UK incidence of achalasia: an 11-year national epidemiological study

Marlais, Matko; Fishman, James R.; Fell, John; Haddad, Munther J.; Rawat, David

doi:10.1136/adc.2009.171975

Cited by 99 publications

(56 citation statements)

References 6 publications

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“…The three patients with nutcracker oesophagus in G1 were all symptomatic but had normal barium swallow findings. On the other hand, studies in Central Brazil shows that around 10% of achalasia was idiopathic, and even if patients came for CD endemic regions, in some countries of Europe the incidence of new cases of achalasia ranged between 0.018/100.000/year [37] and 1.59 cases/100.000/year [38], [39].…”

Section: Discussionmentioning

confidence: 99%

Characterization of Digestive Involvement in Patients with Chronic T. cruzi Infection in Barcelona, Spain

et al. 2014

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BackgroundDigestive damage due to Chagas disease (CD) occurs in 15–20% of patients diagnosed as a result of peristaltic dysfunction in some endemic areas. The symptoms of chronic digestive CD are non-specific, and there are numerous confounders. Diagnosis of CD may easily be missed if symptoms are not evaluated by a well trained physician. Regular tests, as barium contrast examinations, probably lack the necessary sensitivity to detect early digestive damage.Methods71 individuals with T. cruzi infection (G1) and 18 without (G2) coming from Latin American countries were analyzed. They were asked for clinical and epidemiological data, changes in dietary habits, and history targeting digestive and cardiac CD symptoms. Serological tests for T. cruzi, barium swallow, barium enema, an urea breath test, and esophageal manometry were requested for all patients.Principal findingsG1 and G2 patients did not show differences in lifestyle and past history. Fifteen (21.1%) of G1 had digestive involvement. Following Rezende criteria, esophagopathy was observed in 8 patients in G1 (11.3%) and in none of those in G2. Manometry disorders were recorded in 34 G1 patients and in six in G2. Isolated hypotensive lower esophageal sphincter (LES) was found in sixteen G1 patients (23.9%) and four G2 patients (28.8%). Achalasia was observed in two G1 patients. Among G1 patients, ineffective esophageal motility was seen in six (five with symptoms), diffuse esophageal spasm in two (one with dysphagia and regurgitation), and nutcracker esophagus in three (all with symptoms). There were six patients with hypertonic upper esophageal sphincter (UES) among G1. Following Ximenes criteria, megacolon was found in ten G1 patients (13.9%), and in none of the G2 patients.ConclusionsThe prevalence of digestive chronic CD in our series was 21.1%. Dysphagia is a non-pathognomonic symptom of CD, but a good marker of early esophageal involvement. Manometry could be a useful diagnostic test in selected cases, mainly in patients with T. cruzi infection and dysphagia in whose situation barium swallow does not evidence alterations. Constipation is a common but non-specific symptom that can be easily managed. Testing for CD is mandatory in a patient from Latin America with constipation or dysphagia, and if diagnosis is confirmed, megacolon and esophageal involvement should be investigated.

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Section: Discussionmentioning

confidence: 99%

Characterization of Digestive Involvement in Patients with Chronic T. cruzi Infection in Barcelona, Spain

et al. 2014

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“…Cardinal symptoms of reflux (painful regurgitation and burning epigastric pain) were not found in our sample of children with rumination. In addition organic conditions like achalasia and bulimia nervosa are rare diseases in children [32-34]. …”

Section: Discussionmentioning

confidence: 99%

Rumination syndrome in children and adolescents: a school survey assessing prevalence and symptomatology

