Persisting symptoms and decreased health-related quality-of-life in a cross-sectional study of treated achalasia patients

Abstract

Copyright © 2007 The Authors The definitive version is available at www.blackwell-synergy.comSummaryBackgroundLittle is known about symptom characteristics of treated achalasia patients and their effect on health‐related quality‐of‐life (HRQoL).AimsTo examine clinical remission, achalasia‐associated symptoms and HRQoL in treated achalasia patients.MethodsThe Eckardt clinical symptom score, RAND‐36 and a disease‐specific HRQoL questionnaire were sent to 171 treated achalasia patients.Results76.6% of the patients returned their questionnaire. 44.9% of them were not in symptomatic remission. Prevalence of frequent dysphagia (at least daily) and chest pain (at least weekly) was 46% and 38%, respectively. Achalasia patients had lower general HRQoL scores than control subjects (all RAND‐36 subscales, except health change; P ≤ 0.002). Patients with frequent symptoms of chest pain and dysphagia showed lower HRQoL than patients with less frequent symptoms on three RAND‐36 subscales (pain, social functioning and general health perceptions; P < 0.003). Patients in clinical remission showed higher HRQoL than patients who were not, however HRQoL in the ‘remission group’ remained significantly impaired as compared to controls (all RAND‐36 subscales except emotional role limitations and mental health; P < 0.001).ConclusionsMany achalasia patients remain severely symptomatic after treatment and have decreased HRQoL. Frequent symptoms are associated with lower HRQoL. Patients in clinical remission show substantially improved, but not restored HRQoL.R. Frankhuisen, M. A. Van Herwaarden, R. Heijkoop, A. J. P. M. Smout, A. Baron, J. R. Vermeijden, H. G. Gooszen and M. Samso