{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:29:10Z","timestamp":1787020150498,"version":"build-2736575974"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pneumatic dilation (PD) is often billed as a \u201cshort term\u201d treatment for achalasia but anecdotally can last years. This study sought to explore how long a single pneumatic dilation may induce symptom remission in a treatment-na\u00efve achalasia patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single center, retrospective chart review of patients with an ICD-9 or\u2009\u2212\u200910 code of achalasia between 2005 and 2017 was performed. Treatment na\u00efve patients with manometric diagnosis of primary achalasia were included. Outcomes (success or failure); single vs multiple PD; age; and estimated duration of effect were evaluated. Each patient underwent a single PD unless re-intervention was required for relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      83 patients (52% female, median 51.6\u2009\u00b1\u20093.6\u2009years) were included. 43% underwent 2 PD and 13% underwent 3 PD. There was no significant relation between age, gender, and number of PDs. After 1 PD, 87.5% of patients reported &gt;\u20091\u2009year of symptom remission. 80.5% of relapsed patients reported success after a 2nd dilation. 1 PD was more likely to result in success than multiple PDs (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001). The measured median duration of remission after 1 PD was 4.23\u2009years, and for 2 PDs, 3.71\u2009years. The median estimated remission time after 1 PD was 8.5\u2009years (CI 7.3\u20139.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PD is a safe, durable treatment for achalasia. A single PD is likely to last years. A second PD, if required, also has a high likelihood of success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-019-1104-z","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T09:03:25Z","timestamp":1573463005000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Durability of pneumatic dilation monotherapy in treatment-naive achalasia patients"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4953-9739","authenticated-orcid":false,"given":"Abid T.","family":"Javed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Batte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Khalaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Abdul-Hussein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja S.","family":"Elias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald O.","family":"Castell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"1104_CR1","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1056\/NEJM197907263010404","volume":"301","author":"S Cohen","year":"1979","unstructured":"Cohen S. Motor disorders of the esophagus. N Engl J Med. 1979;301:184\u201392.","journal-title":"N Engl J Med"},{"issue":"1","key":"1104_CR2","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/0016-5085(80)90090-6","volume":"79","author":"G Vantrappen","year":"1980","unstructured":"Vantrappen G, Hellemans J. Treatment of achalasia and related motor disorders. Gastroenterology. 1980;79(1):144\u201354.","journal-title":"Gastroenterology."},{"key":"1104_CR3","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1111\/j.1572-0241.2005.41775.x","volume":"100","author":"W Park","year":"2005","unstructured":"Park W, Vaezi MF. Etiology and pathogenesis of achalasia: the current understanding. Am J Gastroenterol. 2005;100:1404\u201314.","journal-title":"Am J Gastroenterol"},{"issue":"401","key":"1104_CR4","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1007\/s00535-017-1314-5","volume":"52","author":"J Tuason","year":"2017","unstructured":"Tuason J, Inoue H. Current status of achalasia management: a review on diagnosis and treatment. J Gastroenterol. 2017;52(401):401\u20136.","journal-title":"J Gastroenterol"},{"issue":"3","key":"1104_CR5","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.cgh.2016.08.030","volume":"15","author":"S Samo","year":"2017","unstructured":"Samo S, Carlson DA, Gregory DL, Gawel SH, Pandolfino JE, Kahrilas PJ. Incidence and prevalence of achalasia in Central Chicago, 2004-2014, since the widespread use of high-resolution Manometry. Clin Gastroenterol Hepatol. 2017;15(3):366\u201373.