Achalasia may occur at any age; however, incidence increases with age. The median age at diagnosis is 53 years.[1]Sadowski DC, Ackah F, Jiang B, et al. Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil. 2010 Sep;22(9):e256-61.
http://www.ncbi.nlm.nih.gov/pubmed/20465592?tool=bestpractice.com
Achalasia affects both sexes equally.[1]Sadowski DC, Ackah F, Jiang B, et al. Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil. 2010 Sep;22(9):e256-61.
http://www.ncbi.nlm.nih.gov/pubmed/20465592?tool=bestpractice.com
[2]van Hoeij FB, Ponds FA, Smout AJ, et al. Incidence and costs of achalasia in The Netherlands. Neurogastroenterol Motil. 2018 Feb;30(2).
http://www.ncbi.nlm.nih.gov/pubmed/28836740?tool=bestpractice.com
Geographic, ethnic, and temporal differences have been reported for the prevalence and incidence of achalasia. Incidence rates of 2.92/100,000 persons per year and 2.3 to 2.8/100,000 persons per year have been reported in North America and South Australia.[3]Duffield JA, Hamer PW, Heddle R, et al. Incidence of achalasia in South Australia based on esophageal manometry findings. Clin Gastroenterol Hepatol. 2017 Mar;15(3):360-5.
http://www.ncbi.nlm.nih.gov/pubmed/27266979?tool=bestpractice.com
[4]Samo S, Carlson DA, Gregory DL, et al. Incidence and prevalence of achalasia in central Chicago, 2004-2014, since the widespread use of high-resolution manometry. Clin Gastroenterol Hepatol. 2017 Mar;15(3):366-73.
http://www.ncbi.nlm.nih.gov/pubmed/27581064?tool=bestpractice.com
The incidence in Korea is 0.39/100,000 persons per year, in Zimbabwe is 0.03/100,000 persons per year, and in Singapore is 0.3/100,000 persons per year.[5]Kim E, Lee H, Jung HK, et al. Achalasia in Korea: an epidemiologic study using a national healthcare database. J Korean Med Sci. 2014 Apr;29(4):576-80.
http://jkms.org/DOIx.php?id=10.3346/jkms.2014.29.4.576
http://www.ncbi.nlm.nih.gov/pubmed/24753707?tool=bestpractice.com
[6]Stein CM, Gelfand M, Taylor HG. Achalasia in Zimbabwean blacks. S Afr Med J. 1985 Feb 16;67(7):261-2.
http://www.ncbi.nlm.nih.gov/pubmed/3983775?tool=bestpractice.com
[7]Ho KY, Tay HH, Kang JY. A prospective study of the clinical features, manometric findings, incidence and prevalence of achalasia in Singapore. J Gastroenterol Hepatol. 1999 Aug;14(8):791-5.
http://www.ncbi.nlm.nih.gov/pubmed/10482430?tool=bestpractice.com
Estimates of prevalence range from 8.0/100,000 persons per year to 27.1/100,000 persons per year.[1]Sadowski DC, Ackah F, Jiang B, et al. Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil. 2010 Sep;22(9):e256-61.
http://www.ncbi.nlm.nih.gov/pubmed/20465592?tool=bestpractice.com
[2]van Hoeij FB, Ponds FA, Smout AJ, et al. Incidence and costs of achalasia in The Netherlands. Neurogastroenterol Motil. 2018 Feb;30(2).
http://www.ncbi.nlm.nih.gov/pubmed/28836740?tool=bestpractice.com
[8]Birgisson S, Richter JE. Achalasia in Iceland, 1952-2002: an epidemiologic study. Dig Dis Sci. 2007 Aug;52(8):1855-60.
http://www.ncbi.nlm.nih.gov/pubmed/17420933?tool=bestpractice.com
[9]Harvey PR, Thomas T, Chandan JS, et al. Incidence, morbidity and mortality of patients with achalasia in England: findings from a study of nationwide hospital and primary care data. Gut. 2019 May;68(5):790-5.
http://www.ncbi.nlm.nih.gov/pubmed/29925629?tool=bestpractice.com
Some studies demonstrate increasing incidence and prevalence over time.[1]Sadowski DC, Ackah F, Jiang B, et al. Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil. 2010 Sep;22(9):e256-61.
http://www.ncbi.nlm.nih.gov/pubmed/20465592?tool=bestpractice.com
[2]van Hoeij FB, Ponds FA, Smout AJ, et al. Incidence and costs of achalasia in The Netherlands. Neurogastroenterol Motil. 2018 Feb;30(2).
http://www.ncbi.nlm.nih.gov/pubmed/28836740?tool=bestpractice.com
[10]Marlais M, Fishman JR, Fell JM, et al. UK incidence of achalasia: an 11-year national epidemiological study. Arch Dis Child. 2011 Feb;96(2):192-4.
http://www.ncbi.nlm.nih.gov/pubmed/20515971?tool=bestpractice.com
In the US, there has been an increase in the number of Heller myotomies performed, with a concomitant increase in utilization of the laparoscopic rather than the open approach.[11]Haisley KR, Preston JF, Dolan JP, et al. Twenty-year trends in the utilization of Heller myotomy for achalasia in the United States. Am J Surg. 2017 Aug;214(2):299-302.
http://www.ncbi.nlm.nih.gov/pubmed/28460739?tool=bestpractice.com
The study authors concluded that these findings likely reflect increased disease prevalence alongside improving surgical technique (and, therefore, a concomitant growth in the number of surgical candidates).[11]Haisley KR, Preston JF, Dolan JP, et al. Twenty-year trends in the utilization of Heller myotomy for achalasia in the United States. Am J Surg. 2017 Aug;214(2):299-302.
http://www.ncbi.nlm.nih.gov/pubmed/28460739?tool=bestpractice.com
Racial differences have been highlighted in some studies, with a study from New Zealand showing a higher incidence of achalasia in Pacific Islanders and people of Maori descent than in white people.[12]Mayberry JF, Mayell MJ. Epidemiological study of achalasia in children. Gut. 1988 Jan;29(1):90-3.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1433259
http://www.ncbi.nlm.nih.gov/pubmed/3343019?tool=bestpractice.com
In Singapore, one study found that achalasia was more common in Chinese and Indian people than in Malay people.[7]Ho KY, Tay HH, Kang JY. A prospective study of the clinical features, manometric findings, incidence and prevalence of achalasia in Singapore. J Gastroenterol Hepatol. 1999 Aug;14(8):791-5.
http://www.ncbi.nlm.nih.gov/pubmed/10482430?tool=bestpractice.com
In the US, achalasia occurs at a similar rate in people of all races.[13]Sonnenberg A, Massey BT, McCarty DJ, et al. Epidemiology of hospitalization for achalasia in the United States. Dig Dis Sci. 1993 Feb;38(2):233-44.
http://www.ncbi.nlm.nih.gov/pubmed/8425436?tool=bestpractice.com
Regional and ethnic variations in the incidence of achalasia suggest a role for both environmental and genetic factors in its etiology.