Frequency and factors associated with malnutrition among patients with achalasia and effect of pneumatic dilation.

Although achalasia patients are undernourished, studies are scant. We studied: (i) the frequency of malnutrition among these patients and (ii) the effect of pneumatic dilatation (PD) on malnutrition.A total of 70 adult achalasia patients and 70 healthy controls were evaluated through dietary recall, anthropometry, and biochemical parameters, and patients were reevaluated 6 months after PD.

Patients had lower intake of calories (median, interquartile range [IQR]: 1835.0 [1682.5-1915.0] vs 2071.5 [1950-2276.2] kcal/day, P < 0.001), protein (40.9 [36.3-42.2] vs 52.9 [45.7-62] g/day, P < 0.001), calcium (310 [192.5-392.4] vs 477.5 [350-560] mg/day, P < 0.001), and iron (6.7 [4.7-8.8] vs 10.1 [7.5-11.50] mg/day, P < 0.001) than controls. Patients had lower body mass index (BMI: 19.6 [16.6-22] vs 22.8 [19.5,29.1], P < 0.001), midarm circumference (MAMC; 20 [17.5-23] vs 24.1 [21.4-28.5], P < 0.001), biceps (BSFT; 3.1 [1.9-3.9] vs 5.5 [3.8-9.2] mm, P < 0.001), triceps' skin fold thickness (TSFT; 5 [2.4-7] vs 7.8 [5.1-9.4] mm, P < 0.001), serum protein (7.2 ± 0.8 vs 7.6 ± 0.8 g/dL, P = 0.005), and albumin (4.0 [3.5-4.4] vs 4.1 [3.9-4.2] g/dL, P = 0.009). PD increased calories (1803 [950-2400] vs 2050 [1470-2950] kcal/day), protein intake (41.0 [22-70] vs 45.0 [37.5-80.0] gm/day), BMI (19.6 [12.8-30.0] vs 22.2[15.9-30.0] P = 0.001 for all), and MAMC (21 [14.1-32.0] vs 24.2 [15-32.0] cm, P = 0.03). Reduced intake was a determinant of malnutrition.

Malnutrition is common in achalasia patients, and PD improved it.