Background and aim:
Therapies for achalasia aim to patients’ symptom
relief, but they affect patient’s quality of life (QoL), too. An ad hoc question-
naire evaluating both achalasia-related symptoms and disease related QoL is
lacking.
Aim: To validate a disease specific QoL questionnaire in perspectively
evaluated Italian achalasia patients.
Material and methods:
22 consecutive achalasia patients (4 men, age range
19–86 years) were included in the study. At baseline a structured question-
naire was used to evaluate both esophageal symptoms and disease specific
QoL. Questionnaire graded achalasia-related symptoms severity (dysphagia for solids and liquids, food regurgitation, chest pain, nocturnal cough) from 0
to 3, based on their impact on daily activities. Also a disease specific QoL was
evaluated by a self administred questionnaire, the AE-18, that investigated
four domains (physical, psychological and social functioning, and sleep dis-
turbance). Scores for each item range from 1
(“always”) to 5 (“never”); higher
scores corresponding to better quality of life. All patients were questioned
before, 1 and 6 months after a specific t
reatment regimen, that according
to patients clinical status consisted in pneumatic dilation, botulinum toxin
injection or surgical myotomy.
Results:
Patients within each specific treatment groups were the following
(3/22 surgical myotomy, 14/22 pneumatic dilation and 5/22 Botox injections,
respectively. In the table are reported the baseline demographics and achalasia-
related symptoms’ severity and QoL (data are expressed as mean
±
SD) within
each treatments group.
Table 1
Surgery group Dilation group Botox group p
Age at diagnosis
42.3
±
6.5 42.3
±
13 81.8
±
4.8
<
0.001
Age at onset of symptoms
39.3
±
7.5 40.3
±
12.4 80.8
±
5.6
<
0.001
Dysphagia for solids
2.7
±
0.6 2.2
±
0.7 2.2
±
0.5 0.5
Dysphagia for liquids
2.0
±
1.0 2.1
±
0.7 2.2
±
0.5 0.9
Regurgitation of undigested food 1.0
±
1.7 0.7
±
0.8 0.6
±
1.3 0.8
Chest pain
0.7
±
1.1 1.1
±
1.1 1.0
±
1.4 0.8
Nocturnal cough
1.3
±
1.5 1.3
±
1.2 1.0
±
1.4 0.9
AE-18 total score
54
±
14 53
±
12 53
±
11 0.9
At both 1 and 6 months of the follow-up, the severity mean scores of dysphagia
achalasia-related symptoms severity were significantly reduced compared to
baseline (p
<
0.05). Similarly, the AE-18 total score was significantly improved
(p
<
0.001).
Conclusions:
We showed that therapy-induced improvement of achalasia-
related symptoms correlate with a significant improvement of patients quality
of life as assessed by a specific questionnaire
