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Achalasia is a condition where the lower part of the oesophagus leading to the stomach is unable to relax normally after swallowing. Food may become stuck there rather than going through into the stomach. Although the cause of achalasia is not known, it is well demonstrated that loss of oesophageal neurons is the underlying problem. Patients may experience dysphagia, regurgitation of food, retrosternal pain and so on. Nitrates are drugs that may relax the muscle and they are used to try to relieve the symptoms. They can be taken either as tablets, or absorbed under the tongue. Nitrates can be used in patients with mild symptoms, where it is not necessary to perform an invasive procedure such as surgery or if the patient is not a suitable candidate for surgery for some other reason. Nitrates can also be used if there is no response to injections of botulinum toxin to relax the muscle of the oesophagus. One other widely used option for the treatment of achalasia is dilation of the oesophagus using endoscopic methods. This review found there is not enough evidence from trials to show if nitrates are an effective treatment to relieve achalasia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Achalasia is an oesophageal motility disorder which results in increased lower oesophageal sphincter (LOS) tone and symptoms of difficulty swallowing. Treatments are aimed at reducing the tone of the LOS and include the endoscopic options of pneumatic dilation (PD) or local botulinum toxin (BTX) injection. We set out to undertake a systematic review comparing randomised controlled trials that examined the efficacy and safety of PD and BTX injection in people with achalasia. We searched databases (MEDLINE, EMBASE, ISI Web of Science, and The Cochrane Library) in April 2014 for reports of relevant randomised controlled trials. Seven randomised controlled trials were identified for inclusion in the review, and five were suitable for meta‐analysis. Meta‐analysis suggested that, although both interventions had similar initial response rates, the remission rates at six and 12 months were significantly greater with PD than with BTX injection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Expert-reviewed information summary about tests used to detect or screen for esophageal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 27, 2015

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