Heartburn in patients with achalasia.

Spechler, Stuart J.; Souza, Rhonda F.; Rosenberg, Stanley J.; Ruben, Robert A.; Goyal, Raj K.

doi:10.1136/gut.37.3.305

Cited by 104 publications

(58 citation statements)

References 12 publications

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“…Heartburn occurs frequently in achalasia. Patients with heartburn have lower LES pressures than those without this symptom [19] . Heartburn may occur as a result of gastro-esophageal reflux or other causes, such as direct irritation of the esophageal mucosa by foods, pills, and the lactate produced by bacterial fermentation of retained carbohydrates [19,20] .…”

Section: Clinical Featuresmentioning

confidence: 91%

“…Patients with heartburn have lower LES pressures than those without this symptom [19] . Heartburn may occur as a result of gastro-esophageal reflux or other causes, such as direct irritation of the esophageal mucosa by foods, pills, and the lactate produced by bacterial fermentation of retained carbohydrates [19,20] . Hiccup is also a frequent symptom in achalasia, partly because of the obstruction of the distal esophagus [21] .…”

Section: Clinical Featuresmentioning

confidence: 91%

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Achalasia: A review of Western and Iranian experiences

Mikaeli¹,

Islami²,

Malekzadeh³

2009

WJG

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Achalasia is a primary motor disorder of the eso phagus, in which esophageal emptying is impaired. Diagnosis of achalasia is based on clinical findings. The diagnosis is confirmed by radiographic, endoscopic, and manometric evaluations. Several treatments for achalasia have been introduced. We searched the PubMed Database for original articles and meta analyses about achalasia to summarize the current knowledge regarding this disease, with particular focus on different procedures that are used for treatment of achalasia. We also report the Iranian experience of treatment of this disease, since it could be considered as a model for mediumresource countries. Myotomy, particularly laparoscopic myotomy with fundoplication, i s t h e m o s t e ffe c t i ve t re a t m e n t fo r a c h a l a s i a . Compared to other treatments, however, the initial cost of myotomy is usually higher and the recovery period is longer. When performing myotomy is not indicated or not possible, graded pneumatic dilation with slow rate of balloon inflation seems to be an effective and safe initial alternative. Injection of botulinum toxin into the lower esophageal sphincter before pneumatic dilation may increase remission rates. However, this needs to be confirmed in further studies. Due to lack of adequate information regarding the role of expandable stents in the treatment of achalasia, insertion of stents does not currently seem to be a recommended treatment. In summary, laparoscopic myotomy can be considered as the procedure of choice for treatment of achalasia. Graded pneumatic dilation is an effective alternative when the performance of myotomy is not possible for any reason.

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Section: Clinical Featuresmentioning

confidence: 91%

Section: Clinical Featuresmentioning

confidence: 91%

Achalasia: A review of Western and Iranian experiences

Mikaeli¹,

Islami²,

Malekzadeh³

2009

WJG

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“…19,20 However, whether the low esophageal pH in these patients is caused by retention of lactic acid from bacterial fermentation of retained food or true refluxed gastric acid is controversial. Spechler et al 10 showed that patients who have achalasia with heartburn have lower basal LES pressure than patients without heartburn. Because GERD and achalasia are 2 coincidental diseases, patients with heartburn have lower basal LES pressure due to GERD.…”

Section: Are Gastroesophageal Reflux Disease and Achalasia Coincidentmentioning

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.…”

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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