title: Disease-specific health-related quality of life in patients with esophageal achalasia before and after therapy.
abstract: BACKGROUND
  To evaluate disease-specific health-related quality of life (HRQoL) in patients with symptomatic esophageal achalasia before and after therapy.
  
  
  METHODS
  Symptoms and disease-specific HRQoL were evaluated before and 3 months after therapy. Therapy selection, either dilatation or myotomy, depended exclusively on the opinion of the physician on charge of the patient. Symptom severity was graded from 0 to 3, using a scoring system. A disease-specific questionnaire for achalasia developed and validated in Spanish language with 18 items and four subscales (AE-18) was used to evaluate HRQoL. Changes after therapy in HRQoL and its association with clinical improvement were analyzed.
  
  
  RESULTS
  Sixty-five patients were prospectively included in eight hospitals in Spain. Of them, 47 were treated with dilatation, and 18 with laparoscopic Heller myotomy. After therapy, AE-18 global and subscales scores improved significantly. Changes in HRQoL were associated with improvement in symptoms. An important improvement in symptoms (>or=50%) was needed to obtain a minimal clinically important improvement (>or=20%) in HRQoL.
  
  
  CONCLUSIONS
  Disease-specific HRQoL improves in patients with symptomatic achalasia after therapy with dilatation or myotomy. The degree of improvement of HRQoL depends on the degree of improvement of esophageal symptoms.
authors.affiliation: Servicio de Medicina Digestiva, Hospital Universitari La Fe, Valencia, Spain. garrigues_vic@gva.es
authors.forename: V
authors.initials: V
authors.lastname: Garrigues
authors.forename: V
authors.initials: V
authors.lastname: Ortiz
authors.forename: C
authors.initials: C
authors.lastname: Casanova
authors.forename: L
authors.initials: L
authors.lastname: Bujanda
authors.forename: E
authors.initials: E
authors.lastname: Moreno-Osset
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Téllez
authors.forename: A
authors.initials: A
authors.lastname: Montserrat
authors.forename: A
authors.initials: A
authors.lastname: Brotons
authors.forename: E
authors.initials: E
authors.lastname: Fort
authors.forename: J
authors.initials: J
authors.lastname: Ponce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology; D003625:Data Collection; D003627:Data Interpretation, Statistical; D003680:Deglutition Disorders / Q000209:etiology; D004106:Dilatation; D004931:Esophageal Achalasia / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012919:Social Behavior; D013030:Spain; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult