Achalasia and Gut Microbiota: Is Dysbiosis an Overlooked Factor in Postoperative Surgical Outcomes? Article Swipe
Agostino Fernicola
,
Giuseppe Palomba
,
Armando Calogero
,
Antonella Sciarra
,
Annachiara Cavaliere
,
Felice Crocetto
,
Caterina Sagnelli
,
Antonio Alvigi
,
Raffaele Basile
,
Domenica Pignatelli
,
Andrea Paolillo
,
Federico Maria D’Alessio
,
Giacomo Benassai
,
Gennaro Quarto
,
Michele Santangelo
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3390/surgeries6030063
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3390/surgeries6030063
Background: Esophageal achalasia is a rare motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and food stasis. Surgical interventions, including Heller myotomy with fundoplication or peroral endoscopic myotomy (POEM), effectively alleviate symptoms but induce significant anatomical and functional alterations. In various gastrointestinal surgeries, microbiota have been implicated in modulating clinical outcomes; however, their role in achalasia surgery remains unexplored. Methods: We performed a narrative literature search of various databases to identify studies exploring potential interactions between the gastroesophageal microbiota, achalasia pathophysiology, and surgical treatment, proposing clinical implications and future research avenues. Results: Chronic esophageal stasis in achalasia promotes local dysbiosis by facilitating aberrant bacterial colonization. Surgical restoration of esophageal motility and gastroesophageal transit induces substantial shifts in the microbial ecosystem. Analogous microbiota alterations following procedures such as fundoplication, gastrectomy, and bariatric surgery underscore the significant impact of mechanical modifications on microbial composition. Comprehensive microbiota profiling in patients with achalasia may enable the identification of dysbiotic phenotypes predisposed to complications, thereby providing personalized therapeutic interventions including probiotics, prebiotics, dietary modulation, or targeted antibiotic therapy. These insights hold promise for clinical benefits, including the mitigation of inflammation and infection, monitoring of surgical efficacy through microbial biomarkers, and optimization of postoperative nutritional strategies to reestablish microbial homeostasis, ultimately enhancing patient outcomes beyond conventional treatment paradigms. Conclusions: The gastroesophageal microbiota is a compelling mediator of surgical outcomes in achalasia. Future investigations integrating microbiological and inflammatory profiling are warranted to elucidate the functional role of the gastroesophageal microbiota and assess its potential as a biomarker and therapeutic target.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/surgeries6030063
- https://www.mdpi.com/2673-4095/6/3/63/pdf?version=1753701786
- OA Status
- gold
- Cited By
- 1
- References
- 98
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4412699217
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4412699217Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3390/surgeries6030063Digital Object Identifier
- Title
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Achalasia and Gut Microbiota: Is Dysbiosis an Overlooked Factor in Postoperative Surgical Outcomes?Work title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-07-28Full publication date if available
- Authors
-
Agostino Fernicola, Giuseppe Palomba, Armando Calogero, Antonella Sciarra, Annachiara Cavaliere, Felice Crocetto, Caterina Sagnelli, Antonio Alvigi, Raffaele Basile, Domenica Pignatelli, Andrea Paolillo, Federico Maria D’Alessio, Giacomo Benassai, Gennaro Quarto, Michele SantangeloList of authors in order
- Landing page
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https://doi.org/10.3390/surgeries6030063Publisher landing page
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https://www.mdpi.com/2673-4095/6/3/63/pdf?version=1753701786Direct link to full text PDF
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
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https://www.mdpi.com/2673-4095/6/3/63/pdf?version=1753701786Direct OA link when available
- Concepts
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Achalasia, Dysbiosis, Medicine, Gut flora, Gastroenterology, Internal medicine, Esophagus, ImmunologyTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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98Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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