Gender effect on clinical features of achalasia: a prospective study.
BACKGROUND
Achalasia is a well-characterized esophageal motor disorder but the rarity of the disease limits performing large studies on its demographic and clinical features.


METHODS
Prospectively, 213 achalasia patients (110 men and 103 women) were enrolled in the study. The diagnosis established by clinical, radiographic, and endoscopic as well as manometry criteria. All patients underwent a pre-designed clinical evaluation before and within 6 months after the treatment.


RESULTS
Solid dysphagia was the most common clinical symptom in men and women. Chest pain was the only symptom which was significantly different between two groups and was more complained by women than men (70.9% vs. 54.5% P value = 0.03). Although the occurrence of chest pain significantly reduced after treatment in both groups (P < 0.001), it was still higher among women (32% vs. 20.9% P value = 0.04). In both sexes, chest pain did not relate to the symptom duration, LES pressure and type of treatment patients received. Also no significant relation was found between chest pain and other symptoms expressed by men and women before and after treatment. Chest pain was less frequently reported by patients over 56 yrs of age in comparison to those less than 56 yrs (p < 0.05).


CONCLUSIONS
It seems that chest pain is the distinct symptom of achalasia which is affected by sex as well as age and does not relate to the duration of illness, LESP and the type of treatment achalasia patients receive.
Achalasia Research Unit, Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran 14114, Iran. mikaeli@ams.ac.ir
Javad
J
Mikaeli
Farnoosh
F
Farrokhi
Faraz
F
Bishehsari
Mahboobeh
M
Mahdavinia
Reza
R
Malekzadeh
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization; D002637:Chest Pain / Q000209:etiology; D003627:Data Interpretation, Statistical; D003680:Deglutition Disorders / Q000209:etiology; D004724:Endoscopy; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009498:Neurotoxins / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011859:Radiography; D012737:Sex Factors; D013997:Time Factors
D009498:Neurotoxins; D019274:Botulinum Toxins, Type A