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Risk Factors for Diagnostic Delay in Achalasia

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Abstract

This study investigates whether the frequentlydelayed diagnosis of achalasia is attributable toatypical symptoms, misleading diagnostic features, orthe number of physicians consulted. Eighty-sevenconsecutive patients with newly diagnosed achalasia wereprospectively investigated with the use of structuredinterviews as well as manometric, endoscopic, andradiographic studies. The mean duration of symptoms was 4.7 ± 6.4 years. Quality and intensityof symptoms had no effect on early diagnosis. Amongdifferent radiographic and manometric features, only thewidth of the gastric cardia showed a significantcorrelation with a delay in diagnosis (P < 0.01).However, the most significant association was foundbetween the duration of symptoms prior to consideringthe diagnosis of achalasia and the number ofunsuccessful physician consultations (P = 0.001). We conclude that thefrequent delay in the diagnosis of achalasia is not dueto an atypical clinical presentation of this disease butrather to misinterpretation of typical findings by the physician consulted.

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Eckardt, V., Kohne, U., Junginger, T. et al. Risk Factors for Diagnostic Delay in Achalasia. Dig Dis Sci 42, 580–585 (1997). https://doi.org/10.1023/A:1018855327960

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  • DOI: https://doi.org/10.1023/A:1018855327960

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