Journal of Neurogastroenterology and Motility : eISSN 2093-0887 / pISSN 2093-0879

Table. 1.

Chicago Classification of Esophageal Motility Disorders Version 4.0

Disorders of EGJ outflow Criteria
• Type 1 achalasia - Elevated median IRP (supine and/or upright) and 100% failed peristalsis
• Type 2 achalasia - Elevated median IRP (supine and/or upright), 100% failed peristalsis, and ≥ 20% swallows with panesophageal pressurization
• Type 3 achalasia - Elevated median IRP (supine and/or upright) and ≥ 20% swallows with premature/spastic contraction and no evidence of peristalsis
• EGJ outflow obstruction - Elevated median IRP (supine and upright), ≥ 20% elevated intrabolus pressure (supine), and not meeting criteria for achalasia
- Clinically relevant symptoms with at least one confirmatory non-HRM supportive test (FLIP or TBE)
Disorders of peristalsis Criteria
• Absent contractility - Normal median IRP (supine and upright) and 100% failed peristalsis
• Distal esophageal spasm - Normal median IRP and ≥ 20% swallows with premature/spastic contraction
- Clinically relevant symptoms
• Hypercontractile esophagus - Normal median IRP and ≥ 20% hypercontractile swallows
- Clinically relevant symptoms
• Ineffective esophageal motility - Normal median IRP, with > 70% ineffective swallows or ≥50% failed peristalsis

EGJ, esophagogastric junction; IRP, integrated relaxation pressure; HRM, high-resolution manometry; FLIP, functional lumen imaging probe; TBE, timed barium esophagogram.

J Neurogastroenterol Motil 2022;28:531~539 https://doi.org/10.5056/jnm22082
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