Achalasia in central Israel, 1973-83: clinical aspects.
In the framework of an epidemiologic study we collected data on all the 162 patients with achalasia in central Israel. The mean (+/- SD) follow-up was 9.9 +/- 8.7 years (range 1-52). At the last, as compared to the initial examination, the clinical condition of the patients had improved: 38% were without dysphagia as compared to 0% initially, 67% did not vomit and 92% did not complain of aspiration as compared to 17% and 68% initially, and 67% did not complain of chest pain as against 36% initially. In contrast, X-ray examinations, endoscopy as well as manometry did not show major changes. Esophageal retention of a semisolid radiolabeled meal 10 min after ingestion was 46 +/- 25% initially and 34 +/- 26% at last examination (NS). Medical therapy was given to 99 patients and a beneficial response was initially noted in 65% of them. About 88.7% had a beneficial response to surgery and 82.7% to pneumatic dilatations which were associated with a 7.3% perforation rate. Overall the clinical course of this unselected, regional group of patients was better than expected.
Arber
N
N
Department of Gastroenterology, Tel Aviv Sourasky Medical Center (Ichilov), Israel.
Grossman
A
A
Tiomny
E
E
Rattan
J
J
Kadish
U
U
Novis
B
B
Neuman
G
G
Lilos
P
P
Rozen
P
P
Gilat
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000175:diagnosis; D004106:Dilatation; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007557:Israel; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D009566:Nitrates / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000175:diagnosis
D009566:Nitrates; D009543:Nifedipine