Objective: To document demographic and treatment data of patients diagnosed with achalasia at Songklanagarind Hospital and compare with data from previous studies.
Meterial and Methods: We retrospectively reviewed the data of achalasia patients. This included age, sex, presenting symptoms, type of investigations, choice of treatment, and the results and complications of the achalasia patients. This information was collected from inpatient and outpatient records at Songklanagarind Hospital from October 1983 to February 2003.
Results: Sixty patients (34 females and 26 males) were diagnosed with achalasia. The mean age was 50 years, and more than 90% presented with dysphagia. A barium-swallow esophagogram was the most commonly selected investigation. It was performed in 58 cases followed by a gastroesophagoscopy in 56 cases and an esophageal manometry in 23 cases. In total, thirty-six patients underwent an esophagocardiomyotomy, 6 patients received pneumatic balloon dilatation, 3 patients were treated with medication, 1 patient was treated with a Botulinum toxin injection and 1 patient was treated with an esophagectomy. Thirteen patients refused treatment. Over eighty percent of all treated patients achieved satisfactory results comprising 35/36 in the esophagocardiomyotomy group, 2/6 in the pneumatic balloon dilatation group and 1/3 in the medication group. One patient who had received Botulinum toxin injection did not achieve a satisfactory result. Complications occurred in 13/47 treated patients with 1 patient dying from post-esophagectomy septic complication.
Conclusion: These results represent the demographic and treatment profile of our achalasia patients in Songklanagarind Hospital, and is similar to previous studies done in Thailand. The majority of cases undergoing an esophagocardiomyotomy achieved satisfactory results. Among the 6 patients who had undergone pneumatic balloon dilatation, satisfactory results were achieved in only 2 cases.