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New Ways to Predict Achalasia by Kyler Hood

Friday, June 17, 2011 @ 09:06 AM
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A 2004-2005 study at Toronto General Hospital claimed to have found new ways to predict achalasia, a rare autoimmune disease characterized by the inability of food to travel down the esophagus properly and an overly tense esophageal sphincter.

Researchers recognized that esophageal manometry, a procedure to measure fluid pressure in the esophagus, is the best means to diagnose achalasia, but most patients do not have access to the medical facilities with the technology required for a diagnosis. More readily available procedures like radiology, x-ray photography of organs, and endoscopy, a procedure using a long slender instrument to examine the esophagus, paired with symptom scores from an achalasia symptoms questionnaire can predict the probability of achalasia onset in patients already suffering from dysphagia, a condition characterized by difficulty swallowing food.

If both the Upper gastro-intestinal radiograph, UGI, and the esophagogastroduodnos-copy, EGD, showed no abnormality, then the dysphagia patient had a 6.3% chance of an achalasia diagnosis. Abnormalities included dilated esophagus, retained food, a tight LES muscle in the esophagus, bird’s beak, a deformity shaped like its namesake, contrast-hold up, and a sigmoid esophagus. If both the UGI and EGD showed abnormalities than the dysphagia patient had an 89.6% chance of contracting achalasia. Scores from the achalasia symptoms questionnaire ranged from 25-40. Higher scores on the questionnaire indicated a higher probability for the contraction of achalasia, especially when paired with an abnormality on the UGI and/or the EGD.

The mathematical model created to compare UGI, EGD, and results from the symptoms questionnaire more accurately reflects the achalasia population because researchers used a control group, unlike past studies. But more studies will be necessary to expedite an achalasia diagnosis because researchers estimate it takes an average of 4.7 years to diagnose and treat a patient after the onset of achalasia. A delayed diagnosis increases the risk of malignancy and fluid in the lungs.

Works Cited

endoscopy. Dictionary.com. The American Heritage® Science Dictionary. Houghton Mifflin Company. http://dictionary.reference.com/browse/endoscopy (accessed: June 14, 2011).

Ferri, L., J. Cools-Lartigue, L. Miller, S. Maryrand, G. Fried, and G. Darling. “Clinical Predictors of Achalasia.” Diseases of the Esophagus 23, no. 1 (2010): 76-81.

radiology. Dictionary.com. Collins English Dictionary – Complete & Unabridged 10th Edition. HarperCollins Publishers. http://dictionary.reference.com/browse/radiology (accessed: June 14, 2011).

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