ReviewJournal of clinical medicine2021
Achalasia in the Elderly: Diagnostic Approach and a Proposed Treatment Algorithm Based on a Comprehensive Literature Review.
Review in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 15 citations in OpenAlex.
- Intraoperative indocyanine green (ICG) fluorescence to assess mucosal integrity during laparoscopic Heller-Dor surgery: a pilot randomized study.Updates in surgery · 2026Article
- Achalasia in Geriatric Patients: A Comprehensive Overview.Digestive diseases and sciences · 2026Review
- Effect of sex on the outcomes of peroral endoscopic myotomy for the treatment of achalasia.World journal of gastroenterology · 2025Article
- [A Case of Type II Achalasia Occurring in a Nonagenarian Diagnosed with Acute Food Impaction].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2024Article
- Safety of Pneumatic Dilation in Older Adults with Achalasia: An International Multicenter Cross-Sectional Study.Journal of clinical medicine · 2023Article
- An Uncommon Case of Weight Loss in a Nonagenarian.Annals of geriatric medicine and research · 2023Article
- The possible association between neurodegenerative/demyelinating neurological disorders in achalasia patients.Translational neuroscience · 2022Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Achalasia is not uncommonly diagnosed in elderly patients and its incidence and prevalence are growing in this population. However, a scarcity of studies has assessed the typical pathophysiological and clinical features of the disease as well as the effectiveness and safety of the various therapeutic options in elderly populations. Botulinum toxin injection has been used for achalasia treatment since 1994 and is traditionally considered the preferred treatment for fragile elder patients. However, recently more evidence has become available regarding the safety and effectiveness of pneumatic balloon dilation (BD), laparoscopic Heller myotomy (LHM) and per-oral endoscopic myotomy (POEM) in elderly patients with achalasia. In the current review we present the current literature on this topic with a focus on the clinical presentation of achalasia in the elderly and manometric features thereof, as well as summarize the effectiveness and safety of the various therapeutic options. Furthermore, we propose a practical management algorithm as a means to guide the treatment of future cases. We recommend that a conservative/BTI approach should be adopted in the fragile unfit patient. In the elderly fit patient, the treatment decision should be based on the achalasia type, patient preference and the available expertise, similar to the approach adopted for the non-elderly population.
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