Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
Clin Gastroenterol Hepatol. 2011 Dec;9(12):1020-4. doi: 10.1016/j.cgh.2011.04.022. Epub 2011 May 6.
BACKGROUND & AIMS: Most experienced gastroenterologists have seen one or several cases of achalasia patients who have been erroneously diagnosed with gastroesophageal reflux disease (GERD) or even underwent antireflux surgery. We aim to describe the current knowledge about the diagnostic features of achalasia and their overlap with GERD. Furthermore, we present 3 cases in which achalasia was mistaken for GERD.
Search of the literature published in English using the PubMed database and relevant abstracts presented at international conventions.
Typical features of GERD such as heartburn, retrosternal pain, esophagitis, and pathologic acid exposure can be observed in achalasia patients. Diagnostic tests such as endoscopy and radiography lack sensitivity and specificity for achalasia. Current diagnostic guidelines for antireflux surgery do not stipulate that achalasia should be ruled out preoperatively.
Clinical presentation as well as the diagnostic work-up of achalasia patients can show overlap with GERD. Mistaking achalasia for GERD can be avoided by esophageal manometry and this should therefore be performed in all patients undergoing surgical fundoplication.
大多数经验丰富的胃肠病学家都曾见过一例或多例贲门失弛缓症患者被误诊为胃食管反流病（GERD）甚至接受了抗反流手术的情况。我们旨在描述目前关于贲门失弛缓症的诊断特征及其与 GERD 的重叠，并介绍 3 例误诊为 GERD 的贲门失弛缓症患者。
使用 PubMed 数据库检索发表的英文文献和国际会议上的相关摘要。
GERD 的典型特征，如烧心、胸骨后疼痛、食管炎和病理性酸暴露，可在贲门失弛缓症患者中观察到。内镜检查和影像学等诊断性检查对贲门失弛缓症缺乏敏感性和特异性。目前用于抗反流手术的诊断指南并未规定术前应排除贲门失弛缓症。
贲门失弛缓症患者的临床表现和诊断过程可能与 GERD 存在重叠。通过食管测压术可避免将贲门失弛缓症误诊为 GERD，因此应在所有接受手术胃底折叠术的患者中进行此项检查。
