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- W3022083695 abstract "Introduction Absolute absent contractility (AAC) of the oesophagus has been affiliated with failed peristalsis.1 and pathological reflux.2 However, a group of patients showed minimal to no reflux in AAC which is a compatible feature of non-relaxing lower oesophageal sphincter (LOS). A group of these patients may indeed have achalasia but such a diagnosis is not catered to Chicago Classification (CC).3 when the LOS basal tone is Method AAC patients were selected between September 2014 and December 2017. The patients underwent the following inclusion and exclusion criteria. Inclusion criteria: a) LOS relaxation pressure ≥LOS basal tone (=non relaxing LOS), b) No remanence of peristalsis (defined by DCI≥10–99 mmHgscm) or features sequential contraction waveform on line tracing. Exclusion criteria a) Relevant surgical or endoscopic therapy, b) LOS basal tone outside of 5–15 mmHg range. The control group was selected in the same period within the same population of AAC patients that fulfil the exclusion criteria but having remanences of peristalsis and relaxation pressures to be less than LOS basal tone during swallows. Reflux parameters were compared between the two groups as a confirmation of non-relaxing LOS. Reflux Disease Questionnaire (RDQ) and Hospital Odynophagia Dysphagia Questionnaire (HODQ) scores were also compared between groups. Statistical method used was t-test. Results 14 patients (F:M≥9:5, age 28–73 years) and 9 controls (F:M≥6:2, age 15–77 years) were found. In the patient group, significantly reduced acid exposure time was observed (1.6 vs. 71.2, p≥0.0002), lower number of acid reflux events occurred (1.5 vs. 21, p≥0.035) and decreased RDQ scores were found (2 vs. 4.1, p≥0.0047). Conclusion A group of patients with AAC demonstrate characteristics of achalasia which explains the absence of pathological reflux and also not meeting CC criteria for achalasia. Considering relative relaxation pressure and remanences of peristalsis can further distinguish these hidden achalasia patients. This study was limited by the sample size and requires larger population to confirm the findings. Reference Miah I, et al. Gut BMJ2017, 66 (Suppl 2) A270-A271. Miah I, et al. Gut BMJ2017, 66 (Suppl 2) A263-A264. Kahrilas PJ, et al. Neurogastroenterol Motil2015;27(2):160–174." @default.
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- W3022083695 date "2018-06-01" @default.
- W3022083695 modified "2023-09-27" @default.
- W3022083695 title "PWE-143 Hidden achalasia in absent contractility" @default.
- W3022083695 doi "https://doi.org/10.1136/gutjnl-2018-bsgabstracts.437" @default.
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