Background: Achalasia is a primary esophageal motor disorder of unknown etiology. One of the standard treatments is pneumatic balloon dilatation under fluoroscopic guidance. Endoscopic-guided balloon dilatation without fluoroscopy can also be performed, but the efficacy and associated safety issues remain unclear.

Objective: To assess efficacy and safety of endoscopic-guided balloon dilatation technique for achalasia treatment at Maharaj Nakorn Chiang Mai Hospital.

Materials and Methods: This study is a retrospective, descriptive study in achalasia patients who were initially diagnosed and treated with the endoscopic-guided balloon dilatation technique between January 2007 and December 2012. Achalasia symptoms before and after treatment were evaluated to assess the efficacy. Immediate complications and long term follow-up were used to assess safety of this method.

Results: Sixteen eligible achalasia patients who underwent the dilatation under endoscopic guidance were included in the analysis. There was a significant improvement in Eckardt score from 6.6+1.9 to 0.5+0.7 (p-value <0.001). All patients (100%) had improvement in dysphagia symptoms and gained weight after the dilatation procedure. No serious complications were observed.

Conclusion: Endoscopic guided pneumatic balloon dilatation as an initial treatment of achalasia is a safe technique and has a high level of efficacy.

Keywords: Achalasia, Endoscopy, Fluoroscopy, Pneumatic balloon dilatation