Quality of life among patients treated for achalasia

Abstract

The present study is an attempt to capture the quality of life of achalasia patients after a successful treatment. It is also an effort to assess the extent of the subsequent restrictions achalasia may have imposed upon the patients' life-style. All achalasia patients who were successfully treated between 1984 and 1992 were identified. Qualified patients were supplied with a 12-item quality-of-life questionnaire that had been designed to assess the patients' perceptions of their swallowing function and their general health; the restrictions achalasia had imposed on five areas of performance, which encompassed social activities, family relationships, travel experiences, sports and housework activities, were also assessed. Sixty-six patients were offered the questionnaire and 52 (77.6%) returned a completed form. Forty-one of the group had pneumatic dilatation and the remaining 11 had cardiomyotomy. Some form of dysphagia was reported by 36 patients (69%) and a dietary modification was exercised by 29 (56%) of them. Heartburn was reported by 31 (59%) of the patients. Fifteen percent of the patients felt that the disease interfered with their social activities, 8% experienced difficulty in their family relations, 13% believed that the disease restricted travel and athletics, and finally, 9% stated that their symptoms placed restrictions on their ability to do housework. The group that received pneumatic dilation experienced less restriction in the performance areas of sports, travel, and housework. However, this difference was only significant in the area of sports (P = 0.04). It is concluded that: (1) The restoration of the normal swallowing mechanism is not often achieved after treatment for achalasia. The majority of patients who have been treated continue to have a component of difficulty for the rest of their lives. (2) These residual symptoms leave an impact on the patients' life-style. This impact is least important in the performance area of family relationship and most impressive in the area of sports. (3) Finally, those patients who have been treated with cardiomyotomy are more restricted in sport activities than those who received pneumatic dilatation.