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J R Soc Med 1986;79:71-73
© 1986 Royal Society of Medicine

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Journal of the Royal Society of Medicine, Vol 79, Issue 2 71-73, Copyright © 1986 by Royal Society of Medicine

ORIGINAL ARTICLES

Achalasia following gastro-oesophageal reflux

HL Smart, JF Mayberry and M Atkinson

Five patients initially presenting with symptomatic gastro-oesophageal reflux, proven by radiology or pH monitoring, subsequently developed achalasia, confirmed by radiology and manometry, after an interval of 2-10 years. During this period dysphagia, present as a mild and intermittent symptom accompanying the initial reflux in 3 of the 5, became severe and resulted in oesophageal stasis of food in all. Three of the 5 had a demonstrable hiatal hernia. In none was reflux a troublesome symptom after Rider-Moeller dilatation or cardiomyotomy undertaken for the achalasia. Gastro-oesophageal reflux does not protect against the subsequent development of achalasia. It is suggested that the autonomic damage eventually leading to achalasia may in its initial phases cause gastro-oesophageal reflux.
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