaluations including symptom scoring using the Eckardt score six months after treatment. Additional tests include measuring barium height in esophagograms, lower esophageal sphincter pressure, stent migration shortly after placement, and acid exposure in the esophagus. The study is non-randomized and does not involve masking. Follow-up and assessments will continue to ensure safety and measure treatment outcomes over time.

Per Oral Endoscopic Myotomy (POEM) and Prolonged Dilatation (PRD) for Achalasia