title: Is it an eating disorder or achalasia or both? A literature review and diagnostic challenges.
abstract: BACKGROUND
  Achalasia is a rare oesophageal motility disorder characterized by physical, behavioural and psychosocial features that are strikingly similar to eating disorders (ED).
  
  
  METHODS
  A literature search of PubMed and Google Scholar identified 36 cases of achalasia from 11 countries misdiagnosed as ED between 1980 and 2013.
  
  
  RESULTS
  On average, the typical misdiagnosed case was an 18-year-old female with an average weight loss of 16.2 kg. Vomiting behaviour in achalasia was distinguished by occurring after both solids and liquids, occurring in public, and worsening at night or while lying down, and was associated with pain relief. Manometric investigations of oesophageal functioning in clinical ED samples are few and have shown little evidence of dysmotility.
  
  
  CONCLUSIONS
  Achalasia and ED share numerous clinical features including weight loss and vomiting. Pain associated with swallowing difficulties may lead to an increasingly restricted pattern of eating and food avoidance. Increased awareness of achalasia in ED treatment settings can help facilitate detection of achalasia, thereby reducing treatment delay.
authors: Regional Eating Disorders Service, Division of Mental Health and Addiction, Oslo University Hospital, Norway.
authors: Deborah L
authors: DL
authors: Reas
authors: Stephan
authors: S
authors: Zipfel
authors: Øyvind
authors: Ø
authors: Rø
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004931:Esophageal Achalasia / Q000175:diagnosis*; D001068:Feeding and Eating Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D014839:Vomiting; D015431:Weight Loss; D055815:Young Adult
keywords: achalasia; avoidant/restrictive food intake disorder; eating disorders; gastrointestinal; oesophageal dysmotility