Objective Indices of Therapeutic Effects of Pneumatic Balloon Dilatation in Primary Achalasia

Sohn, Young Hae; Na, Ho Young; Cho, Sung Bum; Joo, Young Eun; Kim, Hyun Soo; Choi, Sung Kyu; Rew, Jong Sun; Kim, Sei Jong

Abstract

Pneumatic balloon dilataion (BD) is considered to be the first line of treatment in primary achalasia. The aim of this study was to determine the relationship between changes in symptom improvements and esophageal motor function in response to BD. Twenty three patients (10 males and 13 females) with primary achalasia treated by BD were included. To evaluate the therapeutic effects of BD, esophageal manometry and barium esophagogram were performed before BD, and 1 month after. Main symptoms were dysphagia for liquid and solid, odynophagia, and chest pain. Patients were divided into 3 groups; Group I (excellent response), symptom score improvement (deltaSS)> or =75%; Group II (good response), 25%< or =deltaSS<75%; Group III (poor response), deltaSS<25%. We evaluated the correlation between changes in the symptom score and objective indices of esophageal motor dysfunction. After BD, there was a significant decrease in the grade of symptoms (p<0.05). Excellent responders (Group I) had older age compared to other groups. A significant correlation was detected between changes in the symptom score and reduction of barium column height (r=0.59, p<0.05). Conclusions: Our study suggested that advanced age at diagnosis and the change in barium column height were most reliable indices for evaluating the therapeutic effects of BD.