Achalasia and Down's syndrome: Coincidential association or something else?

Achalasia is an uncommon esophageal motor disorder. It has been associated with other diseases such as Parkinson's disease and depressive disorders, b ut coincidence of achalasia and Down's syndrome is rare. We report five cas es of achalasia in Down's syndrome patients seen in our institution. Two of the five cases were diagnosed at pediatric age. Respiratory symptoms and g rowth retardation were the main clinical manifestations in pediatric patien ts, whereas adult patients mainly complained of dysphagia. Taking into acco unt the prevalence rate of both disorders, the association seems higher tha n that expected by chance. The possible etiopathogenic implications of this association, as well as its clinical relevance, are discussed. (Am J Gastr oenterol 1999;94:1674-1677. (C) 1999 by Am. Cell. of Gastroenterology).