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"1104_CR6","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.cgh.2016.05.036","volume":"15","author":"JA Duffield","year":"2017","unstructured":"Duffield JA, Hamer PW, Heddle R, Holloway RH, Myers JC, Thompson SK. Incidence of achalasia in South Australia based on esophageal Manometry findings. Clin Gastroenterol Hepatol. 2017;15(3):360\u20135.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"12","key":"1104_CR7","first-page":"209","volume":"109","author":"I Gockel","year":"2012","unstructured":"Gockel I, M\u00fcller M, Schumacher J. Achalasia--a disease of unknown cause that is often diagnosed too late. Dtsch Arztebl Int. 2012;109(12):209\u201314.","journal-title":"Dtsch Arztebl Int"},{"issue":"2","key":"1104_CR8","first-page":"a810","volume":"8","author":"H Winter","year":"2015","unstructured":"Winter H, Shukla R, Elshaer M, et al. Current management of achalasia \u2013 a review. BJMP. 2015;8(2):a810.","journal-title":"BJMP"},{"issue":"18","key":"1104_CR9","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.1001\/jama.2015.2996","volume":"313","author":"JE Pandolfino","year":"2015","unstructured":"Pandolfino JE, Gawron AJ. Achalasia: a systematic review. JAMA. 2015 May 12;313(18):1841\u201352.","journal-title":"JAMA."},{"issue":"6","key":"1104_CR10","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1097\/MCG.0000000000000137","volume":"48","author":"A Moonen","year":"2014","unstructured":"Moonen A, Boeckxstaens G. Current diagnosis and management of achalasia. J Clin Gastroenterol. 2014;48(6):484\u201390.","journal-title":"J Clin Gastroenterol"},{"issue":"2","key":"1104_CR11","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1111\/nmo.12477","volume":"27","author":"PJ Kahrilas","year":"2015","unstructured":"Kahrilas PJ, Bredenoord AJ, Fox M. Et al; international high resolution Manometry working group. The Chicago classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27(2):160\u201374.","journal-title":"Neurogastroenterol Motil"},{"issue":"5","key":"1104_CR12","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1053\/j.gastro.2008.07.022","volume":"135","author":"JE Pandolfino","year":"2008","unstructured":"Pandolfino JE, Kwiatek MA, Nealis T, Bulsiewicz W, Post J, Kahrilas PJ. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology. 2008;135(5):1526\u201333.","journal-title":"Gastroenterology."},{"issue":"6","key":"1104_CR13","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1016\/0016-5085(92)91428-7","volume":"103","author":"VF Eckardt","year":"1992","unstructured":"Eckardt VF, Aignherr C, Bernhard G. Predictors of outcome in patients with achalasia treated by pneumatic dilation. Gastroenterology. 1992;103(6):1732\u20138.","journal-title":"Gastroenterology."},{"issue":"120","key":"1104_CR14","first-page":"2503","volume":"59","author":"C Gheorghe","year":"2012","unstructured":"Gheorghe C, Bancila I. Tutuian R et alPredictors of short term treatment outcome in patients with achalasia following endoscopic or surgical therapy. Hepatogastroenterology. 2012;59(120):2503\u20137.","journal-title":"Hepatogastroenterology"},{"key":"1104_CR15","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1053\/j.gastro.2013.08.038","volume":"145","author":"PJ Kahrilas","year":"2013","unstructured":"Kahrilas PJ, Boeckxstaens G. The spectrum of achalasia: lessons from studies of pathophysiology and high-resolution manometry. Gastroenterology. 2013;145:954\u201365.","journal-title":"Gastroenterology"},{"key":"1104_CR16","doi-asserted-by":"crossref","unstructured":"Rohof WO, Salvador R, Annese V et al. Outcomes of treatment for achalasia depend on manometric subtype. Gastroenterology 2013;144:718\u2013725; quiz e13-e14.","DOI":"10.1053\/j.gastro.2012.12.027"},{"key":"1104_CR17","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1159\/000452354","volume":"95","author":"E Ihara","year":"2017","unstructured":"Ihara E, Muta K, Fukaura K, Nakamura K. Diagnosis and treatment strategy of achalasia subtypes and Esophagogastric junction outflow obstruction based on high-resolution Manometry. Digestion. 2017;95:29\u201335.","journal-title":"Digestion."},{"issue":"4","key":"1104_CR18","doi-asserted-by":"publisher","first-page":"485","DOI":"10.5056\/jnm.2013.19.4.485","volume":"19","author":"JY Lee","year":"2013","unstructured":"Lee JY, Kim N, Kim SE, et al. Clinical characteristics and treatment outcomes of 3 subtypes of achalasia according to the Chicago classification in a tertiary institute in Korea. J Neurogastroenterol Motil. 