RESUMO
INTRODUCTION: Symptomatic gastroesophageal reflux (GER) occurs in 0-20% of patients treated with pneumatic dilation and in 5-30% with cardiomyotomy. However, the prevalence of GER evaluated with esophageal pH-monitoring is unknown. AIM: To investigate the frequency of GER in achalasia patients treated with pneumatic dilation or myotomy. MATERIAL AND METHODS: Patients with achalasia were evaluated prospectively and classified in 4 groups: group A = treated with pneumatic dilation; group B = treated with open abdominal myotomy; group C = transthoracic myotomy; and group D = submitted to laparoscopic abdominal myotomy with antireflux procedure. Esophageal manometry and 24 h pH-monitoring were performed in all patients. GER was defined as a pH < 4 in more than 4% of the total time. RESULTS: Thirty-one patients, 22 women and 9 men, with a mean age of 44.7 years were evaluated. Nine patients had GER symptoms and 22 were asymptomatic. GER was detected with pH-metry in 42% of the total group: 33% for group A, 75% for group B, 44% for group C and none for group D. CONCLUSIONS: Prevalence of GER in achalasia patients treated with pneumatic dilation and surgical myotomy was high. We suggest the inclusion of 24 hr esophageal pH-metry in the follow-up due to the significant prevalence of asymptomatic GER. Minimal hiatus dissection and antireflux procedure were surgical factors related with a lower frequency of GER after achalasia myotomy.