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.
Castell DO. Esophageal disorders in the elderly. Gas troenterol Clin North Am. 1990;19:235–54.
2.
Dimenas E. Methological aspects of evaluation of qu ality of life in upper gastrointestinal diseases. Scan J Gastroenterol. 1993;28(Suppl 199):18–21.
3.
Patrick DL, Deyo RA. Generic and disease-specific me asures in assessing health status and quality of life. Med Care. 1989;27(suppl):217–32.
4.
Dupuy HJ. The Psychological General Well - Being (PGWB) index. In: Assessment of Quality of Life in Clinical Trials of Cardiovascular Therapies. 1984.
5.
Svedlund SI, GSRS DG. A Clinical Rating Scale for Gastrointestinal Symtoms in Patients with Irri table Bowel Syndrome and Peptic Ulcer Disease.Dig Dis. Sci. 1988;33:129–34.
6.
Svedlund J, Sullivan M, Sjodin I, Liedman B, Lundell L. Quality of life in gastric cancer prior to gastrectomy. Qual Life Res. 1996;5:255–64.
7.
Birgisson S, Richter JE. Achalasia: What’s New in Dia gnosis and Treatment? Dig. 1997;(15(Suppl 1)):1 27.
8.
Ott DJ. Motility disorders of the esophagus. In: Textbook of gadstrointestinal radiology. 2000. p. 316–28.
9.
Hirano I, Tatum RP, Shi G, Sang Q, Joehl RJ, Kahrilas PJ. Manometric heterogeneity in patients with idio pathic achalasia. Gastroenterology. 2001;120:789–98.
10.
Shi G, Ergun GA, Manka M, Kahrilas PJ. Lower esopha geal sphincter relaxation characteristics using a sleeve sensor in clinical manometry. Am J Gastroenterol. 1998;93:2373–9.
11.
Dimenäs E, Carlsson G, Glise H. Relevance of Norm Values as Part of the Documentation of Quality of Life Instruments for Use in Upper Gastrointestinal Disease. Scand J Gastroenterol. 1996;31(Suppl 221):8–13.
12.
Ho K, Tay HH, Kang JY. A prospective study of the cli nical features, manometric findings, incidence and prevalence of achalasia in Singapore. J Gastroenterol Hepatol. 1999;14:791–5.
13.
Kamolz T, Pointner R, Velanovich V. The impact of gas troesophageal reflux disease on quality of life. Surg Endosc. 2003;17:1193–9.
14.
Decker G, Borie F, Bouamrirene D. Gastrointestinal quality of life before and after laparoscopic Heller my otomy with partial posterior fundoplication. Ann Surg. 2002;236:750–8.
15.
Ben-Meyer A, Urbach DR, Kajanchee YS. Qua lity of Life before and after laparoscopic Heller myo tomy for achalasia. Am J Surg. 2001;181:471–4.
16.
Raptopoulos Y, Hayetian LRJ, F. Fac tors affecting quality of life after minimally invasive He ller myotomy for achalasia. J Gastrointest Surg. 2004;8:233–9.
17.
GA URUT, JL. H. A mea sure of disease-specific health related quality of life for achalasia. Am J Gastroenterol. 2005;100:1668–76.
18.
Katz PO, Richter JE, Cowan R, Castell DO. Apparent complete lower esophageal sphincter relaxation in ac halasia. Gastroenterology. 1986;90:978–83.
19.
Mearin F, Malegelada. Complete lower esophageal spincter relaxation observed in achalasia patients is functionally inadequate. Am J Physiol Gastrointest Li ver Physiol. 2000;278 376-383.
20.
Herwaarden MA, Samsom M, Smout AJPM. Pro longed manometric recordings of oesophagus and lo wer oesophageal sphincter in achalasia patients. Gut. 2001;49:813–21.
21.
Quality of life scale for gastroesophageal re flux disease. J Am Coll Surg. 1996;183:217–24.
22.
Sonneberg A, Massey BT, DJ M. Epide miology of hospitalisation for achalasia in the United States. Dig Dis Sci. 1993;38:233–44.
23.
Mayberry JF, Atkinson M. Variations in the prevalence of achalasia in Great Britain and Ireland: an epide miological study based on hospital admissions. Q J Med. 1987;62:67–74.
24.
Howard PJ, Maher L, Pryde A. Five years pro spective study of the inncidence, clinical features, and diagnosis of achalasia in Edinburgh. GUT. 1992;33:1011–5.
25.
Park W, Vaezi MF. Etiology and pathogenesis of acha lasia: the current understanding. Am J Gastro-ente rology. 2005;100:1404–14.
26.
Abir F, Modlin I, Kidd M, Bell R. Surgical treatment of achalasia: current status and controversies Dig Surg 2004;21:165-76.
27.
Dimenäs E, Glise H, Hallerbäck B. Well-Being and Gastrointestinal Symptoms among Patients Refe rred to Endoscopy Owing to Suspected Duodenal Ul cer. Scan J Gastroenterol. 1995;30:1046–52.
28.
Blomqvist A, Lönroth H, J D. Quality of life assessment after laparoscopic and open fundo plications. Results of a prospective, clinical study. Scand J Gastroenterol. 1996;31:1052–8.
29.
Pedersen SA, Carlsson R, Junghard O. Quality of life patients with heartburn but without esophagitis: effects of treatment with omeprazole 2001;96. 1998;
30.
Havelund T, Lind T, Wiklund I. Quality of life patients with heartburn but without esophagitis: ef fects of treatment with omeprazole. Am J Gastroen terol. 1999;94:1782–9.
31.
Mayberry JF, Atkinson M. Epidemiology and demogra phics of achalasia. Gastrointest Endoscopy Clin N Am. 2001;11:235–48.
32.
Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with Gastroesoephageal reflux dise ase. Quality of Life Research. 1998(7).
33.
Blomqvist A, Dalenbäck J, Hagedorn C. Impact of complete gastric fundus mobilization on out-come after laparoscopic total fundoplication. Journal Gastro intestinal Surg. 2000;4:493–500.
34.
Dakkak M, Bennet. A new dysphagia score with objective validation. J Clin Gastroenterol. 1992(14).
35.
Watson DI, Pike GK, Baigrie RJ. Prospective do uble-blind randomized trial of laparoscopic Nis-sen fun doplication with division and without division of short gastric vessels. Ann Surg. 1997;22:642–52.
Rydberg R, Ruth M, Lundell L. Mechanism of action of antireflux surgery. Br J Surg. 1999;86:405–10.
38.
Engström C, Ruth M, Lönroth H, Lundell L. Manome tric characteristics of the gastro-esophageal junction after an anterior compared to a posterior partial fun doplication. Dis Esophagus. 2005;18:31–6.
39.
Bove M, Ruth M, Cange L, Månsson I. 24-hour phary ngeal pH monitoring in healthy volunteers: a norma tive study. Scand J Gastroenterol. 2000;35:234–41.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