2013 Oct;19(4):485\u201394.","journal-title":"J Neurogastroenterol Motil"},{"key":"1104_CR19","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1097\/MCG.0000000000000107","volume":"49","author":"S Clayton","year":"2015","unstructured":"Clayton S, Castell DO. Multiple good options are available for achalasia management. J Clin Gastroenterol. 2015;49:194\u20138.","journal-title":"J Clin Gastroenterol"},{"issue":"1","key":"1104_CR20","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1097\/SLA.0b013e31818e43ab","volume":"249","author":"GM Campos","year":"2009","unstructured":"Campos GM, Vittinghoff E, Rabl C, et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg. 2009;249(1):45\u201357.","journal-title":"Ann Surg"},{"key":"1104_CR21","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1056\/NEJMoa1010502","volume":"36","author":"GE Boeckxstaens","year":"2011","unstructured":"Boeckxstaens GE, Annese V, Des Varannes SB, et al. pneumatic dilation versus laparoscopic Heller\u2019s myotomy for idiopathic achalasia. N Engl J Med. 2011;36:1807\u201316.","journal-title":"N Engl J Med"},{"key":"1104_CR22","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/S1542-3565(05)00986-9","volume":"4","author":"MF Vela","year":"2006","unstructured":"Vela MF, Richter JE, Khandwala F, et al. The long-term efficacy of pneumatic dilatation and Heller myotomy for the treatment of achalasia. Clin Gastroenterol Hepatol. 2006;4:580\u20137.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"5","key":"1104_CR23","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1136\/gutjnl-2015-310602","volume":"65","author":"An Moonen","year":"2015","unstructured":"Moonen A, Annese V, Belmans A et al.. Long-term results of the European achalasia trial: a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy. Gut. May;65(5):732\u2013739.","journal-title":"Gut"},{"key":"1104_CR24","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/S1542-3565(04)00123-5","volume":"2","author":"K Farhoomand","year":"2004","unstructured":"Farhoomand K, Connor JT, Richter JE, et al. Predictors of outcome of pneumatic dilation in achalasia. Clin Gastroenterol Hepatol. 2004;2:389\u201394.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"1104_CR25","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1016\/j.jamcollsurg.2010.01.035","volume":"210","author":"AS Rosemurgy","year":"2010","unstructured":"Rosemurgy AS, Morton CA, Rosas M, et al. A single institution\u2019s experience with more than 500 laparoscopic Heller myotomies for achalasia. J Am Coll Surg. 2010;210:637\u201345 645\u2013637.","journal-title":"J Am Coll Surg"},{"issue":"2","key":"1104_CR26","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1111\/j.1572-0241.2005.40093.x","volume":"100","author":"G Karamanolis","year":"2005","unstructured":"Karamanolis G, Sgouros S, Karatzias G, et al. Long-term outcome of pneumatic dilation in the treatment of achalasia. Am J Gastroenterol. 2005 Feb;100(2):270\u20134.","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"1104_CR27","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/gut.2003.029298","volume":"53","author":"VF Eckardt","year":"2004","unstructured":"Eckardt VF, Gockel I, Bernhard G. Pneuamtic dilation for achalasia: late results of a prospective follow up investigation. Gut. 2004 May;53(5):629\u201333.","journal-title":"Gut."},{"key":"1104_CR28","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1023\/A:1018898824135","volume":"44","author":"RM Gideon","year":"1999","unstructured":"Gideon RM, Castell DO, Yarze J. Prospective randomized comparison of pneumatic dilatation technique in patients with idiopathic achalasia. Dig Dis Sci. 1999;44:1853.","journal-title":"Dig Dis Sci"},{"key":"1104_CR29","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1111\/j.1572-0241.1998.00330.x","volume":"91","author":"A Khan","year":"1998","unstructured":"Khan A, Shah W, Alam A, et al. Pneumatic balloon dilation in achalasia:a prospective comparison of balloon distention time. Am J Gastroenterol. 1998;91:1064.","journal-title":"Am J Gastroenterol"},{"key":"1104_CR30","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1038\/ajg.2016.248","volume":"111","author":"PS Elias","year":"2016","unstructured":"Elias PS, Castell DO. Pneumatic dilation for achalasia: obliterate the waist! Am J Gastroenterol. 