Table 4.
Results of oesophageal function tests, endoscopy and questionnaires in treated achalasia patients with (RS+) and without reflux symptoms (RS–)
| Patients with reflux symptoms (RS+) | Patients without reflux symptoms (RS–-) | P value | |
| (n=19) | (n=19) | ||
| High-resolution manometry | |||
| Basal LOS pressure (mm Hg, median (IQR)) | 3 (2–6) | 3 (3–6) | 0.88 |
| Integrated relaxation pressure (mm Hg, median (IQR)) | 6.2 (2.1–8.7) | 5.9 (4.1–9) | 0.87 |
| Classification of oesophageal contractility | 1 | ||
| Failed contractility (n (%)) | 13 (68) | 13 (68) | |
| Weak contractility (n (%)) | 6 (32) | 6 (32) | |
| OGJ distensibility (at 50 mL: mm2/mm Hg, median (IQR)) | 5.3 (4.5–6.9) | 5.3 (4.5–6.9) | 0.18 |
| Timed barium oesophagogram | |||
| Barium column at 5 min (cm, median (IQR)) | 1 (0–2) | 1.8 (0–2.5) | 0.34 |
| Barium column at 2 min | 1.6 (0–2) | 2.4 (1–3.5) | 0.1 |
| Oesophageal diameter (cm, median (IQR)) | 2.1 (1.8–3) | 2.5 (2–3.4) | 0.12 |
| Endoscopy | |||
| Reflux oesophagitis (n (%)) | 10 (53) | 4 (21) | 0.91 |
| Grade A | 5/10 (50) | 2/4 (50) | |
| Grade B | 5/10 (50) | 2/4 (50) | |
| Questionnaires (median (IQR)) | |||
| RDQ total score* | 1.9 (1.4–3.3) | 0.3 (0–0.6) | <0.001 |
| Heartburn | 3 (2–4.3) | 0 (0–1) | <0.001 |
| Regurgitation | 1 (0.8–2.8) | 0 (0–0.3) | <0.001 |
| Dyspepsia | 1.8 (0–4) | 0 (0–0.5) | <0.002 |
| GORD | 2.1 (1.5–2.8) | 0.3 (0–0.8) | <0.001 |
| Achalasia-DSQoL† | 19 (14–22) | 13 (12–16) | <0.005 |
| SF-36‡ | |||
| Physical component summary score | 51 (46–55) | 54 (51–58) | 0.06 |
| Mental component summary score | 57 (53–60) | 54 (53–58) | 0.37 |
*RDQ: 12-item questionnaire, providing a score for each typical reflux symptom on a Likert scale, range 0 to5. Per domain the mean score was calculated per patient.
†Achalasia-DSQoL: quality of life related to achalasia, range 10 to 33, lower score indicated better quality of life.
‡SF-36 score consisted of a physical and mental component summary score, each ranged from 0 to 100, with higher scores indicating better quality of life.
DSQoL, Disease-Specific Quality-of-Life questionnaire; GORD, gastro-oesophageal reflux dimension; LOS, lower oesophageal sphincter; OGJ, oesophagogastric junction; RDQ, Reflux Disease Questionnaire; SF-36, 36-item Short-Form Health Survey.