Role of Red Blood Cell Distribution Width in the evaluation and follow-up of patients with achalasia

Background. Current studies demonstrate red blood cell distribution width (RDW) as a possible surrogate inflammation biomarker. Aim. To determine RDW in achalasia patients, compare it to GERD and healthy donor groups, and evaluate its clinical relevance. Methods . It was an ambispective study. One hundred sixty-one achalasia, 161 gastroesophageal reflux disease (GERD) patients, and 500 healthy donors (HD) were included and followed up 5 years. The achalasia and GERD patient groups were matched with the HD control groups by demographic characteristics and laboratory variables. The achalasia and GERD diagnosis were made with high-resolution esophageal manometry, upper gastrointestinal endoscopy, barium esophagogram, and 24-hour pH monitoring. For the achalasia group, correlation between RDW and clinical characteristics, Eckardt, EAT-10, GERD-HRQL questionnaire scores, achalasia types, gender, comorbidities, and integrated relaxation pressure were evaluated by logistic regression analysis between patients. Results. The RDW values at baseline differed significantly between patients (achalasia versus GERD) and these versus HD ( P <0.001). During follow-up, the achalasia group had significantly higher RDW values than the GERD ( P =0.031). The achalasia patients sustained increased RDW during follow-up compared to its baseline value (All: P =0.010; type I: P =0.006; type II: P < 0.001; female: P =0.003; men: P = 0.948). Conclusion. The results highlight the importance of RDW as an inflammatory marker, showing significant variation over time. This finding contrasts sharply with the stability of RDW observed in patients with GERD.