Pediatric Achalasia in the Netherlands: Incidence, Clinical Course, and Quality of Life

Comparison of peroral endoscopic myotomy and endoscopic balloon dilation for primary treatment of pediatric achalasia

“…In a series of 24 patients reported by Di Nardo et al [5], treatment success rate was 67% after the first dilation, and overall success rate after a maximum of 3 dilations was 87% with a median follow-up of 6 years, indicating a favorable long-term efficacy. However, in other studies, the intermediate and long-term efficacy of EBD was unsatisfactory, and exceeding 60% of the patients underwent recurrence and needed surgery ultimately [2,[15][16][17]. In the present study, 66.7% (6/9) of the patients recurred after primary EBD treatment within three years, and received other treatments.…”

“…Conclusions: Short-term efficacy of POEM and EBD for primary treatment of pediatric achalasia was comparable, however POEM could result in a better intermediate and long-term efficacy. Large scale, randomized study is necessary for a confirmed conclusion.Achalasia is a rare primary esophageal dysmotility disorder, with an estimated annual incidence of 0.01-0.11 cases per 100,000 children [1,2]. It is characterized by failed relaxation of the lower esophageal sphincter (LES) and absent peristalsis of the distal esophagus.…”

“…Achalasia is a rare primary esophageal dysmotility disorder, with an estimated annual incidence of 0.01-0.11 cases per 100,000 children [1,2]. It is characterized by failed relaxation of the lower esophageal sphincter (LES) and absent peristalsis of the distal esophagus.…”

Pediatric enteric neuropathies: diagnosis and current management

“…Esophageal achalasia is uncommon in children, with an incidence of 0.1 per 100,000 [15,16] and an average age at diagnosis of 11 years. [17,18] The disease is characterized by impaired relaxation of the lower esophageal sphincter (LES) and abnormal esophageal motility, resulting in dysphagia and regurgitation, often with retrosternal chest discomfort and weight loss.…”

“…[20] Initial treatment with botulinum toxin injection into the LES is only temporizing, requiring subsequent Heller myotomy in 85% of cases in a recent retrospective review. [17] Endoscopic pneumatic dilatation is commonly performed, but has been associated with a high rate of retreatment for persistent or recurrent symptoms, ranging from 71-88% [16,18], leading some to recommend Heller myotomy as first-line therapy for newly diagnosed children.…”