Achalasia is a chronic incurable esophageal motility disorder characterized by 
impaired lower esophageal sphincter (LES) relaxation and loss of esophageal 
peristalsis. Although rare, it is currently the most common primary esophageal 
motility disorder, with an annual incidence of around 1.6 per 100,000 persons 
and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include 
dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and 
weight loss. As the underlying etiology of achalasia remains unclear, there is 
currently no curative treatment for achalasia. Management of achalasia mainly 
involves improving the esophageal outflow in order to provide symptomatic relief 
to patients. The most effective treatment options for achalasia include 
pneumatic dilation, Heller myotomy and peroral endoscopic myotomy (POEM), with 
the latter increasingly emerging as the treatment of choice for many patients. 
This review focusses on evidence for current and emerging treatment options for 
achalasia with a particular emphasis on POEM.