Surface; a Better Predictor of Disease Severity in Patients with Primary Achalasia than Height of Barium Column

Abstract

Background: Subjective assessment of primary achalasia is not accurate. We aimed to evaluate surface of barium retention in the objective assessment of these patients.

Materials and Methods: Subjective and objective esophageal functions of 99 patients with primary achalasia were evaluated initially and 43 of them were reevaluated one month after balloon dilation.

Results:

Predilation:  9cases enrolled .Mean age was 37.5±15.3 years. Mean score, resting LES pressure, height, and surface of barium retention at 5 minutes were 8.03±3.1.59.1±20 mmhg, 9.9±4.9 cm, and 23.6±13.9 cm2 respectively. Surface at 5 minutes had best correlation and predictive value for LES pressure.

Post dilation: 43 of 99 cases reevaluated. Mean age was 36.8±13.6 years .17 of them were male. Mean score, resting LES pressure, height and surface of barium retention at 5 minutes were 3.4±3.4, 38.6±22.6 mmhg, and 8.1±4.2 cm and 18.8±11.3 cm2 respectively. Variables dropped significantly after dilation. Surface at 5 minutes had best correlation and predictive value for LES pressure.

Conclusions: Surface of barium retention at 5 minutes is an accurateobjective tool to assess patients with primary achalasia. It is cheap and easy to perform; therefore it could be used more frequently in follow up.