Response Rate to Treatment of Achalasia Patients With Thyroid Disorders Versus Euthyroid Patients: A Cross-Sectional Study in Iran.

Background: Achalasia, characterized by impaired esophageal motility, presents a challenge in diagnosis and management. Emerging evidence suggests a potential association between achalasia and thyroid disorders (TD). Understanding the prevalence and treatment response of achalasia in Iranian patients with TD compared to euthyroid counterparts is crucial for optimizing clinical care and informing further research efforts. This study aimed to investigate and compare the response rate to treatment in euthyroid and TD achalasia patients and to determine the prevalence rate of autoimmune TD in individuals with achalasia.

Methods And Materials: This cross-sectional study was conducted on 393 achalasia patients. Initially, the patients underwent thyroid tests to identify any TD. Following these tests, they were treated for achalasia and followed up at 1, 6, and 12 months. The collected data were analyzed to assess the outcomes.

Results: The study examined data from 393 patients with achalasia and found no statistically significant correlation between the response rate to treatment in patients with normal thyroid function and those with TD ( = 0.176). Of all the participants, 292 (74.3%) underwent anti-TPO testing, revealing that 60 patients (20.5%) had autoimmune thyroiditis. The analysis showed a notable link between autoimmune thyroiditis and the patients' age ( = 0.024).

Conclusion: Achalasia is linked to various TD, including hyperthyroidism, hypothyroidism, and thyroid nodular diseases. Patients with autoimmune TD and esophageal issues should undergo a thorough examination, especially for excessive weight loss. Autoimmune diseases may contribute to inflammation in the esophageal myenteric plexus.