Achalasia: should we or should we not follow the bag?

This article concerns the long-term therapeutic effect of pneumatic dilations (PDs) in achalasia. Specifically, it is a retrospective study that follows a large cohort of achalasia patients treated with PD. Efficacy and need for repeat PDs were determined utilizing a score obtained from measuring symptoms after PD. After PDs that resulted in symptomatic improvement, patients were followed at 6-month intervals to determine the need for repeat PD. The major point of this article is that exacerbations of symptoms may occur in 35% of patients undergoing PD; however, follow-up at specific intervals using a symptom score to determine the need for repeat PD resulted in excellent long-term success. This article emphasizes the need for continued follow-up of achalasia patients following initial successful therapy.