Manometry reveals failed peristalsis (≥50% of swallows with absent or failed peristalsis) with incomplete lower esophageal sphincter (LES) relaxation (median integrated relaxation pressure ≥15 mmHg). According to Chicago Classification v4.0, this pattern is best classified as:
- A Type I achalasia ✓
- B Type II achalasia
- C Type III achalasia
- D Esophagogastric junction outflow obstruction (EGJOO)
Explanation
Chicago Classification v4.0 defines three achalasia subtypes based on high-resolution manometry. Type I (classic achalasia): absent peristalsis + impaired LES relaxation — all swallows show absent contraction with minimal pressurization. Type II: absent peristalsis + pan-esophageal pressurization in ≥20% of swallows — considered best responder to therapy. Type III (spastic achalasia): premature/spastic contractions in ≥20% of swallows + impaired LES relaxation. Type I has the described pattern of complete absence of peristalsis without pressurization. EGJOO has impaired relaxation with preserved or disordered peristalsis.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.