Heartburn in patients with achalasia

S. J. Spechler, R. F. Souza, S. J. Rosenberg, R. A. Ruben, R. K. Goyal

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Heartburn, the main symptom of gastro-oesophageal reflux disease (GORD), might be expected to occur infrequently in achalasia, a disorder characterised by a hypertensive lower oesophageal sphincter (LOS) that fails to relax. Nevertheless, it is often described by patients with achalasia. The medical records of 32 patients with untreated achalasia who complained of heartburn, and of 35 similar patients who denied the symptom, were reviewed to explore the implications of heartburn in this condition. Data on endoscopic and manometric findings, and on the onset and duration of oesophageal symptoms were collected. Three patterns of heartburn were observed: (1) in 8 patients (25%) the onset of heartburn followed the onset of dysphagia, (2) in 15 patients (47%) heartburn preceded the onset of dysphagia and persisted as dysphagia progressed, and (3) in 9 patients (28%), heartburn preceded the onset of dysphagia and stopped as dysphagia progressed. The mean (SD) basal LOS pressure in the patients with heartburn (38 (16) mm Hg) was significantly lower than that in patients without the symptom (52 (26) mm Hg); the lowest LOS pressure (29 (11) mm Hg) was observed in the subset of patients whose heartburn preceded the onset of dysphagia and then stopped. It is concluded that patients who have achalasia with heartburn have lower basal LOS pressures than patients who have achalasia without this symptom. In some patients with achalasia, the appearance of dysphagia is heralded by the disappearance of longstanding heartburn. For these patients, it is speculated that achalasia develops in the setting of underlying GORD.

Original languageEnglish (US)
Pages (from-to)305-308
Number of pages4
JournalGut
Volume37
Issue number3
StatePublished - 1995

Fingerprint

Heartburn
Esophageal Achalasia
Deglutition Disorders
Lower Esophageal Sphincter
Esophageal Diseases
Gastroesophageal Reflux
Pressure
Medical Records

Keywords

  • Gastro-oesophageal reflux disease
  • Motility disorders
  • Oesophageal achalasia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Spechler, S. J., Souza, R. F., Rosenberg, S. J., Ruben, R. A., & Goyal, R. K. (1995). Heartburn in patients with achalasia. Gut, 37(3), 305-308.

Heartburn in patients with achalasia. / Spechler, S. J.; Souza, R. F.; Rosenberg, S. J.; Ruben, R. A.; Goyal, R. K.

In: Gut, Vol. 37, No. 3, 1995, p. 305-308.

Research output: Contribution to journalArticle

Spechler, SJ, Souza, RF, Rosenberg, SJ, Ruben, RA & Goyal, RK 1995, 'Heartburn in patients with achalasia', Gut, vol. 37, no. 3, pp. 305-308.
Spechler SJ, Souza RF, Rosenberg SJ, Ruben RA, Goyal RK. Heartburn in patients with achalasia. Gut. 1995;37(3):305-308.
Spechler, S. J. ; Souza, R. F. ; Rosenberg, S. J. ; Ruben, R. A. ; Goyal, R. K. / Heartburn in patients with achalasia. In: Gut. 1995 ; Vol. 37, No. 3. pp. 305-308.
@article{d61a7d1869d1405692bb7bc738e46602,
title = "Heartburn in patients with achalasia",
abstract = "Heartburn, the main symptom of gastro-oesophageal reflux disease (GORD), might be expected to occur infrequently in achalasia, a disorder characterised by a hypertensive lower oesophageal sphincter (LOS) that fails to relax. Nevertheless, it is often described by patients with achalasia. The medical records of 32 patients with untreated achalasia who complained of heartburn, and of 35 similar patients who denied the symptom, were reviewed to explore the implications of heartburn in this condition. Data on endoscopic and manometric findings, and on the onset and duration of oesophageal symptoms were collected. Three patterns of heartburn were observed: (1) in 8 patients (25{\%}) the onset of heartburn followed the onset of dysphagia, (2) in 15 patients (47{\%}) heartburn preceded the onset of dysphagia and persisted as dysphagia progressed, and (3) in 9 patients (28{\%}), heartburn preceded the onset of dysphagia and stopped as dysphagia progressed. The mean (SD) basal LOS pressure in the patients with heartburn (38 (16) mm Hg) was significantly lower than that in patients without the symptom (52 (26) mm Hg); the lowest LOS pressure (29 (11) mm Hg) was observed in the subset of patients whose heartburn preceded the onset of dysphagia and then stopped. It is concluded that patients who have achalasia with heartburn have lower basal LOS pressures than patients who have achalasia without this symptom. In some patients with achalasia, the appearance of dysphagia is heralded by the disappearance of longstanding heartburn. For these patients, it is speculated that achalasia develops in the setting of underlying GORD.",
keywords = "Gastro-oesophageal reflux disease, Motility disorders, Oesophageal achalasia",
author = "Spechler, {S. J.} and Souza, {R. F.} and Rosenberg, {S. J.} and Ruben, {R. A.} and Goyal, {R. K.}",
year = "1995",
language = "English (US)",
volume = "37",
pages = "305--308",
journal = "Gut",
issn = "0017-5749",
publisher = "BMJ Publishing Group",
number = "3",

