Authors' note: portions of these data were presented at the 2009 Annual Combined Meeting of the Washington and Oregon State Chapters of the American College of Surgeons in Lake Chelan, Washington.
Prevalence of respiratory symptoms in patients with achalasia
Article first published online: 12 NOV 2010
© 2010 Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus
Diseases of the Esophagus
Volume 24, Issue 4, pages 224–228, May 2011
How to Cite
Sinan, H., Tatum, R. P., Soares, R. V., Martin, A. V., Pellegrini, C. A. and Oelschlager, B. K. (2011), Prevalence of respiratory symptoms in patients with achalasia. Diseases of the Esophagus, 24: 224–228. doi: 10.1111/j.1442-2050.2010.01126.x
- Issue published online: 20 MAY 2011
- Article first published online: 12 NOV 2010
- Heller myotomy;
- respiratory disease
Achalasia is a primary esophageal motor disorder that results in poor clearance of the esophagus. Although an esophagus filled with debris and undigested food should put these patients at risk for aspiration, the frequency with which the latter occurs has never been documented. In this study, we sought to determine the incidence of respiratory symptoms and complaints in patients with achalasia. A comprehensive symptom questionnaire was administered to 110 patients with achalasia presenting to the Swallowing Center at the University of Washington between 1994 and 2008 as part of their preoperative work-up. Questionnaires were analyzed for the frequency of respiratory complaints in addition to the more typical symptoms of dysphagia, regurgitation, and chest pain. Twenty-two achalasia patients with respiratory symptoms who had also undergone Heller myotomy and completed a post-op follow-up questionnaire were analyzed as a subset. Ninety-five patients (86%) complained of at least daily dysphagia. Fifty-one patients (40%) reported the occurrence of at least one respiratory symptom daily, including cough in 41 patients (37%), aspiration (the sensation of inhaling regurgitated esophagogastric material) in 34 patients (31%), hoarseness in 23 patients (21%), wheezing in 17 patients (15%), shortness of breath in 11 patients (10%), and sore throat in 13 patients (12%). Neither age nor gender differed between those with and those without respiratory symptoms. In the subset of patients with respiratory symptoms who had undergone Heller myotomy, respiratory symptoms improved in the majority after the procedure. Patients with achalasia experience respiratory symptoms with much greater frequency than the approximately 10% that was previously believed. Awareness of this association may be important in the workup and ultimate treatment of patients with this uncommon esophageal disorder.