Incidence, clinical features and para-clinical findings of achalasia in Algeria: Experience of 25 years

Table 1 Mean incidence of achalasia between 1990-2014

Year interval	Mid-period population	Cases, n	Mean incidence, (cases/105 inhabitants/yr)	95%CI
1990-1997	28385621	87	0.04	0.028-0.025
1998-2005	32370618	274	0.108	0.072-0.144
2006-2014	37128618	895	0.268	0.215-0.321

Significance degree P < 0.001.

Table 2 Mean Incidence of achalasia according to different region of country

Regions of country	Mid-period population 1990 to 2014 (2002)	Cases, n	Cases/105 habitants/yr	95%CI
R1 North	12689307	693	0.2184	0.1811-0.2501
R2 High plains	15501671	488	0.1256	0.0921-0.1536
R3 South	3870607	75	0.0772	0.0432-0.1121

Mean incidence of cases: P < 0.001.

Table 3 Clinical profile of 1256 patients with achalasia n (%)

Female/male	653 (52)/603 (48)
Age	43.3 ± 18.7 yr (3 mo-86 yr)
Adult/children	1127 (89)/129 (10.3)
Non-syndromic achalasia/syndromic achalasia	1153/97
Familial achalasia (18)	41
Syndromic achalasia	34
Sporadic (isolated) achalasia	7
Duration of symptoms (mo)	59.5 (2-480)
Dysphagia	1243 (99)
Regurgitation	1042 (83)
Chest pain	690 (55)
Weight loss	879 (70)
Mean weight loss (kg)	7 ± 5.9 (1-40)
Heartburn	308 (24.5)
Respiratory manifestations	280 (22.3)

Values are expressed as number of patients (%) or mean ± SD.

Table 4 Esophageal barium swallow results in 1193 (95) patients with achalasia n (%)

Bird's beak aspect	1037 (87)
Mean esophageal diameter (cm), mean ± SD	5.8 ± 4.3
≤ 2 cm (normal)	60 (5)
2-4	334 (28)
4-6	513 (43)
6-9	286 (24)
Hiatal hernia	6
Epiphrenic diverticula	2

Table 5 Manometric results in 1186 (94.5) n (%)

LES pressure (mmHg)	954 (76); mean: 32 ± 15 (10-87)
12-24	257 (27)
24-34	192 (20)
> 34	504 (53.5)
< 12	2 (0.6)
LES relaxation	1130 (90)
Absent	46%
Incomplete	56%
EAC mean (mmHg)	1186 (94.5) 26.78 ± 19.67
	(0-134)
Classic achalasia (mmHg)	20.78 ± 18.76 (0-37)
Vigorous achalasia	57 ± 19 (40-134)

LES: Lower esophageal sphincter; EAC: Esophageal amplitude contraction.