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Esophageal stasis in achalasia patients without symptoms after treatment does not predict symptom recurrence
Author(s) -
Hoeij F. B.,
Smout A. J. P. M.,
Bredenoord A. J.
Publication year - 2017
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13059
Subject(s) - achalasia , medicine , esophagus , blood stasis , reflux , quality of life (healthcare) , surgery , gastroenterology , traditional chinese medicine , disease , pathology , alternative medicine , nursing
Background After achalasia treatment, a subset of patients has poor esophageal emptying without having symptoms. There is no consensus on whether to pre‐emptively treat these patients. We hypothesized that, if left untreated, these patients will experience earlier symptom recurrence than patients without stasis. Methods 99 treated achalasia patients who were in clinical remission (Eckardt ≤3) at 3 months after treatment were divided into two groups, based on presence or absence of esophageal stasis on a timed barium esophagogram performed after 3 months. Key Results Two years after initial treatment, patients with stasis after treatment still had a wider esophagus (3 cm; IQR : 2.2‐3.8) and more stasis (3.5 cm; IQR : 1.9‐5.6) than patients without stasis (1.8 cm wide and 0 cm stasis; both P <.001). In patients with stasis, the esophageal diameter had increased from 2.5 to 3.0 cm within 2 years of follow‐up. The symptoms, need for and time to retreatment were comparable between the two groups. Quality of life and reflux symptoms were also comparable between the two groups. Conclusions & Inferences Although patients with stasis initially had a wider esophagus and 2 years after treatment also had a higher degree of stasis and a more dilated esophagus, compared to patients without stasis, they did not have a higher chance of requiring retreatment. We conclude that stasis in symptom‐free achalasia patients after treatment does not predict treatment failure within 2 years and can therefore not serve as a sole reason for retreatment.