What intervention for achalasia is associated with the risk of developing gastroesophageal reflux disease?

Surgical myotomy, specifically the Heller myotomy, is a common intervention for achalasia that involves cutting the muscle fibers at the lower esophageal sphincter to allow for easier passage of food into the stomach. While this procedure is effective in alleviating the symptoms of achalasia, such as difficulty swallowing, it is also associated with an increased risk of developing gastroesophageal reflux disease (GERD) post-operatively. This happens because the surgery reduces the effectiveness of the lower esophageal sphincter, which normally helps to prevent stomach contents from refluxing back into the esophagus.

Patients who undergo surgical myotomy may experience a more relaxed sphincter, leading to the potential for acid reflux, which can result in symptoms of GERD, such as heartburn and regurgitation. This is an important consideration for both patients and healthcare providers when deciding on the most appropriate treatment for achalasia, as managing the risk of GERD may necessitate additional treatment or lifestyle modifications following the procedure.

In contrast, other interventions like balloon dilation and botulinum toxin injection do not typically lead to the same high incidence of GERD as surgical myotomy. Instead, they tend to provide temporary relief of symptoms without significantly altering the mechanical