Achalasia: A review of Western and Iranian experiences

Table 1 Causes of secondary achalasia

Malignancy, especially carcinoma

Chagas’ disease

Amyloidosis

Sarcoidosis

Neurofibromatosis

Eosinophilic gastroenteritis

Multiple Endocrine Neoplasia, type 2B

Juvenile Sjögren’s syndrome with achalasia and gastric ypersecretion

Chronic idiopathic intestinal pseudo-obstruction

Anderson-Fabry disease

Table 2 Prevalence of symptoms in achalasia

Symptom	Percentage (%)
Dysphagia to solids	99
Dysphagia to liquids	93
Active regurgitation	84
Passive regurgitation	68
Weight loss	61
Chest pain	59
Nocturnal cough	45
Heartburn	35
Nocturnal dyspnea	20
Hiccup	8

Table 3 Frequency of cardinal symptoms in achalasia

Symptom	Frequency (%)
	Each meal	Daily	Weekly	None
Dysphagia to solids	84	13	2	1
Dysphagia to liquids	60	25	8	7
Active regurgitation	33	36	15	16
	Daily	Weekly	Monthly	None
Passive regurgitation	20	44	4	32
Chest pain	12	39	8	41

Table 4 Scoring system for evaluation of clinical symptoms

Symptom	Score by frequency of symptoms
	Each meal	Daily	Weekly	None
Dysphagia to solids	3	2	1	0
Dysphagia to liquids	3	2	1	0
Active regurgitation	3	2	1	0
	Daily	Weekly	Monthly	None
Passive regurgitation	3	2	1	0
Chest pain	3	2	1	0