Pneumatic dilatation in achalasia.

Fellows, Ian; Ogilvie, A L; Atkinson, Michael

doi:10.1136/gut.24.11.1020

Cited by 113 publications

(37 citation statements)

References 11 publications

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“…It seems likely that no single therapeutic technique will be found to be optimal for all patients with achalasia. Our findings extend those reported earlier [2] that pneumatic di latation is significantly more effective in the elderly than in the younger patient. Although oesophageal dilatation is commoner in the older patients, relief from pneumatic dilata tion is not explicable on this basis.…”

Section: Discussionsupporting

confidence: 81%

“…Elderly patients present prob lems in management, and an earlier study suggested that pneumatic dilatation of the cardia may be particularly effective in this age-group [2]. This paper presents the long-term results of pneumatic dilatation for achalasia over an 11-year period, examined in relation to age and other factors of possible prognostic sig nificance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Choice of Therapy for Achalasia in Relation to Age

Cs¹,

Fellows²,

Mayberry³

et al. 1988

Digestion

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Over an 11-year period 132 patients with achalasia underwent a total of 253 pneumatic bag dilatations of the cardia as the initial treatment. Adequate symptomatic relief was obtained in the majority, but 16 needed cardiomyotomy after pneumatic dilatation had failed to give lasting symptomatic relief. Older patients, aged 60 years or more, showed longer-lasting improvement with pneumatic dilatation than did younger ones and only 1 patient over 50 required cardiomyotomy. Benefit from pneumatic dilatation showed a closer relationship to age than to oesophageal diameter. Of 50 patients followed for more than 5 years, 48% required no further treatment, 40% needed at least one further dilatation to achieve symptomatic relief and 12 % came to cardiomyotomy. This study suggests that pneumatic dilatation is safe, effective and particularly useful in the management of the elderly achalasic patient.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Choice of Therapy for Achalasia in Relation to Age

Cs¹,

Fellows²,

Mayberry³

et al. 1988

Digestion

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“…In these studies, advanced age, a moderately dilated esophagus and a long history of symptoms prior to diagnosis were all found to predict a favorable treatment result [14,[25][26][27] , whereas male gender was found to predict a poor outcome [15] . However, the most significant factor predicting response to treatment appears to be the age at diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of pneumatic dilation for achalasia: A 15 years’ experience

Katsinelos¹,

Kountouras²,

Paroutoglou³

et al. 2005

WJG

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AIM:Although most patients with achalasia respond to pneumatic dilation, one-third experienced recurrence, and prolonged follow-up studies on parameters associated with various outcomes are scanty. In this retrospective study, we reported a 15-years' experience with pneumatic dilation treatment in patients with primary achalasia, and determined whether previously described predictors of outcome remain significant after endoscopic dilation. METHODS:Between September 1989 and September 2004, 39 consecutive patients with primary symptomatic achalasia (diagnosed by clinical presentation, esophagoscopy, barium esophagogram, and manometry) who received balloon dilation were followed up at regular intervals in person or by phone interview. Remission was assessed by a structured interview and a previous symptoms score. The median dysphagia-free duration was calculated by Kaplan-Meier analysis. RESULTS:Symptoms were dysphagia (n = 39, 100%), regurgitation (n = 23, 58.7%), chest pain (n = 4, 10.2%), and weight loss (n = 26, 66.6%). A total of 74 dilations were performed in 39 patients; 13 patients (28%) underwent a single dilation, 17 patients (48.7%) required a second procedure within a median of 26.7 mo (range 5-97 mo), and 9 patients (23.3%) underwent a third procedure within a median of 47.8 mo (range 37-120 mo). Post-dilation lower esophageal sphincter (LES) pressure, assessed in 35 patients, has decreased from a baseline of 35.8±10.4-10.0±7.1 mmHg after the procedure. The median follow-up period was 9.3 years (range 0.5-15 years). The dysphagiafree duration by Kaplan-Meier analysis was 78%, 61% and 58.3% after 5, 10 and 15 years respectively. CONCLUSION:Balloon dilation is a safe and effective treatment for primary achalasia. Post-dilation LES pressure estimation may be useful in assessing response.

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“…28 The mean delay in diagnosis is 5 years (range, 2-7 years). [29][30][31][32][33][34][35] Howard et al 36 reported that 36.8% of achalasia patients had been treated for GERD. Additionally, Rosenzweig and Traube 9 showed that the initial diagnosis was achalasia in only 12 of out 25 achalasia patients, whereas the other 13 patients were diagnosed incorrectly.…”

Section: Attributing Factors For Diagnostic Delay In Achalasiamentioning

confidence: 99%

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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Pneumatic dilatation in achalasia.

Cited by 113 publications

References 11 publications

Choice of Therapy for Achalasia in Relation to Age

Choice of Therapy for Achalasia in Relation to Age

Long-term results of pneumatic dilation for achalasia: A 15 years’ experience

Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

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