Clinical and nutritional correlates associated with weight changes in achalasia patients and the impact of laparoscopic Heller myotomy.

Body mass index Caloric intake Dysphagia and symptoms’ severity Esophageal achalasia Weight loss

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
14 Aug 2024
Historique:
received: 14 06 2024
revised: 23 07 2024
accepted: 28 07 2024
medline: 16 8 2024
pubmed: 16 8 2024
entrez: 15 8 2024
Statut: aheadofprint

Résumé

Achalasia is characterized by symptoms of esophageal obstruction, preventing food consumption. However, weight loss is observed only in a subset of patients, and data from literature is conflicting. Our study aimed at evaluating predictors of weight loss in achalasia patients and at verifying the impact of treatment on nutritional status. 123 achalasia patients, eligible for laparoscopic Heller myotomy, were studied. Demographic, clinical and nutritional data (calorie intake and macronutrient composition) were recorded at baseline and one-year post-treatment. Significant weight loss/gain was considered for variation of 10 % of body weight at baseline and post-treatment, respectively. 57.7 % of patients reported weight loss at presentation. These subjects had shorter disease duration, worse symptoms, lower BMI and consumed fewer calories than patients without weight loss. Post-treatment, we observed a considerable improvement in Eckardt score and BMI values. Almost 50 % of the population reported significant weight gain, particularly in individuals with weight loss at baseline. Caloric intake also rose significantly, positively affecting BMI categories. We showed that achalasia-induced weight loss is associated with symptoms' severity and disease duration. Conversely, over 50 % of treated patients were in the overweight/obese category, highlighting the need for individualized nutritional interventions in achalasia patients.

Sections du résumé

BACKGROUND BACKGROUND
Achalasia is characterized by symptoms of esophageal obstruction, preventing food consumption. However, weight loss is observed only in a subset of patients, and data from literature is conflicting.
AIMS OBJECTIVE
Our study aimed at evaluating predictors of weight loss in achalasia patients and at verifying the impact of treatment on nutritional status.
METHODS METHODS
123 achalasia patients, eligible for laparoscopic Heller myotomy, were studied. Demographic, clinical and nutritional data (calorie intake and macronutrient composition) were recorded at baseline and one-year post-treatment. Significant weight loss/gain was considered for variation of 10 % of body weight at baseline and post-treatment, respectively.
RESULTS RESULTS
57.7 % of patients reported weight loss at presentation. These subjects had shorter disease duration, worse symptoms, lower BMI and consumed fewer calories than patients without weight loss. Post-treatment, we observed a considerable improvement in Eckardt score and BMI values. Almost 50 % of the population reported significant weight gain, particularly in individuals with weight loss at baseline. Caloric intake also rose significantly, positively affecting BMI categories.
CONCLUSION CONCLUSIONS
We showed that achalasia-induced weight loss is associated with symptoms' severity and disease duration. Conversely, over 50 % of treated patients were in the overweight/obese category, highlighting the need for individualized nutritional interventions in achalasia patients.

Identifiants

DOI: 10.1016/j.dld.2024.07.027 PMID: 39147673
pubmed: 39147673
pii: S1590-8658(24)00891-0
doi: 10.1016/j.dld.2024.07.027
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest The Authors declare that there is no conflict of interest.

Auteurs

Laura Aurino (L)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: laura.aurino@unina.it.

Marcella Pesce (M)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: marcella.pesce@unina.it.

Sara Rurgo (S)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: sararurgo91@gmail.com.

Maria Giovanna Puoti (MG)

Department of Pediatric Gastroenterology and Hepatology, Santobono-Pausilipon Children's Hospital, Via Mario Fiore, 6, 80129, Naples, Italy. Electronic address: giovanna.puoti@hotmail.it.

Barbara Polese (B)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: barbara.polese@gmail.com.

Marianna Capuano (M)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: marianna.capuano@unina.it.

Giuseppe Palomba (G)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: giuseppepalomba3@virgilio.it.

Giovanni Aprea (G)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: aprea@unina.it.

Luisa Seguella (L)

Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy. Electronic address: luisa.seguella@uniroma1.it.

Giuseppe Esposito (G)

Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy. Electronic address: giuseppe.esposito@uniroma1.it.

Irene Palenca (I)

Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy. Electronic address: irene.palenca@uniroma1.it.

Eleonora Efficie (E)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: eleonora.efficie@hotmail.it.

Giovanni Sarnelli (G)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy, Via Pansini 5, 80131, Naples, Italy. Electronic address: sarnelli@unina.it.

Classifications MeSH