Obesity has been shown to be an independent risk factor for developing esophageal
motility disorders, with a prevalence of 20% to 61% [
1
,
2
,
3
,
4
]. Achalasia is a rare primary esophageal motility disorder that is even more rare
among the obese population. It is characterized by aperistalsis of the esophagus and
lack of relaxation of the lower esophageal sphincter. Associated symptoms in the nonobese
patient include dysphagia, regurgitation, reflux, and weight loss. On the contrary,
among the obese population regurgitation, cough and aspiration are the presenting
symptoms. Atypical symptoms in the obese can create a challenge in diagnosis and management.
Achalasia after bariatric surgery has limited data [
2
,
4
,
5
,
6
,
7
] but will likely become more apparent with increasing case volumes in the foreseeable
future.Keywords
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References
- High prevalence of asymptomatic esophageal motility disorders among morbidly obese patients.Obes Surg. 1999; 9: 390-395
- Achalasia and laparoscopic gastric bypass.Surg Obes Relat Dis. 2009; 5: 132-134
- Achalasia in the context of morbid obesity: a rare but important association.Obes Surg. 2003; 13: 896-900
- Achalasia after bariatric surgery.J Laparoendosc Adv Surg Tech A. 2016; 26: 428-432
- Laparoscopic Heller's myotomy for achalasia after gastric bypass: a case report.Int J Surg Case Rep. 2013; 4: 396-398
- Laparoscopic Heller's cardiomyotomy and Roux-En-Y gastric bypass for missed achalasia diagnosed after laparoscopic sleeve gastrectomy.Surg Obes Relat Dis. 2014; 10: 1002-1004
- Surgical management of achalasia in a patient with previous gastric bypass.Innovations (Phila). 2016; 11: 214-216
- Morbid obesity with achalasia: a surgical challenge.Obes Surg. 2010; 20: 1456-1458
- Simultaneous surgical management of achalasia and morbid obesity.Obes Surg. 2007; 17: 547-549
Article info
Publication history
Published online: August 25, 2017
Accepted:
August 18,
2017
Received:
August 3,
2017
Identification
Copyright
© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
