title: Persisting symptoms and decreased health-related quality-of-life in a cross-sectional study of treated achalasia patients.
abstract: BACKGROUND
  Little is known about symptom characteristics of treated achalasia patients and their effect on health-related quality-of-life (HRQoL).
  
  
  OBJECTIVE
  To examine clinical remission, achalasia-associated symptoms and HRQoL in treated achalasia patients.
  
  
  METHODS
  The Eckardt clinical symptom score, RAND-36 and a disease-specific HRQoL questionnaire were sent to 171 treated achalasia patients.
  
  
  RESULTS
  76.6% of the patients returned their questionnaire. 44.9% of them were not in symptomatic remission. Prevalence of frequent dysphagia (at least daily) and chest pain (at least weekly) was 46% and 38%, respectively. Achalasia patients had lower general HRQoL scores than control subjects (all RAND-36 subscales, except health change; P < or = 0.002). Patients with frequent symptoms of chest pain and dysphagia showed lower HRQoL than patients with less frequent symptoms on three RAND-36 subscales (pain, social functioning and general health perceptions; P < 0.003). Patients in clinical remission showed higher HRQoL than patients who were not, however HRQoL in the 'remission group' remained significantly impaired as compared to controls (all RAND-36 subscales except emotional role limitations and mental health; P < 0.001).
  
  
  CONCLUSIONS
  Many achalasia patients remain severely symptomatic after treatment and have decreased HRQoL. Frequent symptoms are associated with lower HRQoL. Patients in clinical remission show substantially improved, but not restored HRQoL.
authors.affiliation: Gastrointestinal Research Unit, Departments of Gastroenterology and Surgery, University Medical Center Utrecht, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Frankhuisen
authors.forename: M A
authors.initials: MA
authors.lastname: van Herwaarden
authors.forename: R
authors.initials: R
authors.lastname: Heijkoop
authors.forename: A J P M
authors.initials: AJ
authors.lastname: Smout
authors.forename: A
authors.initials: A
authors.lastname: Baron
authors.forename: J R
authors.initials: JR
authors.lastname: Vermeijden
authors.forename: H G
authors.initials: HG
authors.lastname: Gooszen
authors.forename: M
authors.initials: M
authors.lastname: Samsom
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome