Overview
Definition
Failure of the lower esophageal sphincter (LES) to relax and absent peristalsis.
Epidemiology
Varies globally depending on genetics, environment, or exposure.
Etiology & Risk Factors
- Degeneration of inhibitory neurons in the myenteric (Auerbach's) plexus.
Clinical Symptoms
- Progressive dysphagia to both solids AND liquids
- regurgitation.
Clinical Approach
Diagnosis
- Esophageal manometry
- Barium swallow (bird's beak appearance).
Management
- Pneumatic dilation
- Heller myotomy
- Botulinum toxin injection.
Complications
- Esophageal squamous cell carcinoma.