Jain Mayank, Baijal Neha, Srinivas Melpakkam, Baijal Rajiv, Pratap Nitesh, Bachkaniwala Vatsal, Ganesh P, Venkataraman Jayanthi
Arihant Hospital and Research Centre Indore India.
Maulana Azad Medical College New Delhi India.
JGH Open. 2020 Mar 24;4(5):856-859. doi: 10.1002/jgh3.12328. eCollection 2020 Oct.
Achalasia cardia is a rare esophageal motor disorder that is frequently diagnosed late.
The aim of this study was to study the symptoms, treatment given, and response to treatment in patients with achalasia cardia in an Indian setting.
This retrospective study included all patients diagnosed with achalasia cardia on high-resolution esophageal manometry, using Chicago Classification v 3.0. On follow up, patients were contacted by telephone, and details of the treatment given and response were recorded in a predesigned pro forma. We excluded overseas patients, postoperative cases of achalasia, and those in whom the manometry catheter could not be passed across the gastroesophageal junction.
A total of 452 patients (260 males, median age 44.5 years) were included in the study cohort. The major symptoms included dysphagia for solids and liquids (428, 94.7%), regurgitation (360, 79.6%), naso-oral regurgitation (182, 40.3%), weight loss (322, 71.3%), and chest pain (158, 35%). Type 2 achalasia (229, 50.6%) was the most common subtype, followed by type 3 (154, 34.1%). Chest pain was more common in type 3, and weight loss and naso-oral regurgitation were more common in type 2 achalasia. A majority of patients underwent Heller's myotomy and pneumatic dilatation. Of 280 patients for whom treatment details were available, 98% reported good response to endoscopic/surgical management.
The predominant symptoms of achalasia cardia vary per the manometric subtype. Heller's myotomy and pneumatic dilatation are the most commonly used treatment options. Response to treatment is good. The choice of treatment modality was likely influenced by financial reasons and availability of local expertise.
贲门失弛缓症是一种罕见的食管运动障碍性疾病，常常在晚期才得以诊断。
本研究旨在探讨印度环境下贲门失弛缓症患者的症状、接受的治疗及治疗反应。
本回顾性研究纳入了所有经高分辨率食管测压诊断为贲门失弛缓症的患者，采用芝加哥分类法第3.0版。随访时，通过电话联系患者，并将所给予治疗的详细情况及反应记录在预先设计的表格中。我们排除了海外患者、贲门失弛缓症术后病例以及测压导管无法通过胃食管交界处的患者。
研究队列共纳入452例患者（男性260例，中位年龄44.5岁）。主要症状包括固体和液体吞咽困难（428例，94.7%）、反流（360例，79.6%）、鼻口反流（182例，40.3%）、体重减轻（322例，71.3%）和胸痛（158例，35%）。2型贲门失弛缓症（229例，50.6%）是最常见的亚型，其次是3型（154例，34.1%）。胸痛在3型中更常见，体重减轻和鼻口反流在2型贲门失弛缓症中更常见。大多数患者接受了海勒肌切开术和气囊扩张术。在有治疗详细信息的280例患者中，98%报告对内镜/手术治疗反应良好。
贲门失弛缓症的主要症状因测压亚型而异。海勒肌切开术和气囊扩张术是最常用的治疗选择。治疗反应良好。治疗方式的选择可能受经济因素和当地专业技术可及性的影响。
