Clinical, Radiological, and Manometric Profile in 145 Patients with Untreated Achalasia

Fisichella, P. Marco; Raz, Dan J.; Palazzo, Francesco; Niponmick, Ian; Patti, Marco G.

doi:10.1007/s00268-008-9656-z

Cited by 163 publications

(110 citation statements)

References 21 publications

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“…However, the analysis of pH monitoring tracings in all seven patients showed that the abnormal scores were induced by false reflux. 8 Otherwise, among those with a normal reflux profile, a primary esophageal motility disorder such as achalasia or diffuse esophageal spasm occurred in 18% of patients. 24 Patti et al 7 demonstrated that DeMeester scores were abnormal in 14 out of 40 achalasia patients for whom preoperative ambulatory pH was performed.…”

Section: Does Reflux Occur In Achalasia?mentioning

confidence: 97%

“…According to a previous report, proton pump inhibitors were prescribed to 53% of achalasia patients, histamine H 2 blockers to 10%, and both to 6% on the assumption that GERD was the cause of heartburn and regurgitation. 8 Dysphagia occurs in patients with achalasia and is not easily recognized by patients and physicians. 9 Spechler et al 10 demonstrated that in some patients, the dissolution of heartburn and regurgitation and appearance of dysphagia could be a symptom of achalasia.…”

Section: Overlap Between Gastroesophageal Reflux Disease and Achalasiamentioning

confidence: 99%

“…10,17,21,22 Conversely, patients with achalasia are insensitive to acid in the esophagus. 23 Fisichella et al 8 reported data from 145 untreated achalasia patients. Among them, ambulatory pH monitoring was performed for 54 patients.…”

Section: Does Reflux Occur In Achalasia?mentioning

confidence: 99%

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Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Jung

Park

2017

J Neurogastroenterol Motil

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Achalasia and gastroesophageal reflux disease (GERD) are on opposite ends of the spectrum of lower esophageal sphincter dysfunction. Heartburn is the main symptom of GERD. However, heartburn and regurgitation are frequently observed in patients who have achalasia. The diagnosis of achalasia might be delayed because these symptoms are misinterpreted as gastroesophageal reflux. Here, we reviewed the clinical characteristics of patients with the erroneous diagnosis of GERD who actually had untreated achalasia.

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Section: Does Reflux Occur In Achalasia?mentioning

confidence: 97%

Section: Overlap Between Gastroesophageal Reflux Disease and Achalasiamentioning

confidence: 99%

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Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Jung

Park

2017

J Neurogastroenterol Motil

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“…The prevalence of heartburn in our patients with achalasia was 59.4%, which is higher than that reported elsewhere. [9][10][11] It is generally thought that the diagnosis of GERD can be reliably made on the basis of clinical symptoms: if a patient has heartburn or regurgitation it is assumed that acid reflux is present, and therefore a PPI is prescribed. However, symptoms are less sensitive and specific than commonly believed.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Patients with Untreated Achalasia

Jeon

Kim

Youn

et al. 2017

J Neurogastroenterol Motil

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Background/Aims Patients with untreated achalasia frequently complain of heartburn and regurgitation. The diagnosis of achalasia might be delayed because these symptoms are misinterpreted as gastroesophageal reflux. We aim to evaluate the clinical, radiologic, and manometric findings in patient with untreated achalasia. Methods The records of patients diagnosed with primary achalasia between July 2004 and January 2012 at Gangnam Severance Hospital, Seoul, Korea were evaluated. We reviewed their clinical history and the findings of barium esophagogram, upper gastrointestinal endoscopy, and esophageal transit scintigraphy. We also compared the clinical, radiologic, and manometric findings of patients according to heartburn symptoms and proton pump inhibitor use. Results Our study included a total of 64 patients with a median age of 44.5 (interquartile range, 31.5–54.0). The median duration of symptoms was 23.5 (interquartile range, 5.3–57.0) months. Sixty-four patients (100%) had dysphagia, 49 (76.6%) had regurgitation, 35 (54.7%) had chest pain, and 38 (59.4%) had heartburn. Typical clinical features of gastroesophageal reflux disease (GERD) such as regurgitation, heartburn, and chest pain were observed in more than 50% of achalasia patients. Proton pump inhibitors were prescribed for 16 patients (25%) on the assumption that they had GERD. Patients with heartburn were more likely to experience weight loss ( P = 0.009), regurgitation ( P = 0.001), or chest pain ( P = 0.019). Conclusions Heartburn, regurgitation, and chest pain were commonly observed in patients with untreated achalasia. Therefore, these findings suggest that achalasia should be suspected in patients with refractory GERD.

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“…9 기저 하부식도괄약근 압력의 증가, 기저 식 도체부의 안정 시 압력증가, 연동파의 동시수축은 achalasia 진 단에 있어 보조적인 소견이며, 임상적으로 achalasia로 진단했 던 환자의 50%가 기저 하부식도괄약근 압력의 증가 소견이 없 는 것으로 보고되었다. [10][11][12] 식도체부의 무연동증과 불완전한 하 부식도 괄약근 이완소견을 가진 achalasia의 아형과 완전한 하 부식도 괄약근의 이완을 가진 achalasia의 아형은 드물지만 보 고된 바 있다. 13 …”

Section: 식도내압검사unclassified

Diagnosis of Achalasia

Cho

Kim

2014

Korean J Helicobacter Up Gastrointest Res

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Achalasia is a rare primary motor disorder of the esophagus. Achalasia is characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. The patients present with symptoms such as dysphagia, regurgitation and chest pain. The diagnostic tools of achalasia include esophageal manometry, esophagogram, and endoscopy. Esophageal manometry is the gold standard however endoscopy and esophagogram plays complementary roles for diagnosis of achalasia. Endoscopy is essential to rule out pseudoachalasia and mechanical obstruction before diagnosis of achalasia. Esophagogram is recommended to assess esophageal emptying and gastroesophageal junction morphology in those with equivocal esophageal manometry findings.

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Clinical, Radiological, and Manometric Profile in 145 Patients with Untreated Achalasia

Cited by 163 publications

References 21 publications

Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Clinical Characteristics of Patients with Untreated Achalasia

Diagnosis of Achalasia

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