Achalasia in patients over 65

Achalasia is a disease of undertermined etiology characterized by a defect in the innervation of esophageal smooth muscle causing aperistalsis of the esophageal body, increased lower esophageal sphnicter (LES) tone and inappropriate relaxation of the LES during swallowing. Several of the manometric and radiographic features of achalasia are also seen in individuals without the disease but they are reported much more frequently in older populations. We reviewed our cases of new onsst achalasia in patients over age 65 to see if their presentation and response to treatment might differ from that reported in younger patients. We found dysphagia to be the predominant symptom in our elderly patients just as it is in younger patients. Chest pain, on the other hand, was significantly less common. Additionally, our achalasia group had a high response rate to pneumatic dilatation, confirming an earlier study that showed greater efficacy in older patients than in younger patients.