Basal and residual lower esophageal pressures increase in old age in classic achalasia, but not vigorous achalasia.
OBJECTIVE
The relationship between age and esophageal motility parameters (i.e. basal and residual pressure of the lower esophageal sphincter [LES]) remains to be established in achalasia patients, possibly because most previous studies did not distinguish between classic and vigorous achalasia patients. We investigated the relationship between age and esophageal motility parameters in both classic and vigorous achalasia patients.


METHODS
A retrospective review of esophageal manometry data in a single center was undertaken. Basal and residual pressure for LES was analyzed. A total of 103 achalasia patients were enrolled, comprising 84 classic and 19 vigorous types. They were subdivided into three different age groups as follows: 21-40 years old (group A), 41-60 years old (group B), and over 60 years old (group C).


RESULTS
In classic achalasia patients (M : F = 27:57, mean age = 44 +/- 15 years old) the older age group showed a significantly higher basal LES pressure (49.62 +/- 19.63 mmHg) than the younger age group (P < 0.0001). Moreover, the older age group also showed significantly high residual LES pressure (20.46 +/- 8.61 mmHg) than the younger age group (P = 0.0006). In contrast, in vigorous achalasia patients (M : F = 12:7, mean age: 47 +/- 15 years old) there were no difference between age and motility indices (all P > 0.05).


CONCLUSIONS
In classic achalasia patients there appears to be a correlation between age and esophageal motility indices, especially basal and residual LES pressure. Such correlations do not appear to exist for vigorous achalasia patients.
Jung
Kee Wook
KW
Asan Digestive Disease Research Institute, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Jung
Hwoon-Yong
HY
Yoon
In Ja
IJ
Kim
Do Hoon
DH
Park
Hye-Won
HW
Chung
Jun-Won
JW
Choi
Kwi-Sook
KS
Kim
Kyung Jo
KJ
Choi
Kee Don
KD
Song
Ho June
HJ
Lee
Gin Hyug
GH
Kim
Jin-Ho
JH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging; D004931:Esophageal Achalasia / Q000145:classification / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D056910:Republic of Korea; D012189:Retrospective Studies; D055815:Young Adult