title: Surface area: a better predictor of disease severity than the height and volume of the barium column in patients with primary achalasia.
abstract: 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.
authors.affiliation: Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran. montazer@ams.ac.ir
authors.forename: Ghodrat
authors.initials: G
authors.lastname: Montazeri
authors.forename: Negin
authors.initials: N
authors.lastname: Nouri
authors.forename: Arezoo
authors.initials: A
authors.lastname: Estakhri
authors.forename: Shapoor
authors.initials: S
authors.lastname: Shirani
authors.forename: Shifteh
authors.initials: S
authors.lastname: Abedian
authors.forename: Atoosa
authors.initials: A
authors.lastname: Fazlollahi
authors.forename: Javad
authors.initials: J
authors.lastname: Mikaeli
authors.forename: Mehdi
authors.initials: M
authors.lastname: Nouraie
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: 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
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate