Achalasia: The Current Clinical Dilemma and Possible Pathogenesis

J Neurogastroenterol Motil. 2023 Apr 30;29(2):145-155. doi: 10.5056/jnm22176.

Abstract

Achalasia is a primary esophageal motility disorder manifested by dysphagia and chest pain that impair patients' quality of life, and it also leads to chronic esophageal inflammation by food retention and increases the risk of esophageal cancer. Although achalasia has long been reported, the epidemiology, diagnosis and treatment of achalasia are not fully understood. The current clinical dilemma of achalasia is mainly due to its unclear pathogenesis. In this paper, epidemiology, diagnosis treatment, as well as possible pathogenesis of achalasia will be reviewed and summarized. The proposed hypothesis on the pathogenesis of achalasia is that genetically susceptible populations potentially have a higher risk of infection with viruses, triggering autoimmune and inflammation responses to inhibitory neurons in lower esophageal sphincter.

Keywords: Diagnosis; Epidemiology; Esophageal achalasia; Etiology; Therapeutics.

Publication types

  • Review

Grants and funding

Financial support: The study was supported by grants from the National Natural Science Foundation of China (82170577 and 81970479).