title: Clinical characteristics and treatment outcomes of 3 subtypes of achalasia according to the chicago classification in a tertiary institute in Korea.
abstract: OBJECTIVE
  Achalasia is classified into 3 types according to the Chicago classification. The aim of this study was to investigate characteristics and treatment outcomes of 3 achalasia subtypes in Korean patients.
  
  
  METHODS
  Fifty-five patients diagnosed with achalasia based on conventional or high-resolution esophageal manometry were consecutively enrolled. Their clinical characteristics, manometric, endoscopic and esophagographic findings and treatment responses were analyzed among the 3 subtypes of achalasia.
  
  
  RESULTS
  Of 55 patients, 21 (38.2%) patients had type I, 28 (50.9%) patients had type II and 6 (10.9%) patients had type III. The median follow-up period was 22.4 (interquartile range, 3.6-67.4) months. Type III patients were older than type I and II patients (70.0 vs. 46.2 and 47.6 years, P = 0.023). The width of the esophagus in type I patients was wider with more frequent bird's beak appearance on esophagogram than the other 2 types (P = 0.010 and 0.006, respectively). Of the 50 patients who received the evaluation for treatment response at 3 months, 7 patients (36.8% vs. 26.9%) were treated with pneumatic dilatation and 4 patients (21.1% vs. 15.4%) with laparoscopic Heller's myotomy in type I and II groups, respectively. The treatment responses of pneumatic dilatation and Heller's myotomy in type I group were 71.4 and 50.0% and in type II were 85.7 and 75.0%, respectively, and all 5 patients in type III group showed good response to medical therapy.
  
  
  CONCLUSIONS
  Clinical characteristics of 3 achalasia subtypes in Korean patients are consistent with other studies. Treatment outcomes are variable among 3 subtypes.
authors.affiliation: Department of Internal Medicine, Seoul National University, Bundang Hospital, Seongnam, Gyeonggi-do, Korea.
authors.forename: Ju Yup
authors.initials: JY
authors.lastname: Lee
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
authors.forename: Yoon Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Kyu Keun
authors.initials: KK
authors.lastname: Kang
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Oh
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kwung Jun
authors.initials: KJ
authors.lastname: Park
authors.forename: A Young
authors.initials: AY
authors.lastname: Seo
authors.forename: Hyuk
authors.initials: H
authors.lastname: Yoon
authors.forename: Cheol Min
authors.initials: CM
authors.lastname: Shin
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Park
authors.forename: Jin-Hyeok
authors.initials: JH
authors.lastname: Hwang
authors.forename: Jin-Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Sook-Hyang
authors.initials: SH
authors.lastname: Jeong
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
keywords: Esophageal achalasia; Esophageal motility disorders; Manometry