Progression of diffuse esophageal spasm to achalasia: incidence and predictive factors

Progression of diffuse esophageal spasm to achalasia: incidence and predictive factors

Author Fontes, L. H. S. Autor UNIFESP Google Scholar
Herbella, F. A. M. Autor UNIFESP Google Scholar
Rodriguez, T. N. Google Scholar
Trivino, T. Autor UNIFESP Google Scholar
Farah, J. F. M. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Publ Servants State Hosp
Abstract The progression of certain primary esophageal motor disorders to achalasia has been documented; however, the true incidence of this decay is still elusive. This study aims to evaluate: (i) the incidence of the progression of diffuse esophageal spasm to achalasia, and (ii) predictive factors to this progression. Thirty-five patients (mean age 53 years, 80% females) with a manometric picture of diffuse esophageal spasm were followed for at least 1 year. Patients with gastroesophageal reflux disease confirmed by pH monitoring or systemic diseases that may affect esophageal motility were excluded. Esophageal manometry was repeated in all patients. Five (14%) of the patients progressed to achalasia at a mean follow-up of 2.1 (range 1-4) years. Demographic characteristics were not predictive of transition to achalasia, while dysphagia (P= 0.005) as the main symptom and the wave amplitude of simultaneous waves less than 50mmHg (P= 0.003) were statistically significant. in conclusion, the transition of diffuse esophageal spasm to achalasia is not frequent at a 2-year follow-up. Dysphagia and simultaneous waves with low amplitude are predictive factors for this degeneration.
Keywords achalasia
diffuse esophageal spasm
disease progression
manometry
Language English
Sponsor Department of Surgery of the Federal University of São Paulo
Public Servants State Hospital of the São Paulo
Date 2013-07-01
Published in Diseases of the Esophagus. Hoboken: Wiley-Blackwell, v. 26, n. 5, p. 470-474, 2013.
ISSN 1120-8694 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 470-474
Origin http://dx.doi.org/10.1111/j.1442-2050.2012.01377.x
Access rights Closed access
Type Article
Web of Science ID WOS:000328932400005
URI http://repositorio.unifesp.br/handle/11600/36523

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