QUALITY-OF-LIFE AMONG PATIENTS TREATED FOR ACHALASIA

The present study is an attempt to capture the quality of life of acha lasia patients after a successful treatment. It is also an effort to a ssess the extent of the subsequent restrictions achalasia may have imp osed upon the patients' life-style. All achalasia patients who were su ccessfully treated between 1984 and 1992 were identified. Qualified pa tients were supplied with a 12-item quality-of-life questionnaire that had been designed to assess the patients' perceptions of their swallo wing function and their general health; the restrictions achalasia had imposed on five areas of performance, which encompassed social activi ties, family relationships, travel experiences, sports and housework a ctivities, were also assessed. Sixty-six patients were offered the que stionnaire and 52 (77.6%) returned a completed form. Forty-one of the group had pneumatic dilatation and the remaining 11 had cardiomyotomy. Some form of dysphagia was reported by 36 patients (69%) and a dietar y modification was exercised by 29 (56%) of them. Heartburn was report ed by 31 (59%) of the patients. Fifteen percent of the patients felt t hat the disease interfered with their social activities, 8% experience d difficulty in their family relations, 13% believed that the disease restricted travel and athletics, and finally, 9% stated that their sym ptoms placed restrictions on their ability to do housework. The group that received pneumatic dilatation experienced less restriction in the performance areas of sports, travel, and housework. However, this dif ference was only significant in the area of sports (P = 0.04). It is c oncluded that: (1) The restoration of the normal swallowing mechanism is not often achieved after treatment for achalasia. The majority of p atients who have been treated continue to have a component of difficul ty for the rest of their lives. (2) These residual symptoms leave an i mpact on the patients' life-style. This impact is least important in t he performance area of family relationship and most impressive in the area of sports (3) Finally, those patients who have been treated with cardiomyotomy are more restricted In sport activities than those who r eceived pneumatic dilatation.