Esophageal motility disorders

Since the first surgical techniques for esophageal motility disorders were described in the early twentieth century, the Atlas of knowledge in regarding its varied pathology has grown immensely. Workup is multimodal using a variety of functional imaging and physiologic tools. Medical management, while typically first line, is mostly ineffective. Over the past several decades, the Heller myotomy has been the cornerstone of surgical therapy. However, now recently with the advent of the endoscopic myotomy, for both achalasia and nonachalasia motility disorders, procedural therapy has seen showing increasing success in the past 10 years. A small subset of patient will have persistent disease despite maximum medical and surgical management and go on to require esophagectomy.