Surface area: a better predictor of disease severity than the height and volume of the barium column in patients with primary achalasia.
OBJECTIVE
Subjective assessment of primary achalasia is not accurate. We aimed to study the utility of surface area of barium retention in the objective assessment of these patients.


METHODS
Subjective and objective esophageal functions of 99 patients with primary achalasia were evaluated initially and 43 of them were reevaluated 1 month after balloon dilation.


RESULTS
Before dilation: Ninety-nine patients were enrolled. Forty-one of them were male. The mean age was 37.5+/-15.3 years. The mean score, resting lower esophageal sphincter pressure, height, surface and volume of barium retention at 5 min were 8.03+/-3.1, 59.1+/-20 mmHg, 9.9+/-4.9 cm, and 23.6+/-13.9 cm and 53.2+/-47.7 cm, respectively. Surface area at 5 min had best correlation and predictive value for resting lower esophageal sphincter pressure. After dilation: Forty-three of 99 patients were reevaluated after balloon dilation. The mean age was 36.8+/-13.6 years. Seventeen of them were male. Mean score, resting lower esophageal sphincter pressure, height, surface area and volume of barium retention at 5 min dropped significantly after dilation. Surface area at 5 min had best correlation and predictive value for lower esophageal sphincter pressure.


CONCLUSIONS
Surface area of barium retention at 5 min is an accurate objective tool to assess patients with primary achalasia. It is cheap and easy to perform; therefore, it could be used more frequently in postdilation follow-up.
Montazeri
Ghodrat
G
Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran. montazer@ams.ac.ir
Nouri
Negin
N
Estakhri
Arezoo
A
Shirani
Shapoor
S
Abedian
Shifteh
S
Fazlollahi
Atoosa
A
Mikaeli
Javad
J
Nouraie
Mehdi
M
Malekzadeh
Reza
R
D000328:Adult; D001466:Barium Sulfate; D002404:Catheterization / Q000379:methods; D003287:Contrast Media; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis; D011859:Radiography
D003287:Contrast Media; D001466:Barium Sulfate