Association Between Gastroesophageal Reflux Disease After Pneumatic Balloon Dilatation and Clinical Course in Patients With Achalasia.
- Author:
Yang Won MIN
1
;
Jin Hee LEE
;
Byung Hoon MIN
;
Jun Haeng LEE
;
Jae J KIM
;
Poong Lyul RHEE
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. plrhee@skku.edu
- Publication Type:Original Article
- Keywords:
Esophageal achalasia;
Gastroesophageal reflux;
Pneumatic balloon dilatation;
Prognosis
- MeSH:
Dilatation*;
Esophageal Achalasia*;
Esophageal Sphincter, Lower;
Esophagitis, Peptic;
Follow-Up Studies;
Gastroesophageal Reflux*;
Humans;
Incidence;
Prognosis;
Proton Pumps;
Recurrence;
Retrospective Studies
- From:Journal of Neurogastroenterology and Motility
2014;20(2):212-218
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The occurrence of gastroesophageal reflux disease (GERD) is known to be associated with lower post-treatment lower esophageal sphincter pressure in patients with achalasia. This study aimed to elucidate whether GERD after pneumatic balloon dilatation (PD) has a prognostic role and to investigate how the clinical course of GERD is. METHODS: A total of 79 consecutive patients who were first diagnosed with primary achalasia and underwent PD as an initial treatment were included in this retrospective study. Single PD was performed using a 3.0 cm balloon. The patients were divided into two groups: 1) who developed GERD after PD (GERD group) and 2) who did not develop GERD after PD (non-GERD group). GERD was defined as pathological acid exposure, reflux esophagitis or typical reflux symptoms. RESULTS: Twenty one patients (26.6%) developed GERD after PD during follow-up. There were no significant differences between the two groups in demographic or clinical factors including pre- and post-treatment manometric results. All patients in GERD group were well responsive to maintenance proton pump inhibitor therapy including on demand therapy or did not require maintenance. During a median follow-up of 17.8 months (interquartile range, 7.1-42.7 months), achalasia recurred in 15 patients (19.0%). However, the incidence of recurrence did not differ according to the occurrence of GERD after PD. CONCLUSIONS: GERD often occurs after even a single PD for achalasia. However, GERD after PD is well responsive to PPI therapy. Our data suggest that GERD after PD during follow-up does not appear to have a prognostic role.
