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Target Concepts:
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Query: UMLS:C0014848 (
achalasia
)
2,804
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Achalasia
is a relatively rare primary motor esophageal disorder, characterized by absence of relaxations of the lower esophageal sphincter and of peristalsis along the esophageal body. As a result, patients typically present with dysphagia, regurgitation and occasionally chest pain, pulmonary complication and malnutrition. New diagnostic methodologies and therapeutic techniques have been recently added to the armamentarium for treating
achalasia
. With the aim to offer clinicians and patients an up-to-date framework for making informed decisions on the management of this disease, the International Society for Diseases of the Esophagus Guidelines proposed and endorsed the
Esophageal Achalasia
Guidelines (I-GOAL). The guidelines were prepared according the Appraisal of Guidelines for Research and Evaluation (AGREE-REX) tool, accredited for guideline production by NICE UK. A systematic literature search was performed and the quality of evidence and the strength of recommendations were graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Given the relative rarity of this disease and the paucity of high-level evidence in the literature, this process was integrated with a three-step process of
anonymous
voting on each statement (DELPHI). Only statements with an approval rate >80% were accepted in the guidelines. Fifty-one experts from 11 countries and 3 representatives from patient support associations participated to the preparations of the guidelines. These guidelines deal specifically with the following
achalasia
issues: Diagnostic workup, Definition of the disease, Severity of presentation, Medical treatment, Botulinum Toxin injection, Pneumatic dilatation, POEM, Other endoscopic treatments, Laparoscopic myotomy, Definition of recurrence, Follow up and risk of cancer, Management of end stage
achalasia
, Treatment options for failure,
Achalasia
in children,
Achalasia
secondary to Chagas' disease.
...
PMID:The 2018 ISDE achalasia guidelines. 3016 45
Background and Objective
: The oral health-related quality of life (OHRQoL) of patients with
achalasia
has not been evaluated to date. Therefore, the aim of this study was to assess the OHRQoL of patients with
achalasia
and to get information about the time taken for diagnosis and oral symptoms.
Materials and Methods:
The study was conceived of as an
anonymous
epidemiological survey study in people with
achalasia
in order to assess their OHRQoL in each case. For this, a questionnaire was developed consisting of free-text questions and of the standardized German version of the OHIP-14 questionnaire.
Results:
In total, forty-four questionnaires were analyzed including 31 female and 13 male participants. Regardless of gender, the mean age was 50.57 years (range: 17-78). Of the surveyed individuals, seventy-nine-point-five-five percent had been diagnosed between 25 and 60 years of age. The period from the first signs of the disease to diagnosis was 6.15 years, irrespective of gender. The overall OHIP-14 score without gender differentiation was 8.72 points (range 0-48); the mean score of female participants was 11.13 (range: 0-48), and the OHIP score of male participants was 3.15 on average. Two participants reported oral symptoms.
Conclusions:
The already known problem of the delayed diagnosis of rare diseases was also confirmed in the case of
achalasia
. Females with
achalasia
seemed to be significantly affected by lower OHRQoL than males with
achalasia
and women of the general population. Demineralization of the tooth structure was described in two participants.
...
PMID:Oral Health-Related Quality of Life in People with Achalasia. 3254 17