Jankovic Jelena, Milenkovic Branislava, Simic Aleksandar, Ivanovic Nenad, Skrobic Ognjan
Clinic for Pulmonology, University Clinical Center of Serbia, Belgrade, Serbia.
Medical Faculty, University of Belgrade, Belgrade, Serbia *Email:
Qatar Med J. 2024 Dec 24;2024(4):52. doi: 10.5339/qmj.2024.52. eCollection 2024.
Achalasia is a rare esophageal motility disorder of unknown etiology, which leads to changes in the pressure and relaxation of the lower esophageal sphincter (LES), affecting peristalsis and contraction of the esophageal body. Dysphagia can impact individuals of any age, it is frequent in the elderly. Non-specific gastrointestinal symptoms are delayed and can give false diagnoses. The aim of this study is to compare clinical presentation and pulmonary complications in younger (Group I) and elderly patients (Group II).
108 patients with achalasia were separated into two groups-young and elderly patients. Demographic, clinical, radiological and manometric data, smoking status, and symptom score were compared between these groups.
There was no significant difference in gender, duration of symptoms, body mass index (BMI), or diameter of esophagus between the two patient groups. There was a statistically significant difference between frequencies of comorbidity between groups ( = 0.009). Even though there were no differences in chest tomography scan (CT) findings and diameter, there were statistical differences in diffusion capacity ( = 0.041). Respiratory symptoms occurred in 38 (48.7%) patients in Group I and in 20 (66.7%) in Group II ( = 0.011). Cough was dominant in the younger group, but fatigue and chest pain were statistically significant and frequent in elderly group patients with achalasia. There was no significant difference in Eskardt symptom score (ESS), but there was the difference in the frequency of individual symptoms. Vomitus and regurgitation were statistically higher frequent in Group I, but dysphagia and weight loss in Group II. Subtype 1 was dominant in the younger group, and subtype 2 in a group with older patients.
The younger achalasia population group was found to be associated with decreased diffusion capacity, type 1 achalasia, cough, and gastrointestinal symptoms such as vomitus and regurgitation. Geriatric status was found to be associated with frequent comorbidities, subtype 2, frequent respiratory symptoms, dysphagia, and weight loss. Our findings demonstrated an association between esophageal motility abnormalities and characteristics of geriatric population.
贲门失弛缓症是一种病因不明的罕见食管动力障碍性疾病，它会导致食管下括约肌（LES）压力和松弛的改变，影响食管体部的蠕动和收缩。吞咽困难可影响任何年龄段的个体，在老年人中较为常见。非特异性胃肠道症状出现较晚，可能导致误诊。本研究的目的是比较年轻患者（第一组）和老年患者（第二组）的临床表现和肺部并发症。
108例贲门失弛缓症患者被分为两组——年轻患者和老年患者。比较两组患者的人口统计学、临床、放射学和测压数据、吸烟状况及症状评分。
两组患者在性别、症状持续时间、体重指数（BMI）或食管直径方面无显著差异。两组间合并症发生率存在统计学显著差异（P = 0.009）。尽管胸部断层扫描（CT）结果和直径无差异，但在弥散功能方面存在统计学差异（P = 0.041）。第一组38例（48.7%）患者出现呼吸症状，第二组20例（66.7%）出现呼吸症状（P = 0.011）。咳嗽在年轻组中占主导，但在老年贲门失弛缓症患者中，疲劳和胸痛在统计学上更显著且更常见。Eskardt症状评分（ESS）无显著差异，但个体症状的频率存在差异。呕吐和反流在第一组中在统计学上更频繁，但吞咽困难和体重减轻在第二组中更常见。1型在年轻组中占主导，2型在老年患者组中占主导。
发现年轻的贲门失弛缓症患者群体与弥散功能降低、1型贲门失弛缓症、咳嗽以及呕吐和反流等胃肠道症状相关。老年状态与频繁的合并症、2型、频繁的呼吸症状、吞咽困难和体重减轻相关。我们的研究结果表明食管动力异常与老年人群特征之间存在关联。
