PATHOPHYSIOLOGY AND ENDOSCOPIC BALLOON TREATMENT OF ESOPHAGEAL MOTILITY DISORDERS/

Esophageal dysmotility syndromes encompass disease entities, such as d iffuse esophageal spasm, nutcracker esophagus, hypertensive lower esop hageal sphincter, nonspecific esophageal dysmotility dysfunction, and primary achalasia. The best understood of these remains achalasia. Tra ditional therapeutic modalities have included the use of pharmacologic agents, balloon dilatation, and surgery with varying degrees of succe ss. The novel use of botulinum toxin has proven effective in patients with idiopathic achalasia, and the utility of this potent neurotoxin i n nonachalasia esophageal motor disorders is currently being investiga ted. Conventional and newer therapies with a particular focus on endos copic and balloon treatment of the various esophageal dysmotility diso rders are discussed.