Scanty information is available regarding the clinical characteristics, quality of life (QoL) profile and manometric findings in unselected newly diagnosed cases of achalasia. Fifty-six consecutive cases of newly diagnosed achalasia have been characterized regarding the symptoms when a standardized protocol was applied, to which was added a more detailed instrument enabling a comprehensive description of the character of the swallowing difficulties. The functions of the esophageal muscle wall and distal sphincter (LES) were recorded by use of standard manometry technologies and a specialized sleeve catheter. These patients’ health related quality of life (QoL) has been characterized by use of the instruments-Psychological well-being index Gastrointestinal symptom Symptom rating scale Scale. Most patients presented with a long duration of symptoms (54,5 months). The doctor’s delay amounted to 5,5 months despite profound swallowing difficulties (Watson score 30.5+/- 1.7; m+/- SE). QoL was significantly impaired both when generic (PGWB) and disease specific (GSRS) instruments were applied. This deterioration was most likely caused by the eating disturbances. At the time of diagnosis the motor characteristics of the esophageal body as well as the LES were severely affected. The vast majority of patients with achalasia are diagnosed at a stage when the disease process has already profoundly destroyed the motor function of the esophagus and the gastroesophageal junction and the quality of life are severely impaired.
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