Aurino Laura, Pesce Marcella, Rurgo Sara, Puoti Maria Giovanna, Polese Barbara, Capuano Marianna, Palomba Giuseppe, Aprea Giovanni, Seguella Luisa, Esposito Giuseppe, Palenca Irene, Efficie Eleonora, Sarnelli Giovanni
Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy.
Department of Pediatric Gastroenterology and Hepatology, Santobono-Pausilipon Children's Hospital, Via Mario Fiore, 6, 80129, Naples, Italy.
Dig Liver Dis. 2025 Jan;57(1):225-230. doi: 10.1016/j.dld.2024.07.027. Epub 2024 Aug 14.
Achalasia is characterized by symptoms of esophageal obstruction, preventing food consumption. However, weight loss is observed only in a subset of patients, and data from literature is conflicting.
Our study aimed at evaluating predictors of weight loss in achalasia patients and at verifying the impact of treatment on nutritional status.
123 achalasia patients, eligible for laparoscopic Heller myotomy, were studied. Demographic, clinical and nutritional data (calorie intake and macronutrient composition) were recorded at baseline and one-year post-treatment. Significant weight loss/gain was considered for variation of 10 % of body weight at baseline and post-treatment, respectively.
57.7 % of patients reported weight loss at presentation. These subjects had shorter disease duration, worse symptoms, lower BMI and consumed fewer calories than patients without weight loss. Post-treatment, we observed a considerable improvement in Eckardt score and BMI values. Almost 50 % of the population reported significant weight gain, particularly in individuals with weight loss at baseline. Caloric intake also rose significantly, positively affecting BMI categories.
We showed that achalasia-induced weight loss is associated with symptoms' severity and disease duration. Conversely, over 50 % of treated patients were in the overweight/obese category, highlighting the need for individualized nutritional interventions in achalasia patients.
贲门失弛缓症的特征是食管梗阻症状，妨碍食物摄入。然而，仅在一部分患者中观察到体重减轻，且文献数据相互矛盾。
我们的研究旨在评估贲门失弛缓症患者体重减轻的预测因素，并验证治疗对营养状况的影响。
对123例符合腹腔镜下赫勒肌切开术条件的贲门失弛缓症患者进行了研究。在基线和治疗后一年记录人口统计学、临床和营养数据（热量摄入和宏量营养素组成）。分别将基线和治疗后体重变化10%视为显著体重减轻/增加。
57.7%的患者在就诊时报告体重减轻。与未体重减轻的患者相比，这些患者的病程较短、症状较重、体重指数较低且热量摄入较少。治疗后，我们观察到埃卡德特评分和体重指数值有显著改善。近50%的患者报告体重显著增加，尤其是基线时体重减轻的个体。热量摄入也显著增加，对体重指数类别产生了积极影响。
我们表明，贲门失弛缓症引起的体重减轻与症状严重程度和病程有关。相反，超过50%的接受治疗的患者属于超重/肥胖类别，这突出了对贲门失弛缓症患者进行个体化营养干预的必要性。
