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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Achalasia classification

Introduction

Overview

Overview

Achalasia can be classified according to the pattern of abnormal peristalsis into three types. Different types of achalasia are shown to have different responses to therapies with type II having the best prognosis.

Classification

Classification

Chicago Classification of Achalasia by High-Resolution Manometry

Type I

  • Type I achalasia is associated with no evidence of esophageal pressurization.
  • Integrated relaxation pressure (IRP)>10 mmHg distinguishes type 1 achalasia from absent peristalsis.[1]

Type II

  • Type II achalasia is associated with esophageal compression (panesophageal pressurization).
  • This type of achalasia is most likely to respond to therapy.

Type III

  • Type III achalasia is associated with 2 or more spastic contractions (spastic achalasia).
  • IRP>17 mmHg distinguishes type III achalasia from difuse esophageal spasm.[1]
  • It carries a negative predictive response to therapy. [2][3]
References

References

  1. ↑ 1.0 1.1 Lin Z, Kahrilas PJ, Roman S, Boris L, Carlson D, Pandolfino JE (2012). “Refining the criterion for an abnormal Integrated Relaxation Pressure in esophageal pressure topography based on the pattern of esophageal contractility using a classification and regression tree model”. Neurogastroenterol Motil. 24 (8): e356–63. doi:10.1111/j.1365-2982.2012.01952.x. PMC 3616504. PMID 22716041.
  2. ↑ Pandolfino JE, Kwiatek MA, Nealis T, Bulsiewicz W, Post J, Kahrilas PJ (2008). “Achalasia: a new clinically relevant classification by high-resolution manometry”. Gastroenterology. 135 (5): 1526–33. doi:10.1053/j.gastro.2008.07.022. PMC 2894987. PMID 18722376.
  3. ↑ Roman S, Zerbib F, Quenehervé L, Clermidy H, Varannes SB, Mion F (2012). “The Chicago classification for achalasia in a French multicentric cohort”. Dig Liver Dis. 44 (12): 976–80. doi:10.1016/j.dld.2012.07.019. PMID 22938702.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief:Rim Halaby, Twinkle Singh, M.B.B.S. [2], Ahmed Younes M.B.B.CH [3]