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Clinical Characteristics of Patients with Untreated Achalasia

Authors
 Han Ho Jeon  ;  Jie-Hyun Kim  ;  Young Hoon Youn  ;  Hyojin Park  ;  Jeffrey L Conklin 
Citation
 JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY, Vol.23(3) : 378-384, 2017 
Journal Title
 JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY 
ISSN
 2093-0879 
Issue Date
2017
Keywords
Diagnosis ; Esophageal achalasia ; Gastroesophageal reflux
Abstract
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.
Files in This Item:
T201703077.pdf Download
DOI
10.5056/jnm16177
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160701
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