}

TY - JOUR

T1 - Heartburn in patients with achalasia

AU - Spechler, S. J.

AU - Souza, R. F.

AU - Rosenberg, S. J.

AU - Ruben, R. A.

AU - Goyal, R. K.

PY - 1995

Y1 - 1995

N2 - Heartburn, the main symptom of gastro-oesophageal reflux disease (GORD), might be expected to occur infrequently in achalasia, a disorder characterised by a hypertensive lower oesophageal sphincter (LOS) that fails to relax. Nevertheless, it is often described by patients with achalasia. The medical records of 32 patients with untreated achalasia who complained of heartburn, and of 35 similar patients who denied the symptom, were reviewed to explore the implications of heartburn in this condition. Data on endoscopic and manometric findings, and on the onset and duration of oesophageal symptoms were collected. Three patterns of heartburn were observed: (1) in 8 patients (25%) the onset of heartburn followed the onset of dysphagia, (2) in 15 patients (47%) heartburn preceded the onset of dysphagia and persisted as dysphagia progressed, and (3) in 9 patients (28%), heartburn preceded the onset of dysphagia and stopped as dysphagia progressed. The mean (SD) basal LOS pressure in the patients with heartburn (38 (16) mm Hg) was significantly lower than that in patients without the symptom (52 (26) mm Hg); the lowest LOS pressure (29 (11) mm Hg) was observed in the subset of patients whose heartburn preceded the onset of dysphagia and then stopped. It is concluded that patients who have achalasia with heartburn have lower basal LOS pressures than patients who have achalasia without this symptom. In some patients with achalasia, the appearance of dysphagia is heralded by the disappearance of longstanding heartburn. For these patients, it is speculated that achalasia develops in the setting of underlying GORD.

AB - Heartburn, the main symptom of gastro-oesophageal reflux disease (GORD), might be expected to occur infrequently in achalasia, a disorder characterised by a hypertensive lower oesophageal sphincter (LOS) that fails to relax. Nevertheless, it is often described by patients with achalasia. The medical records of 32 patients with untreated achalasia who complained of heartburn, and of 35 similar patients who denied the symptom, were reviewed to explore the implications of heartburn in this condition. Data on endoscopic and manometric findings, and on the onset and duration of oesophageal symptoms were collected. Three patterns of heartburn were observed: (1) in 8 patients (25%) the onset of heartburn followed the onset of dysphagia, (2) in 15 patients (47%) heartburn preceded the onset of dysphagia and persisted as dysphagia progressed, and (3) in 9 patients (28%), heartburn preceded the onset of dysphagia and stopped as dysphagia progressed. The mean (SD) basal LOS pressure in the patients with heartburn (38 (16) mm Hg) was significantly lower than that in patients without the symptom (52 (26) mm Hg); the lowest LOS pressure (29 (11) mm Hg) was observed in the subset of patients whose heartburn preceded the onset of dysphagia and then stopped. It is concluded that patients who have achalasia with heartburn have lower basal LOS pressures than patients who have achalasia without this symptom. In some patients with achalasia, the appearance of dysphagia is heralded by the disappearance of longstanding heartburn. For these patients, it is speculated that achalasia develops in the setting of underlying GORD.

KW - Gastro-oesophageal reflux disease

KW - Motility disorders

KW - Oesophageal achalasia

UR - http://www.scopus.com/inward/record.url?scp=0029085157&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029085157&partnerID=8YFLogxK

M3 - Article

C2 - 7590421

AN - SCOPUS:0029085157

VL - 37

SP - 305

EP - 308

JO - Gut

JF - Gut

SN - 0017-5749

IS - 3

ER -