Monitoring
After initial treatment with pneumatic dilatation, cardiomyotomy, peroral endoscopic myotomy, or botulinum toxin injection, periodic clinical review is recommended to assess the degree of symptom relief. Follow-up timed barium studies, oesophageal scintigraphy, or manometry enable objective measurements of treatment response. The investigation chosen will depend on local resources and expertise. In patients with long-standing achalasia, clinical vigilance, and possibly regular surveillance endoscopy at 3- to 5-year intervals, is needed for prompt recognition of oesophageal malignancy, a rare complication with a poor prognosis. However, there is no consensus on how often surveillance endoscopy should be performed.[82]
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