A Study of Cases of Achalasia Treated as a Psycological Disorder

Abstract

Achalasia sometimes requires a long time until it is diagnosed because it lacks abnormal findings on upper gastrointestinal endoscopy and barium meal study, and during the long time it has been treated as a psychological disease.
In this study, we analyze our patients operated on for achalasia who had been treated as having a psychological disease, and clarify difficulties in making diagnosis of achalasia. We enrolled consecutive 65 patients who underwent laparoscopic surgery for achalasia in our hospital from October 1997 to May 2010. Fifteen out of the 65 (23%) patients had been received at least either one of upper gastrointestinal endoscopy or barium meal study, and were determined to have no abnormalities. Six out of these 15 patients had some histories of treatment for a psychological disorder. Those six patients had the classical types of esophageal achalasia without esophageal dilatation.
Esophageal manometric study is important for patients with eating disorders or dysphagia who show no abnormalities on upper gastrointestinal endoscopy or barium meal study, because they can have some functional disease.