Assessing the Efficacy of Steroid Treatment of Achalasia

A Pilot Study Assessing the Efficacy of Steroids in the Treatment of Achalasia

Would systemic steroids be an effective treatment in early variants of achalasia?

Inclusion criteria:

• Adults ages 18-90 with a diagnosis of achalasia confirmed by findings on esophageal manometry and barium esophagogram will be eligible for the study.
• Eckardt score6 greater or equal to 6 or 2 or greater for dysphagia and/or regurgitation
• Symptoms less than 2 years

Exclusion criteria:

• Medical conditions such as severe heart or lung disease that preclude safe performance of endoscopy and injection;
• Greater than mild esophageal dilation
• Type 1 achalasia as defined by the Chicago classification scheme7 and/or esophageal diameter > 3cm;
• Prior treatment for achalasia
• Use of medications that might affect LES pressure such as anticholinergics or calcium channel antagonists
• Symptom duration greater than 2 years
• Inability to read due to: Blindness, cognitive dysfunction, or English language illiteracy
• Disorders which predispose to unreliable responses such as Schizophrenia, Alzheimer's disease or significant memory loss
• Pregnant and lactating females will be excluded as steroids are not thought safe for the fetus.