Table 2.
Distal esophageal motility disorders based on pressure topography criteria
| Disorder | Criteria |
| With Normal EGJ Relaxation (mean IRP < 15 mmHg) | |
| Peristaltic Weakness | |
| Intermediate | More than 30% of swallows with mild or severe peristaltic defects, but numerically insufficient to constitute severe peristaltic weakness |
| Severe | >= 70% of swallows with severe peristaltic defects |
| Aperistalsis | 100% swallows with absent peristalsis |
| Nutcracker Esophagus | Normal CFV, Mean DCI > 5000 and < 8000 mmHg × s × cm, can be localized to either distal subsegment or LES |
| Spastic Nutcracker | Normal CFV, Mean DCI > 8000 mmHg × s × cm |
| Distal Esophageal Spasm | Normal EGJ relaxation and spasm (CFV > 8 cm/s) with >= 20% of swallows |
| Esophageal Obstruction | Increased IBP or panesophageal pressurization not associated with EGJ obstruction |
| With Impaired EGJ Relaxation (mean IRP >= 15 mmHg) | |
| Achalasia | |
| Classic achalasia | Impaired EGJ relaxation and aperistalsis |
| Achalasia with esophageal compression | Impaired EGJ relaxation, aperistalsis, and panesophageal pressurization with >= 20% of swallows |
| Spastic achalasia | Impaired EGJ relaxation, aperistalsis, and spasm with >= 20% of swallows |
| EGJ Obstruction | |
| Mild | Elevated IBP (15-30 mmHg) that is compartmentalized between the peristaltic wavefront (normal, weak, or nutcracker) and EGJ |
| Severe | IBP > 30 mmHg that is compartmentalized between the peristaltic wavefront (normal or nutcracker) and EGJ |