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Is It an Eating Disorder or Achalasia or Both? A Literature Review and Diagnostic Challenges
Author(s) -
Reas Deborah L.,
Zipfel Stephan,
Rø Øyvind
Publication year - 2014
Publication title -
european eating disorders review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.511
H-Index - 67
eISSN - 1099-0968
pISSN - 1072-4133
DOI - 10.1002/erv.2307
Subject(s) - achalasia , eating disorders , vomiting , swallowing , psychosocial , dysphagia , weight loss , medicine , esophageal motility disorder , psychiatry , psychology , pediatrics , surgery , esophagus , obesity
Achalasia is a rare oesophageal motility disorder characterized by physical, behavioural and psychosocial features that are strikingly similar to eating disorders (ED). Method A literature search of PubMed and Google Scholar identified 36 cases of achalasia from 11 countries misdiagnosed as ED between 1980 and 2013. Results On average, the typical misdiagnosed case was an 18‐year‐old female with an average weight loss of 16.2 kg. Vomiting behaviour in achalasia was distinguished by occurring after both solids and liquids, occurring in public, and worsening at night or while lying down, and was associated with pain relief. Manometric investigations of oesophageal functioning in clinical ED samples are few and have shown little evidence of dysmotility. Discussion Achalasia and ED share numerous clinical features including weight loss and vomiting. Pain associated with swallowing difficulties may lead to an increasingly restricted pattern of eating and food avoidance. Increased awareness of achalasia in ED treatment settings can help facilitate detection of achalasia, thereby reducing treatment delay. © 2014 The Authors. European Eating Disorders Review published by John Wiley & Sons, Ltd.