Surface; a Better Predictor of Disease Severity in Patients with Primary Achalasia than Height of Barium Column

Subjective assessment of primary achalasia is not accurate. We aimed to evaluate surface of barium retention in the objective assessment of these patients. Subjective and objective esophageal functions of 99 patients with primary achalasia were evaluated initially and 43 of them were reevaluated one month after balloon dilation. Predilation:  9cases enrolled. Mean age was 37.5±15.3 years. Mean score, resting LES pressure, height, and surface of barium retention at 5 minutes were 8.03±3.1.59.1±20 mmhg, 9.9±4.9 cm, and 23.6±13.9 cm2 respectively. Surface at 5 minutes had best correlation and predictive value for LES pressure.Post dilation: 43 of 99 cases reevaluated. Mean age was 36.8±13.6 years. 17 of them were male. Mean score, resting LES pressure, height and surface of barium retention at 5 minutes were 3.4±3.4, 38.6±22.6 mmhg, and 8.1±4.2 cm and 18.8±11.3 cm2 respectively. Variables dropped significantly after dilation. Surface at 5 minutes had best correlation and predictive value for LES pressure. Surface of barium retention at 5 minutes is an accurateobjective tool to assess patients with primary achalasia. It is cheap and easy to perform; therefore it could be used more frequently in follow up.