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Achalasia After Bariatric Surgery.

Mena Boules1, Ricard Corcelles2,3, Andrea Zelisko1

  • 11 Digestive Disease Institute, Cleveland Clinic , Cleveland, Ohio.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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PubMed
Summary

Achalasia can develop after bariatric surgery, even years later. Surgical treatments like Heller myotomy are effective for managing achalasia symptoms in these patients.

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Area of Science:

  • Gastroenterology
  • Bariatric Surgery
  • Esophageal Motility Disorders

Background:

  • Obesity is a growing epidemic associated with various health issues.
  • Motility disorders, such as achalasia, are increasingly recognized in obese individuals.
  • Preoperative identification of motility disorders is crucial for bariatric surgery planning.

Purpose of the Study:

  • To characterize patients who developed achalasia after bariatric surgery.
  • To investigate the presentation and treatment outcomes of achalasia post-bariatric procedures.

Main Methods:

  • Retrospective review of patients diagnosed with achalasia post-bariatric surgery.
  • Data collection included demographics, surgical history, and outcomes.
  • Descriptive statistics were used to analyze the data.

Main Results:

  • Ten patients were identified with achalasia post-bariatric surgery (8 Roux-en-Y gastric bypass, 2 vertical banded gastroplasty).
  • Median time to diagnosis was 6 years; treatments included Botox, dilation, and surgery (Heller myotomy, esophagectomy).
  • Heller myotomy in 8 patients led to symptom resolution in 6, with one recurrence.

Conclusions:

  • Achalasia can occur after bariatric surgery and requires appropriate management.
  • Increased awareness and preoperative screening for motility disorders are recommended.
  • Surgical interventions demonstrate effectiveness in treating achalasia post-bariatric surgery.