Symptoms Vs Disorder

[Guest guest]

We get people coming to this support group because they are trying to

find out if their symptoms are from achalasia. Sometimes this is before

any testing. I caution such people that many things can cause swallowing

problems that seem like achalasia and in most cases the problem is not

achalasia, which is why a manometry test is often the last test not the

first. They try to find the usual suspects first by barium and

endoscopy. If those two are not conclusive for something other than

motility problems a manometry test is done. A manometry test may also be

done for NCCP, without swallowing problems. But, even with people going

to manometry tests for swallowing and NCCP problems it does not mean

that achalasia will be the diagnosis.

Here is a study where they studied the " association between a patient's

presenting symptoms and their manometric diagnosis. "

Insights Gained from Symptom Evaluation of Esophageal Motility Disorders:

A Review of 4,215 Patients.

Creighton University Medical Center, Omaha, Nebr.

http://www.ncbi.nlm.nih.gov/pubmed/22472689

" Twenty-four-year data ... Of the 4,215 patients, 130 (3.1%) had Ach,

192 (4.6%) had DES, 290 (6.9%) had NE, 508 (12.1%) had NSMD, and 3,095

(73.4%) had normal esophageal body motility. ... reported symptoms do

not correlate with their manometric diagnosis in a predictable fashion, ... "

There are some interesting things in those numbers. First, of the

thousands tested only 3.1% had achalasia. That seems odd to me because

they have 4.6% with DES and 6.9% with nutcracker. I would expect more

achalasia compared to those disorders. That may possibly be explained by

having patients from many rural area where young people would move away

leaving a higher percentage of older residents. Most people tested

didn't have any motility problem. You can see that having problems

swallowing or having NCCPs does not mean that having achalasia is likely.

Swallowing problems are not uncommon but achalasia is rare. If you tell

someone you have achalasia they will likely say what is that, but if you

tell them your symptoms they will often say something like, " my uncle

had that " and claim it is the same thing and they know all about it. But

even if the uncle had dilatation it probably was not achalasia. Lots of

GIs do dilatation but not all GIs do achalasia dilatations.

notan

[Guest guest]

Interesting....I was actually originally diagnosed with non-specified motility

disorder. When I got to Mayo, they diagnosed me with achalasia.