Galey et al reported a classification for atypical achalasia which can help to identify patients affected by this condition. The authors are from the University of Rochester.
Evaluation requires high-resolution esophageal manometry
Features of classic achalasia:
(1) aperistalsis of the esophagus
(2) impaired relaxation of the lower esophageal sphincter (LES)
(1) lower esophageal sphincter
Lower Esophageal Sphincter
normal or hypertensive
abnormal or borderline abnormal
spastic or partially spastic contractions
borderline abnormal or normal
aperistalsis with occasional short segment peristalsis
• Hypertensive peristalsis involves a contractile frontal velocity < 8 cm/s, distal esophageal amplitude > 180 mm Hg, or distal contractile integral > 4300 mm Hg•s•cm.
• Spastic peristalsis involves a contractile frontal velocity >= 8 cm/s
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