LAUSR

progression from nutcracker esophagus [NE; the Chicago Classification (2012 version)] to JE was observed during the course of 2 of the 4 patients. In 1 of the 4 patients, the symptoms improved in the absence of treatment. Among the 3 patients who received treatment, the symptoms of 2 patients were controlled within tolerable intensity by conservative treatment, but surgical treatment was selected in the other case. However, because the symptoms recurred after the operation, peroral endoscopic myotomy was performed in addition. Conclusions Because the pathology at the onset and clinical course of JE are not uniform, it is necessary to tailor treatment policy to each individual case and to consider altering treatment policy according to the patient’s clinical course.