BACKGROUND & AIMS: Most experienced gastroenterologists have seen one or several cases of achalasia patients who have been erroneously diagnosed with gastroesophageal reflux disease (GERD) or even underwent antireflux surgery. We aim to describe the current knowledge about the diagnostic features of achalasia and their overlap with GERD. Furthermore, we present 3 cases in which achalasia was mistaken for GERD. METHODS: Search of the literature published in English using the PubMed database and relevant abstracts presented at international conventions. RESULTS: Typical features of GERD such as heartburn, retrosternal pain, esophagitis, and pathologic acid exposure can be observed in achalasia patients. Diagnostic tests such as endoscopy and radiography lack sensitivity and specificity for achalasia. Current diagnostic guidelines for antireflux surgery do not stipulate that achalasia should be ruled out preoperatively. CONCLUSIONS: Clinical presentation as well as the diagnostic work-up of achalasia patients can show overlap with GERD. Mistaking achalasia for GERD can be avoided by esophageal manometry and this should therefore be performed in all patients undergoing surgical fundoplication.
BACKGROUND & AIMS: Most experienced gastroenterologists have seen one or several cases of achalasiapatients who have been erroneously diagnosed with gastroesophageal reflux disease (GERD) or even underwent antireflux surgery. We aim to describe the current knowledge about the diagnostic features of achalasia and their overlap with GERD. Furthermore, we present 3 cases in which achalasia was mistaken for GERD. METHODS: Search of the literature published in English using the PubMed database and relevant abstracts presented at international conventions. RESULTS: Typical features of GERD such as heartburn, retrosternal pain, esophagitis, and pathologic acid exposure can be observed in achalasiapatients. Diagnostic tests such as endoscopy and radiography lack sensitivity and specificity for achalasia. Current diagnostic guidelines for antireflux surgery do not stipulate that achalasia should be ruled out preoperatively. CONCLUSIONS: Clinical presentation as well as the diagnostic work-up of achalasiapatients can show overlap with GERD. Mistaking achalasia for GERD can be avoided by esophageal manometry and this should therefore be performed in all patients undergoing surgical fundoplication.
Authors: Karl Hermann Fuchs; Benjamin Babic; Wolfram Breithaupt; Bernard Dallemagne; Abe Fingerhut; Edgar Furnee; Frank Granderath; Peter Horvath; Peter Kardos; Rudolph Pointner; Edoardo Savarino; Maud Van Herwaarden-Lindeboom; Giovanni Zaninotto Journal: Surg Endosc Date: 2014-05-02 Impact factor: 4.584
Authors: Salvatore Maria Antonio Campo; Angelo Zullo; Chiara Maria Scandavini; Barbara Frezza; Paola Cerro; Genoveffa Balducci Journal: World J Gastrointest Endosc Date: 2013-09-16
Authors: Bram D van Rhijn; Boudewijn F Kessing; Andreas Jpm Smout; Albert J Bredenoord Journal: United European Gastroenterol J Date: 2013-08 Impact factor: 4.623