Background

Achalasia is a rare disorder with annual incidence of 0.0016%. It typically is associated with gradual onset of symptoms which include dysphagia, regurgitation of undigested food, substernal chest pain, heartburn, globus sensation, and weight loss. Several treatments exist, however, a surgical approach with Heller myotomy is a commonly performed modality with success rates reported at 90% in initial symptom management. In our high-volume bariatric center, we have evaluated and treated multiple patients who have both achalasia and obesity. One known complication of a Heller Myotomy is reflux. Obesity can also predispose people to reflux. One potential advantage to concurrent Roux-en-Y gastric bypass and Heller Myotomy is the prevention of this known complication. In this case presentation, we demonstrate that Heller Myotomy with concurrent Roux-en-Y gastric bypass is a safe and effective treatment from those suffering from obesity and achalasia.