2016;111:1362.","journal-title":"Am J Gastroenterol"},{"issue":"12","key":"1104_CR31","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1038\/ajg.2012.332","volume":"107","author":"KL Lynch","year":"2012","unstructured":"Lynch KL, Pandolfino JE, Howden CW, Kahrilas PJ. Major complications of pneumatic dilation and Heller myotomy for achalasia: single-center experience and systematic review of the literature. Am J Gastroenterol. 2012;107(12):1817\u201325.","journal-title":"Am J Gastroenterol"},{"issue":"3","key":"1104_CR32","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1111\/dote.12314","volume":"29","author":"F Borhan-Manesh","year":"2016","unstructured":"Borhan-Manesh F, Kaviani MJ, Taghavi AR. The efficacy of balloon dilation in achalasia is the result of stretching of the lower esophageal sphincter, not muscular disruption. Dis Esophagus. 2016 Apr;29(3):262\u20136.","journal-title":"Dis Esophagus"},{"key":"1104_CR33","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1023\/A:1018898824135","volume":"44","author":"RM Gideon","year":"1999","unstructured":"Gideon RM, Castell DO, Yarze J. Prospective randomized comparison of pneumatic dilatation technique in patients with idiopathic achalasia. Dig Dis Sci. 1999;44:1853\u20137.","journal-title":"Dig Dis Sci"},{"key":"1104_CR34","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1007\/s00268-006-0600-9","volume":"31","author":"S Kostic","year":"2007","unstructured":"Kostic S, Kjellin A, Ruth M, et al. Pneumatic dilatation or laparoscopic cardiomyotomy in the management of newly diagnosed idiopathic achalasia. Results of a randomized controlled trial. World J Surg. 2007;31:470\u20138.","journal-title":"World J Surg"},{"key":"1104_CR35","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1111\/j.1365-2036.2010.04461.x","volume":"32","author":"PA Novais","year":"2010","unstructured":"Novais PA, Lemme EM. 24-h pH monitoring patterns and clinical response after achalasia treatment with pneumatic dilation or laparoscopic Heller myotomy. Aliment Pharmacol Ther. 2010;32:1257\u201365.","journal-title":"Aliment Pharmacol Ther"},{"key":"1104_CR36","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/dote.12064","volume":"27","author":"AA Borges","year":"2014","unstructured":"Borges AA, Lemme EM, Abrahao LJ Jr, et al. Pneumatic dilation versus laparoscopic Heller myotomy for the treatment of achalasia: variables related to a good response. Dis Esophagus. 2014;27:18\u201323.","journal-title":"Dis Esophagus"},{"issue":"1","key":"1104_CR37","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.cgh.2009.09.020","volume":"8","author":"M Hulselmans","year":"2010","unstructured":"Hulselmans M, Vanuytsel T, Degreef T, et al. Long-term outcome of pneumatic dilation in the treatment of achalasia. Clin Gastroenterol Hepatol. 2010;8(1):30\u20135.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"1104_CR38","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1001\/jama.296.18.2227","volume":"296","author":"SR Lopushinsky","year":"2006","unstructured":"Lopushinsky SR, Urbach DR. Pneumatic dilatation and surgical myotomy for achalasia. JAMA. 2006;296:2227\u201333.","journal-title":"JAMA"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-019-1104-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12876-019-1104-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-019-1104-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T19:22:03Z","timestamp":1604949723000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-019-1104-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,11]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["1104"],"URL":"https:\/\/doi.org\/10.1186\/s12876-019-1104-z","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,11]]},"assertion":[{"value":"30 April 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 October 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This was a retrospective study that utilized chart review. It was approved by our institution\u2019s Institutional Review Board for Human Research with expedited status. No live human subjects were used.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors have no competing interests to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"181"}}