Furukawa Fumiko, Kakita Kiyohito
Rehabilitation Medicine, Kyoto Ohara Memorial Hospital, Kyoto, JPN.
Cureus. 2024 Jul 14;16(7):e64529. doi: 10.7759/cureus.64529. eCollection 2024 Jul.
Esophageal achalasia is a disease characterized by esophageal motor dysfunction, leading to various symptoms, including vomiting and chest pain. There is no curative treatment for this disease, and the consensus on nutritional therapy or rehabilitation is unclear. Herein, we present the case of a 90-year-old woman with symptoms of esophageal achalasia, exacerbated by secondary sarcopenia and sarcopenic dysphagia after coronavirus disease 2019 (COVID-19) pneumonia. The patient presented with chest pain and vomiting while on a soft diet, and esophagography revealed typical esophageal achalasia. Her esophageal achalasia symptoms resolved, with improvements in nutritional status, skeletal muscle mass, and physical capacity, when a combination of nutritional and comprehensive rehabilitation therapies was adopted. This case highlights that oral dysphagia is associated with worsening esophageal achalasia symptoms and that nutritional and rehabilitative interventions are effective in relieving the symptoms of achalasia in patients with esophageal achalasia and sarcopenia.
食管失弛缓症是一种以食管运动功能障碍为特征的疾病，可导致包括呕吐和胸痛在内的各种症状。这种疾病没有治愈性治疗方法，关于营养治疗或康复的共识也不明确。在此，我们报告一例90岁女性患者，其患有食管失弛缓症症状，在2019冠状病毒病（COVID-19）肺炎后因继发性肌肉减少症和肌肉减少性吞咽困难而加重。患者在进食软食时出现胸痛和呕吐，食管造影显示典型的食管失弛缓症。当采用营养和综合康复治疗相结合的方法时，她的食管失弛缓症症状得到缓解，营养状况、骨骼肌质量和身体能力均有所改善。该病例突出表明，经口吞咽困难与食管失弛缓症症状加重有关，营养和康复干预对缓解食管失弛缓症合并肌肉减少症患者的失弛缓症状有效。
