Abstract
Five patients initially presenting with symptomatic gastro-oesophageal reflux, proven by radiology or pH monitoring, subsequently developed achalasia, confirmed by radiology and manometry, after an interval of 2-10 years. During this period dysphagia, present as a mild and intermittent symptom accompanying the initial reflux in 3 of the 5, became severe and resulted in oesophageal stasis of food in all. Three of the 5 had a demonstrable hiatal hernia. In none was reflux a troublesome symptom after Rider-Moeller dilatation or cardiomyotomy undertaken for the achalasia. Gastro-oesophageal reflux does not protect against the subsequent development of achalasia. It is suggested that the autonomic damage eventually leading to achalasia may in its initial phases cause gastro-oesophageal reflux.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BINDER H. J., CLEMETT A. R., THAYER W. R., SPIRO H. M. RARITY OF HIATUS HERNIA IN ACHALASIA. N Engl J Med. 1965 Apr 1;272:680–682. doi: 10.1056/NEJM196504012721307. [DOI] [PubMed] [Google Scholar]
- Björck S., Dernevik L., Gatzinsky P., Sandberg N. Oesophagocardiomyotomy and antireflux procedures. Acta Chir Scand. 1982;148(6):525–529. [PubMed] [Google Scholar]
- CASSELLA R. R., BROWN A. L., Jr, SAYRE G. P., ELLIS F. H., Jr ACHALASIA OF THE ESOPHAGUS: PATHOLOGIC AND ETIOLOGIC CONSIDERATIONS. Ann Surg. 1964 Sep;160:474–487. doi: 10.1097/00000658-196409000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- CASSELLA R. R., ELLIS F. H., Jr, BROWN A. L., Jr FINE-STRUCTURE CHANGES IN ACHALASIA OF THE ESOPHAGUS. I. VAGUS NERVES. Am J Pathol. 1965 Feb;46:279–288. [PMC free article] [PubMed] [Google Scholar]
- Mayberry J. F., Rhodes J. Achalasia in the city of Cardiff from 1926 to 1977. Digestion. 1980;20(4):248–252. doi: 10.1159/000198446. [DOI] [PubMed] [Google Scholar]
- Nebel O. T., Fornes M. F., Castell D. O. Symptomatic gastroesophageal reflux: incidence and precipitating factors. Am J Dig Dis. 1976 Nov;21(11):953–956. doi: 10.1007/BF01071906. [DOI] [PubMed] [Google Scholar]
- Ogilvie A. L., James P. D., Atkinson M. Impairment of vagal function in reflux oesophagitis. Q J Med. 1985 Jan;54(213):61–74. [PubMed] [Google Scholar]
- Peyton M. D., Greenfield L. J., Elkins R. C. Combined myotomy and hiatal herniorrhaphy. A new approach to achalasia. Am J Surg. 1974 Dec;128(6):786–790. doi: 10.1016/0002-9610(74)90071-3. [DOI] [PubMed] [Google Scholar]