2019 Seoul Consensus on Esophageal Achalasia Guidelines
Hye‐Kyung Jung, Su Jin Hong, Oh Young Lee, John E. Pandolfino, Hyojin Park, Hiroto Miwa, Uday C. Ghoshal, Sanjiv Mahadeva, Tadayuki Oshima, Minhu Chen, Andrew Seng Boon Chua, Yu Kyung Cho, Tae Hee Lee, Yang Won Min, Chan Hyuk Park, Joong Goo Kwon, Moo In Park, Kyoungwon Jung, Jong Kyu Park, Kee Wook Jung, Hyun Chul Lim, Da Hyun Jung, Do Hoon Kim, Chul‐Hyun Lim, Hee Seok Moon, Jung Ho Park, Suck Chei Choi, Hidekazu Suzuki, Tanisa Patcharatrakul, Justin CY Wu, Kwang Jae Lee, Shinwa Tanaka, Kewin Tien Ho Siah, Kyung Sik Park, Sung Eun Kim, The Korean Society of Neurogastroenterology and Motility
Abstract
Esophageal achalasia is a primary motility disorder characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. Achalasia is a chronic disease that causes progressive irreversible loss of esophageal motor function. The recent development of high-resolution manometry has facilitated the diagnosis of achalasia, and determining the achalasia subtypes based on high-resolution manometry can be important when deciding on treatment methods. Peroral endoscopic myotomy is less invasive than surgery with comparable efficacy. The present guidelines (the "2019 Seoul Consensus on Esophageal Achalasia Guidelines") were developed based on evidence-based medicine; the Asian Neurogastroenterology and Motility Association and Korean Society of Neurogastroenterology and Motility served as the operating and development committees, respectively. The development of the guidelines began in June 2018, and a draft consensus based on the Delphi process was achieved in April 2019. The guidelines consist of 18 recommendations: 2 pertaining to the definition and epidemiology of achalasia, 6 pertaining to diagnoses, and 10 pertaining to treatments. The endoscopic treatment section is based on the latest evidence from meta-analyses. Clinicians (including gastroenterologists, upper gastrointestinal tract surgeons, general physicians, nurses, and other hospital workers) and patients could use these guidelines to make an informed decision on the management of achalasia.