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03.12.2021 | Original Article

Differences in upper esophageal sphincter function and clinical characteristics among the three subtypes of Japanese patients with esophageal achalasia

verfasst von: Ryo Katsumata, Noriaki Manabe, Maki Ayaki, Minoru Fujita, Jun Nakamura, Hirofumi Kawamoto, Yuusaku Sugihara, Hiroyuki Sakae, Kenta Hamada, Ken Haruma

Erschienen in: Esophagus | Ausgabe 2/2022

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Abstract

Background

The rarity of esophageal achalasia has resulted in little being known about the characteristics of its three subtypes. The upper esophageal sphincter is considered one key factor to prevent aspiration pneumonia, a serious complication of esophageal achalasia. This study aimed to reveal the subtype characteristics of esophageal achalasia and how the upper esophageal sphincter functions and relates to other clinical parameters of the disease.

Methods

We retrospectively investigated the clinical records of patients diagnosed with esophageal achalasia. All participants underwent esophagogastroduodenoscopy and then, within 2 weeks, high-resolution manometry. Gastrointestinal symptoms were assessed using a previously validated self-reported questionnaire.

Results

A total of 110 patients with esophageal achalasia were enrolled: 50 with type I, 40 with type II, and 20 with type III. Mean age at diagnosis was 54.5, 50.4, and 66.1 years for types I, II, and III, respectively. Mean resting upper esophageal sphincter pressure was 28.0, 51.8, and 43.6 mmHg for patients with types I, II, and III, respectively (p < 0.01). Patients with type III esophageal achalasia more frequently reported stomachache than those with type I (p = 0.03). A negative correlation between resting upper esophageal sphincter pressure and age was observed in all subtypes.

Conclusions

A negative correlation was confirmed between resting upper esophageal sphincter pressure and age in all subtypes of esophageal achalasia. Type III patients were older at diagnosis, type II patients showed higher upper esophageal sphincter pressure, and type I patients showed a lower upper esophageal sphincter pressure at the early life stage.
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Metadaten
Titel
Differences in upper esophageal sphincter function and clinical characteristics among the three subtypes of Japanese patients with esophageal achalasia
verfasst von
Ryo Katsumata
Noriaki Manabe
Maki Ayaki
Minoru Fujita
Jun Nakamura
Hirofumi Kawamoto
Yuusaku Sugihara
Hiroyuki Sakae
Kenta Hamada
Ken Haruma
Publikationsdatum
03.12.2021
Verlag
Springer Singapore
Erschienen in
Esophagus / Ausgabe 2/2022
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI
https://doi.org/10.1007/s10388-021-00897-z

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