위식도 역류 질환에서 병발한 식도 이완불능증 1예

Achalasia is an uncommon disease in which damage to the autonomic nervous system results in disruption of esophageal motility with failure of the normal relaxation of the lower esophageal sphincter during swallowing. In addition, achalasia is also associated with poor peristalsis within the body of the esophagus. Vagal impairment has been reported in association with gastroesophageal reflux in which the lower esophageal sphincter pressure is commonly subnormal but the power of relaxation is retained. Some authors reported that patients with gastroesophageal reflux disease also proceeded to achalasia. We recently assessed a 29-year-old male patient who complained of an epigastric pain. Reflux esophagitis was initially diagnosed on esophagogastroduodenoscopy. The patient continued to be asymptomatic, while taking acid-suppression treatment. However, the patient was diagnosed with achalasia by esophageal manometry 3 months after the end of medication. Therefore, we report this case of achalasia following gastroesophageal reflux esophagitis and provide a review of the literature. (Kor J Neur ogastr oenter ol Motil 2004;1:86-89)