Comparison of clinical and manometric parameters in Achalasia cardia between elderly and non-elderly patients in West Bengal

Achalasia cardia, a primary esophageal motility disorder of unknown etiology involving lower twothird of esophagus and lower esophageal sphincter (LES), can be specifically diagnosed by gold standard method, manometry, which shows abnormal LES relaxation and absent or vigorous peristalsis. In our study, 125 patients were admitted with dysphagia, regurgitation of food, vomiting, chest pain, retrosternal discomfort, of which, 36 were detected as esophageal carcinoma and lye stricture, rest were non organic. These 89 patients were sent for esophageal manometry. Males were significantly affected than females. Other than dysphagia, common symptoms were regurgitation of food and chest pain. 59.55% patients demonstrated LES pressure <45 mm of Hg. Rest had hypertensive LES. Maximum contraction amplitude was detected in 61.79% of patients (vigorous Achalasia). We also compared symptoms and manometric parameters in two group of patients (one was ≤60 years and second one was >60 years). Incidence of duration of symptoms before diagnosis and vomiting were significant in elderly patients, but manometric parameters showed no significant difference. Basal LES pressure was above normal in our study. Key-words: Achalasia cardia, esophagus, endoscopy, barium study, esophageal manometry, lower esophageal sphincter, esophageal peristalsis