Abstract
Background/Aims: Achalasia is a rare esophageal motility disorder often underrecognized due to nonspecific symptoms and limited physician awareness. Although diagnostic tools have advanced, delays remain common. Previous studies in Türkiye were mainly singlecenter or review-based, with no nationwide assessment of physician-related factors. This study evaluated physician knowledge, diagnostic practices, high-resolution esophageal manometry (HREM) access, and factors influencing diagnostic delay, providing the first nationwide achalasia-focused dataset.
Materials and Methods: A web-based survey was conducted among 4216 physicians; 675 responses (16.0%) were analyzed. The 32-item questionnaire included demographics, achalasia knowledge, diagnostic/referral practices, HREM accessibility, and training. Participants included 12.3% primary care physicians, 26.4% secondary-level, 26.2% tertiary training/research, and 35.1% university hospital physicians. Overall, 89.6% practiced internal medicine, 9.8% surgical sciences, and 0.6% basic medical sciences.
Results: Male physicians demonstrated higher knowledge (60.8% vs. 39.2%; P < .001) and diagnostic recognition, whereas females reported more self-perceived deficiencies (P < .001). Gastroenterologists had superior diagnostic accuracy (P < .001), but easy HREM access was limited (9.1%). Physicians in tertiary hospitals showed higher knowledge and diagnostic accuracy (P = .025 and P = .040). Participation in training programs and treatment familiarity did not vary by hospital type (P = .437 and P = .512).
Conclusion: Variations in physician knowledge and diagnostic practices across specialties, hospital types, and gender may contribute to delayed achalasia recognition. Persistent gaps in practical competence, HREM familiarity, and access to diagnostic resources highlight the need for targeted education and structured interventions. Improving diagnostic infrastructure and HREM access may enable earlier diagnosis and enhance outcomes.
Cite this article as: Eroğlu Haktanır A, Çelebi A. Achalasia: Physician practices and knowledge in Türkiye. Turk J Gastroenterol. 2026;37(2):260-269.
Most read articles by the same author(s)
- Serhat Bor, Hasan Özen, İsmail Hakkı Kalkan, Filiz Akyüz, Altay Çelebi, Dinç Dinçer, Yusuf Serdar Sakin, Expert Opinion on the Efficacy and Safety of Antispasmodics with a Focus on Irritable Bowel Syndrome , Turkish Journal of Gastroenterology: Vol. 36 No. Supplement 2 (2025): Turkish Journal of Gastroenterology
- Serhat Bor, İsmail Hakkı Kalkan, Altay Çelebi, Dinç Dinçer, Filiz Akyüz, Peter Dettmar, Hasan Özen, Alginates: From the ocean to gastroesophageal reflux disease treatment , Turkish Journal of Gastroenterology: Vol. 30 No. Supplement 2 (2019): Turkish Journal of Gastroenterology
- Filiz Akyüz, Altay Çelebi, İbrahim Doğan, Yusuf Erzin, Taylan Kav, Müjde Soytürk, Dilek Oğuz, Birol Özer, Sabahattin Kaymakoğlu, Functional Bowel Disorder Management in Routine Practice with Tips for Hot Topics: Expert Opinion Review , Turkish Journal of Gastroenterology: Vol. 35 No. 6 (2024): Turkish Journal of Gastroenterology
- Altay Çelebi, Dinçer Aydın, Orhan Kocaman, Buğra Tolga Konduk, Ömer Şentürk, Sadetin Hülagü, Comparison of the effects of esomeprazole 40 mg, rabeprazole 20 mg, lansoprazole 30 mg, and pantoprazole 40 mg on intragastrıc pH in extensive metabolizer patients with gastroesophageal reflux disease , Turkish Journal of Gastroenterology: Vol. 27 No. 5 (2016): Turkish Journal of Gastroenterology
- Sadettin HÜLAGÜ, Ömer ŞENTÜRK, Uğur KORKMAZ, Göktuğ ŞİRİN, Ali Erkan DUMAN, Gökhan Dindar, Altay ÇELEBİ, Deniz ÖĞÜTMEN KOÇ, Neslihan BOZKURT, Hasan YILMAZ, Yeşim Gürbüz, Deniz DUMAN, Orhan TARÇIN, Endoscopic submucosal dissection for colorectal laterally spreading tumors , Turkish Journal of Gastroenterology: Vol. 24 No. 6 (2013): Turkish Journal of Gastroenterology
- Sadettin HÜLAGÜ, Ömer ŞENTÜRK, Cem AYGÜN, Yeşim GÜRBÜZ, Orhan KOCAMAN, Altay ÇELEBİ, Buğra Tolga KONDUK, Granular cell tumor of esophagus removed with endoscopic submucosal dissection , Turkish Journal of Gastroenterology: Vol. 18 No. 3 (2007): Turkish Journal of Gastroenterology
- Ali Erkan Duman, Sadettin Hülagü, Altay Çelebi, Uğur Korkmaz, Mahmut Mert Musul, Ömer Şentürk, Göktuğ Şirin, Hasan Yılmaz, Deniz Öğütmen Koç, Gökhan Dindar, Murat Öztürkler, Neslihan Bozkurt, Hale Maral Kır, Differential diagnosis of Crohn’s disease using antibodies to glycoprotein 2 and Saccharomyces cerevisiae , Turkish Journal of Gastroenterology: Vol. 30 No. 1 (2019): Turkish Journal of Gastroenterology
- Orhan KOCAMAN, Cem AYGÜN, Buğra Tolga KONDUK, Altay ÇELEBİ, Ömer ŞENTÜRK, Sadettin HÜLAGÜ, Pegylated interferon treatment of acute pericarditis associated with acute hepatitis C , Turkish Journal of Gastroenterology: Vol. 18 No. 4 (2007): Turkish Journal of Gastroenterology
- Orhan KOCAMAN, Ahmet ALPONAT, Cem AYGÜN, Yeşim GÜRBÜZ, H. Tahsin SARISOY, Altay ÇELEBİ, Ömer ŞENTÜRK, Sadettin HÜLAGÜ, Lower gastrointestinal bleeding, hematuria and splenic hemangiomas in Klippel-Trenaunay syndrome: A case report and literature review , Turkish Journal of Gastroenterology: Vol. 20 No. 1 (2009): Turkish Journal of Gastroenterology
- Altay Çelebi, Hasan Yılmaz, When proton pump inhibitors are compared, are there specific cases in which a certain proton pump inhibitors should be particularly preferred? , Turkish Journal of Gastroenterology: Vol. 28 No. 1 (2017): Turkish Journal of Gastroenterology

This work is licensed under a Creative Commons Attribution 4.0 International License.