2012

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BackgroundRumination syndrome (RS) is a functional gastrointestinal disorder (FGD) increasingly recognized in children and adolescents. The epidemiology of this condition in school aged children is poorly understood. The main objective of this study was to assess the prevalence of rumination and other related associations in a cohort of Sri Lankan children.MethodsChildren aged 10-16 years were randomly selected from 8 schools in 4 provinces in Sri Lanka. RS was diagnosed using Rome III criteria. Data was collected using a self administered questionnaire distributed in an examination setting. It was translated into Sinhala, the native language and pretested before distribution.ResultsA total of 2163 children were included in the study (55% boys, mean age 13.4 years, SD 1.8 years). Prevalence of RS was 5.1% (n = 110); boys 5.1% and girls 5.0%. When symptoms were analyzed, 73.6% reported re-swallowing of regurgitated food, while the rest spat it out. In 94.5% regurgitation occurred during the first hour after the meal. Only 8.2% had daily symptoms while 62.7% had symptoms weekly. Abdominal pain, bloating and weight loss were the commonest symptoms associated with RS (19.1%, 17.3% and 11.8% respectively). No significant association was observed between exposure to stressful events and rumination (p > 0.05). Twenty (18.2%) with RS fulfilled Rome III criteria for at least one other FGD. School absenteeism was seen in 11.8% of affected children.ConclusionRS was reasonably common in this cohort of school-aged children and adolescents in Sri Lanka. However, symptoms were severe enough to affect schooling only in 12% of affected children. Around one fifth with RS had at least one other overlapping FGD.

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“…A barium swallow revealed narrowing of the lower oesophagus with "rat tail" appearance, proximal distension and fluid level characteristic of Achalasia. Results Achalasia is rare in the paediatric population (0.18 per 100,000 children) 1 . It is characterised by the absence of oesophageal peristalsis with increased resting pressure and failure of relaxation of the lower oesophageal sphincter 2 .…”

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confidence: 99%

G447(P) Evaluation of the condition of immune response in children of an early age with paroxysmal disorders

Sozaeva

Berezhanskaya

Afonin

2014

Archives of Disease in Childhood

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Aims To study immunologic mechanisms of paroxysmal states in children with cerebral hypoxia-ischaemia and its consequences in the 1st year of life. Methods We performed prospective clinical-laboratory examination of 60 newborn babies and infants. The examined children were divided into 2 groups: the 1st group was comprised of children with paroxysmal disorders (n = 40) born to mothers with high factors of perinatal risk. The 2nd (control) group consisted of children born to healthy women with physiological course of gestation and labour (n = 20). The examination took place during neonatal period, at the age of 6 months and 1 year. Paroxysmal disorders were represented by the generalised tonic-clonic seizures, isolated focal seizures, focal seizures with secondary generalisation, myoclonias and atonic-astatic seizures. The population structure of lymphocytes of the peripheral blood was determined by means of phenotyping using Beckman Coulter Epics XL-II flow cytofluorometer according to the attached records. Results It was revealed that prognostic indices of the origin of paroxysmal states in the examined group of children were the increase and progredient growth of the level of the activation markers of T-lymphocytes and receptors to IL–2: CD25+, CD95+, CD4+ CD122+, in the peripheral blood over the observation time. They were indicative of an active response of the immune system and cytokine balance shifting towards T-helper cells of the 1st type. Conclusion The development of paroxysmal disorders in children of the early age takes place with systemic disturbances of the mechanisms of immune response and it shows the advisability of further more thorough study of the immune status in the examined group of children.

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UK incidence of achalasia: an 11-year national epidemiological study

Abstract: The mean incidence of childhood achalasia in the UK from 1998 to 2008 is at least 0.18/10(5) children/year; this has risen over the last 11 years and compared to the only other study published in 1988.

Cited by 99 publications

References 6 publications

Characterization of Digestive Involvement in Patients with Chronic T. cruzi Infection in Barcelona, Spain

Characterization of Digestive Involvement in Patients with Chronic T. cruzi Infection in Barcelona, Spain

Rumination syndrome in children and adolescents: a school survey assessing prevalence and symptomatology

G447(P) Evaluation of the condition of immune response in children of an early age with paroxysmal disorders

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