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)
Parameters:
(1) lower esophageal sphincter
(2) peristalsis
Lower Esophageal Sphincter
Peristalsis
Type
abnormal
normal or hypertensive
I
abnormal or borderline abnormal
spastic or partially spastic contractions
II
borderline abnormal or normal
aperistalsis with occasional short segment peristalsis
III
where:
• 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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Specialty: Gastroenterology
