Fig. 4. Serial endoscopic images of patients before diagnosing achalasia and performing peroral endoscopic myotomy (POEM). (A) The patient who was followed up for reflux esophagitis showed a narrowing gastroesophageal junction (GEJ) and slightly dilated lower esophagus from the time of dysphagia onset. (B) The patient who was followed up for regurgitation and intermittent dysphagia showed a narrowing GEJ and spastic contractions in the lower esophagus from the time dysphagia became more frequent and severe.
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