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Background: Epidemiological studies in achalasia and its clinical management in Australia are limited. Aims: To determine the prevalence and trends in incidence rates and describe the types of treatment stratified by subtypes of achalasia. Methods: A retrospective observational study was conducted at a single site that offers a state‐wide high‐resolution manometry (HRM) service in Western Australia (WA). Patients (aged ≥ 18 years) newly diagnosed with achalasia based on HRM findings between 2012 and 2021 were extracted from the HRM database. The crude incidence rate and age‐standardised incidence rate (ASIR) along with the 2021‐point prevalence were calculated. Trends were assessed by the Kendall τb test. The patients' initial and subsequent treatment modalities were described. Results: A total of 296 new cases were identified, and the median age at diagnosis was 56 years. The patient's median age, sex and year of the first treatment did not vary significantly with the subtypes. The lowest and highest ASIR (cases/100 000 person‐years) were 0.8 in 2012 and 2.1 in 2021, respectively. Only type 2 achalasia showed a significant increasing trend (P = 0.009). The 2021‐point prevalence was 16.9 cases/100 000 people and increased with age. Pneumatic balloon dilatation (PBD) was the most common treatment for types 1 and 2, while laparoscopic Heller myotomy was most common for type 3. Peroral endoscopic myotomy (POEM) has become common in the past 5 years. Conclusion: The ASIR of type 2 achalasia significantly increased in WA. PBD was most commonly performed, although peroral endoscopic myotomy has recently increased as a preferred treatment option. [ABSTRACT FROM AUTHOR]

Background: Early and accurate non‐invasive diagnosis of liver fibrosis is important for reducing the burden of cirrhosis and related complications. Aim: This cross‐sectional study compares shear wave elastography (SWE), transient elastography (TE) and clinical markers of chronic liver disease in patients with various liver disorders. Methods: Liver ultrasound with SWE was performed on 421 adult patients, 227 of whom also had TE. Patient age, gender, body mass index (BMI), liver disease aetiology and laboratory results were recorded. Associations between SWE, TE and other tests for liver fibrosis and chronic liver disease severity were sought. Advanced liver fibrosis was defined as liver stiffness measurement (LSM) equivalent to ≥F3 using Metavir staging. Results: Patients were predominantly male (68%), with mean (standard deviation) age 54 (13) years, BMI 28 (6) kg/m2 and serum alanine aminotransferase (ALT) 39 (27) U/L. Liver disorders were predominantly non‐alcoholic fatty liver disease (NAFLD), chronic hepatitis B (CHB), chronic hepatitis C (CHC) and alcohol‐related liver disease. The median (interquartile range) LSM was 10 (6–20) kPa with SWE and 9.2 (6–21) kPa with TE. Advanced liver fibrosis was associated with older age, higher BMI, model for end‐stage liver disease score, aspartate aminotransferase (AST), AST/ALT ratio, AST to platelet ratio index, fibrosis‐4 index and Hepascore. SWE and TE LSM were positively correlated, particularly for NAFLD and CHC. SWE LSM predicted ultrasound and endoscopy‐diagnosed portal hypertension and oesophageal varices. Conclusions: Across various liver diseases, SWE is at least comparable with TE and other non‐invasive tests of liver fibrosis. SWE is accurate for predicting liver‐related portal hypertension. [ABSTRACT FROM AUTHOR]