Factors determining successful outcome following pneumatic balloon dilation in achalasia cardia.

BACKGROUND Pneumatic balloon dilation is a popular method of treating patients with achalasia cardia. It may be useful to know the factors that predict response to this treatment. AIM To determine predictors of outcome following pneumatic balloon dilation in patients with achalasia cardia. METHODS Records of 62 patients who had undergone pneumatic dilation using Rigiflex balloon dilators (Boston Scientific, Boston, MA, USA) were reviewed. Follow-up data were available for 52 patients. Data from patients with and without improvement in symptoms were compared. RESULTS Of the 52 patients (age mean 44 [range 11-68] years; 27 male; median symptom duration 20 [4-90] months], 42 (81%) patients had response in symptoms after balloon dilatation. On univariate analysis, the responders more often had age> 40 years (26/42 [62%] versus 1/10 [10%], p=0.003), and less often had lower esophageal sphincter pressure> 50 mmHg (8/10 [80%] versus 10/42 [24%], p=0.0007) and mid-esophageal body hypocontraction (7/10 [70%] versus 12/24 [29%] p=0.01) than the non-responders. On multivariate analysis only age <or= 40 years (p=0.02) was associated with poor outcome. CONCLUSION Younger age may predict non-response to balloon dilation using Rigiflex balloon dilators in patients with achalasia cardia.