INTRODUCTION: Esophageal achalasia is a primary motility disorder. Although the exact pathogenesis is unknown, autoimmune, and neurodegenerative processes seem to be involved similarly to neurodegenerative and/or demyelinating disorders (NDDs). We hypothesized that the prevalence of NDD may be higher among patients with achalasia and vice versa as the background pathogenetic mechanisms are similar. METHODS: This was a prospective, comparative questionnaire-based study. Patients with achalasia and patients with NDD were enrolled. Selected patients with achalasia were thoroughly examined by a neurologist and selected patients with NDD were examined by a gastroenterologist to confirm or rule out NDD or achalasia. We assessed the prevalence of both achalasia and NDD and compared them with their prevalence in general population. RESULTS: A total of 150 patients with achalasia and 112 patients with NDD were enrolled. We observed an increased prevalence of NDD among patients with achalasia (6.0% (9/150); 95% CI (confidence interval): 3.1-11.2%) as compared to the estimated 2.0% prevalence in general population (p = 0.003). Although 32 out of 112 patients (28.6%) with NDD reported dysphagia, we did not observe significantly increased prevalence of achalasia in these patients (1.8% (2/112) vs 0.8% in general population, p = 0.226). CONCLUSION: The prevalence of NDD was significantly higher among patients with achalasia (6.0%) compared to general population (2.0%), suggesting an association of these disorders. Large-volume studies are necessary to confirm this finding.

1st Faculty of Medicine Charles University 12108 Prague Czech Republic

Charles University 3rd Faculty of Medicine 10000 Prague Czech Republic

Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine 14021 Prague Czech Republic

Department of Neurology 2nd Faculty of Medicine Charles University Motol University Hospital 15000 Prague Czech Republic

Department of Neurology Na Homolce Hospital 15000 Prague Czech Republic

Department of Radiology Na Homolce Hospital 15000 Prague Czech Republic

Institute of Physiology 1st Faculty of Medicine Charles University 12108 Prague Czech Republic

ResTrial s r o 16000 Prague Czech Republic

Sarkamed s r o 27401 Slany Czech Republic

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