Achalasia

The Correct Asnwer is C


Explanation:

Achalasia is best treated with mechanical disruption of the lower esophageal sphincter. Dilation with a large Hurst bougie may give temporary relief; a few patients have been maintained with weekly self-dilations, but this treatment is no longer recommended. Much more effective is dilation with a pneumatic balloon (bag) under radiographic control.

A successful approach to long-term pharmacologic management of achalasia has not been established. Short-term improvement in clinical symptoms and in scintigraphic esophageal emptying may occur with isosorbide mononitrate, a long-acting nitrate, or with nifedipine, a calcium-channel blocker.

Promotility agents like metoclopramide increase the lower esophageal sphincter pressure and thus are contraindicated in achalasia.

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