Quality of Life After POEM for Achalasia

• Conditions: Esophageal Achalasia
• Interventions: Procedure: Peroral endoscopic myotomy (POEM)

• Registration Number: NCT05010889
• Lead Sponsor: First Affiliated Hospital, Sun Yat-Sen University

Brief Summary

Achalasia is an esophageal motility disorder, characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. Patients with achalasia experience distressing gastrointestinal symptoms, including dysphagia, reflux and chest pain, which lead to weight loss and malnutrition. Undoubtedly, health-related quality of life can be significantly diminished in patients with achalasia. At present, POEM has become one of the standard therapies for achalasia. Limited studies have focused on the patient's quality of life before and after POEM. The present study aimed to assess the changes in quality of life of patients with achalasia using the validated achalasia severity questionnaire (ASQ) and the short form (SF)-36 scale.

Detailed Description

Not available

Study Timeline

• Status Verified: 2021-08
• Study First Submitted: 2021-08-10
• Study First Submitted QC: 2021-08-17
• Last Update Submitted: 2021-08-17
• Study First Posted: 2021-08-18
• Last Update Posted: 2021-08-18
• Study Start: 2021-09-01
• Primary Completion: 2022-12-31
• Study Completion: 2022-12-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

• Diagnosed as achalasia base on high resolution manometry, barium esophagram and upper endoscopy
• Scheduled to undergo POEM for treatment of achalasia

Exclusion Criteria

• Coagulopathy and systemic disorders that precluded safe general anesthesia

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Achalasia patients	Peroral endoscopic myotomy (POEM)	Patients schedule to undergo POEM for treatment of symptomatic achalasia. The diagnosis of achalasia was based on high resolution manometry, barium esophagram, and upper endoscopy.

Primary Outcome Measures

Name	Time	Method
Achalasia symptom questionnaire (ASQ)	Baseline, Change from Baseline ASQ score at 3 months and 12 months after treatment	Achalasia symptom questionnaire assess the disease-specific health-related quality of life by sampling the concepts of food tolerance, dysphagia-related behavior modifications, pain, heartburn, distress, lifestyle limitation, and satisfaction in 10 items. The total range is 10 to 31, with higher scores indicating worse quality of life (Urbach et al, Am J Gastroenterol 2005).
Short form (SF)-36	Baseline, Change from Baseline SF-36 score at 3 months and 12 months after treatment	The short form (SF)-36 (best score 100, worst score 0). The short form (SF)-36 assess the health-related quality of life from 8 aspects, including physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and mental health in 36 items. The total range is 0 to 100, with lower scores indicating worse quality of life (Ware et al, J Clin Epidemiol 1998).

Secondary Outcome Measures

Name	Time	Method
Reflux esophagitis on post-POEM endoscopy	3 months after treatment	The severity of reflux esophagitis is graded according to the Los Angeles classification (Armstrong D et al, Gastroenterology 1996).
Eckardt score	baseline, 3 months and 12 months after treatment	The Eckardt score assesses the severity of achalasia symptoms by combining the sum of symptom frequency scores for dysphagia, regurgitation, and chest pain and a weight loss score. Each component can be graded from 0 to 3 points. The total range is 0 to 12, with higher scores indicating more severe symptoms (Eckardt AJ et al, Nat Rev Gastroenterol Hepatol 2011).
Gastroesophageal reflux disease questionnaire (GerdQ) score	baseline, 3 months and 12 months after treatment	The GerdQ has been developed as a tool to facilitate the symptom-based diagnosis of GERD. Scores ranging from 0 to 3 were applied for the four positive predictors (heartburn, regurgitation, sleep disturbance due to reflux symptoms and use of over-the-counter medications for reflux symptoms) and from 3 to 0 for two negative predictors (epigastric pain and nausea). The GerdQ score was calculated as the sum of these scores, giving a total score ranging from 0 to 18. A total GerdQ score \>7 is considered indicative of significant GERD symptoms (Jones R et al, Aliment Pharmacol Ther 2009).

Trial Locations

Locations (1)

First Affiliated Hospital of Sun Yat-sen University; 🇨🇳 Guangzhou, Guangdong, China