Original Scientific ArticlesManometric and radiographic verification of esophageal body decompensation for patients with achalasia1
Section snippets
Methods
Sixty-three patients (36 women and 27 men) with a median age of 44 years (range 11 to 79 years) were evaluated. All patients underwent manometry and most patients had a barium swallow to establish the diagnosis of achalasia. The duration of symptoms ranged from 1 to 442 months, with a median of 48 months. Patients were divided into four groups according to the duration of symptoms: 36 patients with less than 5 years, 11 with 5 to 10 years, 9 with 10 to 15 years, and 7 with 15 years or more.
Results
Differences in age at the time of clinic visit, age of onset, gender, and weight among the groups categorized by the duration of symptoms are shown in Table 1. There was no difference in gender or weight among the groups. The median age at clinic visit for patients with a symptom duration of less than 5 years was significantly younger. There was no significant difference in age of onset.
The average resting pressure of the LES, measured by manometry, in patients experiencing symptoms for less
Discussion
It is commonly accepted that achalasia is a progressive disorder. In this investigation of four groups of patients categorized by duration of symptoms (patient gender, weight, age at onset, and diagnosis were equivalent among groups, as established by the Kruskal-Wallis test), we objectively confirmed by both manometric and radiographic data the progressive nature of achalasia. We also demonstrated for the first time that contraction pressure at each level of the esophageal body was weaker in
References (23)
- et al.
Achalasia, diffuse esophageal spasm, and related motility disorders
Gastroenterology
(1979) - et al.
Syndrome of vigorous achalasia. Clinical and physiologic observations
Dis Chest
(1967) - et al.
Apparent complete lower esophageal sphincter relaxation in achalasia
Gastroenterology
(1986) - et al.
Abnormal esophageal motility. An analysis of concurrent radiographic and manometric findings
Gastroenterology
(1991) Esophageal motor disorders
Surg Clin North Am
(1987)- et al.
Manometric patterns using esophageal body and lower sphincter characteristics. Findings in 1013 patients
Dig Dis Sci
(1992) - et al.
Achalasia. A morphologic study of 42 resected specimens
Am J Surg Pathol
(1994) - et al.
Gastroesophageal sphincter pressure and histological changes in distal esophagus in patients with achalasia of the esophagus
Dig Dis Sci
(1985) - et al.
Esophageal myoplicature in the treatment of decompensated achalasia
Chirurg
(1979) - et al.
Esophageal resection with colon interposition for end-stage achalasia
Arch Surg
(1995)
The natural history of achalasia of the cardia
Proc R Soc Med
Cited by (35)
Impact of peroral endoscopic myotomy on high-resolution manometry findings and their association with the procedure's outcomes
2023, Gastrointestinal EndoscopyMinimally Invasive “3-Stitch” Modification of the Dor Fundoplication: Simple and Effective
2022, Annals of Thoracic SurgeryThe Risk of Esophageal Resection After Esophagomyotomy for Achalasia
2009, Annals of Thoracic SurgeryThe outcome of laparoscopic heller myotomy for achalasia is not influenced by the degree of esophageal dilatation
2008, Journal of Gastrointestinal SurgeryLong-term outcome of Heller myotomy in achalasic sigmoid esophagus
2004, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Yet in this patient group we observed a greater regurgitation score and more frequent respiratory symptoms. In accordance with our results, Shiino and colleagues20 have found that the maximal width of the esophageal body and tortuosity of the esophagus measured on esophagography became greater with longer symptom duration. Nonetheless, in our series the postoperative regurgitation score decreased to the level of the control group, and no patient repeated respiratory symptoms postoperatively.
Cytogenetic alterations in chagasic achalasia compared to esophageal carcinoma
2004, Cancer Genetics and Cytogenetics
- 1
No competing interests declared.