Epidemiological characteristics and treatment outcomes of achalasia: a retrospective study from a tertiary reflux-motility center

Aims: Achalasia is a rare esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and the absence of peristalsis, leading to progressive dysphagia, regurgitation, and weight loss. High-resolution esophageal manometry (HREM) is the gold standard for diagnosis. Management options include pneumatic balloon dilatation (PBD), laparoscopic Heller myotomy (LHM), and peroral endoscopic myotomy (POEM). Delayed diagnosis remains a major clinical issue and may influence disease progression and treatment outcomes. This study aimed to evaluate the demographic and clinical characteristics, diagnostic delay, subtype distribution, and treatment outcomes in patients with achalasia.Methods: This retrospective study included 111 patients diagnosed with achalasia at a tertiary care center. Patients were classified into type I, II, or III according to the Chicago classification v4.0. Demographic data, clinical presentation, diagnostic intervals, and treatment responses were analyzed.Results: The cohort consisted of 55% female and 45% male patients. Type II was the most common subtype (73.9%). The median diagnostic delay was 49.8 months, with no significant difference between subtypes. All patients reported solid food dysphagia, and 95.5% also experienced liquid dysphagia. The median baseline Eckardt score (ES) was 7 (6–9). Post-treatment ES significantly decreased across all subtypes (p