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Achalasia

Last reviewed: 21 Dec 2025
Last updated: 01 Oct 2025

Summary

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • dysphagia
Полная информация

Другие диагностические факторы

  • posturing to aid swallowing
  • retrosternal pressure/pain
  • regurgitation
  • gradual weight loss
  • heartburn
  • slow eating
  • coughing/choking while recumbent
  • recurrent chest infections
  • sensation of a lump in the throat (globus)
  • hiccups
Полная информация

Факторы риска

  • herpes and measles viruses
  • autoimmune disease
  • HLA class II antigens
  • consanguineous parents
  • triple A (Allgrove) syndrome
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • upper gastrointestinal endoscopy
  • barium swallow
  • high-resolution esophageal manometry
Полная информация

Исследования, проведение которых нужно рассмотреть

  • chest x-ray
  • radionucleotide esophageal emptying studies
  • timed barium esophagogram
  • CT chest
  • impedance planimetry
Полная информация

Алгоритм лечения

Начальные

patients awaiting definitive treatment

Острый

good surgical candidate

poor surgical candidate

Составители

Авторы

Jamal Omar Hayat, MBBS, BSc, MRCP, MD (Res)

Consultant Gastroenterologist and Honorary Senior Lecturer

Department of Gastroenterology

St George's University Hospitals NHS Trust

London

UK

Раскрытие информации

JOH declares that he has no competing interests.

Kalliopi Alexandropoulou, MD, FRCP

Consultant Gastroenterologist

Royal Surrey County Hospital

Guildford

Surrey

UK

Раскрытие информации

KA declares that sshe has no competing interests.

Выражение благодарностей

Dr Jamal Omar Hayat and Dr Kalliopi Alexandropoulou wish to gratefully acknowledge Dr Jin-Yong Kang, the previous contributor to this topic.

Раскрытие информации

JYK declares that he has no competing interests.

Рецензенты

Nigel Trudgill, MB ChB

Consultant Gastroenterologist

Sandwell General Hospital

West Bromwich

UK

Раскрытие информации

NT declares that he has no competing interests.

John de Caestecker, BChir

Consultant in General Medicine

Leicester General Hospital

Leicester

UK

Раскрытие информации

JdC declares that he has no competing interests.

David Hackam, MD, PhD

Assistant Professor of Surgery

Children's Hospital of Pittsburgh

Pittsburgh

PA

Раскрытие информации

DH declares that he has no competing interests.

George Y. Wu, MD, PhD

Professor of Medicine

University of Connecticut Health Center

Farmington

CT

Раскрытие информации

GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Zaninotto G, Bennett C, Boeckxstaens G, et al. The 2018 ISDE achalasia guidelines. Dis Esophagus. 2018 Sep 1;31(9).Полный текст  Аннотация

Vaezi MF, Pandolfino JE, Yadlapati RH, et al. ACG clinical guidelines: diagnosis and management of achalasia. Am J Gastroenterol. 2020 Sep;115(9):1393-411.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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