[Esophageal achalasia with apparently normal relaxation of the lower sphincter: clinical significance and therapeutic response to pneumatic dilatation].

OBJECTIVE

To evaluate if the clinical presentation and the response to pneumatic dilation is different in patients with achalasia with an apparent normal lower esophageal sphincter relaxation.

DESIGN

Prospective study to compare clinical, radiographic and manometric characteristics and the response to pneumatic dilation according to the ability of the lower esophageal sphincter to relax normally.

PATIENTS

One hundred and fifty seven consecutive patients with achalasia were included. Relaxation of the lower esophageal sphincter was abnormal in 130 patients and apparently normal in 27. The response to pneumatic dilation was evaluated in 116 patients, 94 with abnormal function of the lower esophageal sphincter and 22 with normal function.

RESULTS

Clinical findings, esophageal diameter and basal pressure of the lower esophageal sphincter were similar in both groups. The efficacy of the dilation, the number of dilations and the rate of complications were also similar.

CONCLUSIONS

Patients with achalasia and an apparent normal lower esophageal sphincter relaxation are not different from patients with typical achalasia and present a similar response to pneumatic dilation.