The Pressure Is On: Optimizing Pneumatic Dilation for Achalasia.

Pneumatic dilation (PD) is a minimally invasive, outpatient treatment modality for achalasia that involves expansion of a rigid balloon across the esophagogastric junction (EGJ) to promote EGJ opening. Its efficacy has been demonstrated especially in type I and II achalasia; however, repeat dilation is often necessary. Younger age, male sex, and type III achalasia are negative predictors for treatment success in achalasia using PD. Careful patient selection and shared decision-making with the patients are essential to optimize treatment success and establish realistic outcome expectations.