Pneumatic balloon dilatation for achalasia-how and why I do it

Pneumatic balloon dilatation for the treatment of achalasia has been used for over a century and continues to have a role. Although relatively simple to perform, there are multiple steps that should be followed to deliver the treatment safely and effectively, and these are detailed. The results of pneumatic dilatation have been compared to those of laparoscopic cardiomyotomy and to per-oral endoscopic myotomy (POEM) and suggest that, provided multiple balloon dilatations are performed, acceptable results can be attained. In patients treated with a previous myotomy, or with anatomical challenges in accessing the hiatus, pneumatic dilatation is a useful option in the treatment of achalasia.