Achalasia classification

Jump to navigation Jump to search

Achalasia Microchapters


Patient Information


Historical Perspective




Differentiating Achalasia from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings

X Ray




Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Achalasia classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Achalasia classification

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical

US National Guidelines Clearinghouse

NICE Guidance

FDA on Achalasia classification

CDC on Achalasia classification

Achalasia classification in the news

Blogs on Achalasia classification

Directions to Hospitals Treating Achalasia

Risk calculators and risk factors for Achalasia classification

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]


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.


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]


  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.