Two onset types of achalasia and the long-term course to diagnosis.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Esophagus Pub Date : 2024-10-01 Epub Date: 2024-06-06 DOI:10.1007/s10388-024-01069-5

Akane Kurosugi, Tomoaki Matsumura, Michiko Sonoda, Tatsuya Kaneko, Satsuki Takahashi, Kenichiro Okimoto, Naoki Akizue, Yuhei Ohyama, Yukiyo Mamiya, Hayato Nakazawa, Ryosuke Horio, Chihiro Goto, Yuki Ohta, Takashi Taida, Atsuko Kikuchi, Mai Fujie, Kentaro Murakami, Masaya Uesato, Yoshihito Ozawa, Jun Kato, Hisahiro Matsubara, Naoya Kato

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Abstract

Background: Recently, the incidence of achalasia has been increasing, but its cause remains unknown. This study aimed to examine the initial symptoms and the course of symptoms and to find new insights into the cause and course of the disease.

Methods: Altogether, 136 patients diagnosed with achalasia by high-resolution manometry (HRM) were enrolled. Questionnaires and chart reviews were conducted to investigate the initial symptoms, time from onset to diagnosis, and comorbidities, as well as the relationship between HRM results, time to diagnosis, and symptom severity.

Results: In total, 67 of 136 patients responded to the questionnaire. The median ages of onset and diagnosis were 42 and 58 years, respectively. The median time from onset to diagnosis was 78.6 months, with 25 cases (37.3%) taking > 10 years to be diagnosed. The symptom onset was gradual and sudden in 52 (77.6%) and 11 (16.4%) patients, respectively. Of the 11 patients with acute onset, three (27.3%) developed anhidrosis at the same time. There was no correlation between the time from onset to diagnosis and esophageal dilatation, resting LES pressure, or mean integrated relaxation pressure (IRP). No correlation was also found between the degree of symptoms and resting LES pressure or IRP.

Conclusion: Esophageal achalasia can have acute or insidious onsets. This finding may help to elucidate the cause of achalasia.

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贲门失弛缓症的两种发病类型和诊断前的长期病程。

背景：近来，贲门失弛缓症的发病率不断上升，但其病因仍然不明。本研究旨在探讨贲门失弛缓症的初期症状和病程，并对其病因和病程寻找新的见解：方法：共纳入了 136 名通过高分辨率测压（HRM）确诊为贲门失弛缓症的患者。通过问卷调查和病历回顾调查了患者的初始症状、发病到确诊的时间、合并症以及高分辨率测压结果、确诊时间和症状严重程度之间的关系：136名患者中共有67人回答了问卷。发病年龄和确诊年龄的中位数分别为 42 岁和 58 岁。从发病到确诊的中位时间为 78.6 个月，其中 25 例（37.3%）的确诊时间超过 10 年。52名患者（77.6%）和11名患者（16.4%）分别是逐渐和突然发病。在急性发病的 11 名患者中，有 3 人（27.3%）同时出现了多汗症。从发病到确诊的时间与食管扩张、静息 LES 压力或平均综合松弛压力 (IRP) 之间没有相关性。结论：食管贲门失弛缓症的症状程度与静息LES压力或IRP之间也没有相关性：结论：食管贲门失弛缓症可以急性发作，也可以隐匿性发作。结论：食管贲门失弛缓症可以急性发作，也可以隐匿性发作，这一发现可能有助于阐明贲门失弛缓症的病因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.