Document Detail

Is aperistalsis with complete lower esophageal sphincter relaxation an early stage of classic achalasia?
MedLine Citation:
PMID:  17376048     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Aperistalsis with complete lower esophageal sphincter (LES) relaxation, characterized by the complete relaxation of the LES and aperistalsis of the esophageal body on manometry, has been considered by some authors to be an early manifestation of classic achalasia, which is defined as incomplete relaxation of the LES and aperistalsis of the esophageal body. The aim of the present study was to compare the clinical features of patients with aperistalsis with complete LES relaxation, with those of patients with classic achalasia. METHODS: Eighteen patients with aperistalsis with complete LES relaxation and 53 patients with classic achalasia were analyzed with regard to clinical history, the maximal diameter of the esophageal body on barium esophagogram, LES resting pressure and the duration of LES relaxation on manometric recordings, and the selected treatment and its efficacy. RESULTS: The aperistalsis with complete LES relaxation group had distinctly different features compared to those of the classic achalasia group including older age, more frequent association with non-cardiac chest pain, less frequent association with dysphagia and weight loss, lower LES resting pressures, and longer duration of LES relaxation. However, the two groups were similar in terms of maximal diameter of the esophageal body, and efficacy associated with pneumatic dilation. CONCLUSIONS: Aperistalsis with complete LES relaxation on manometry is not necessarily an early manifestation of classic achalasia. However, this condition does not preclude a diagnosis of achalasia or a good response to achalasia therapy.
Jeong Hwan Kim; Poong-Lyul Rhee; Sang Soo Lee; Hyuk Lee; Yong Sung Choi; Hee Jung Son; Jae J Kim; Jong Chul Rhee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  22     ISSN:  0815-9319     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-22     Completed Date:  2007-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  536-41     Citation Subset:  IM    
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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MeSH Terms
Balloon Dilatation
Esophageal Achalasia / diagnosis*,  etiology
Esophageal Motility Disorders / physiopathology*
Esophageal Sphincter, Lower / physiopathology*
Esophagus / radiography
Middle Aged
Muscle Relaxation / physiology*
Peristalsis / physiology*
Retrospective Studies

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