Esophageal Motility Disorders

A little information on esophageal mobility disorders from an article by our own Dr. Stuart Spechler!

Classification of esophageal motility abnormalities

Inadequate LES relaxation
 Classic achalasia
 Atypical disorders of LES relaxation
Uncoordinated contraction
 Diffuse esophageal spasm
Hypercontraction
 Nutcracker esophagus
 Isolated hypertensive LES
Hypocontraction
 Ineffective esophageal motility

Manometric features of named esophageal motility abnormalities

Basal LESP LES relaxation Wave progression Distal wave amplitude
Achalasia Usually high, may be normal, rarely low Incomplete Simultaneous or absent, no peristalsis Low or normal
Atypical disorders of LES relaxation Low, normal, or high Inadequate (incomplete or short duration) Some normal peristalsis, may have simultaneous or absent sequences Low, normal, or high
Isolated hypertensive LES High Complete Normal Normal
Diffuse esophageal spasm Low, normal, or high Complete Simultaneous in >10% of swallows Normal or high
Nutcracker esophagus Low, normal, or high Complete Normal High
Ineffective esophageal motility Low or normal Complete Normal, simultaneous, or absent Low in ⩾30% of wet swallows
  • LESP, lower esophageal sphincter pressure; LES, lower esophageal sphincter.

ReviewClassification of oesophageal motility abnormalities. S J SPECHLERD O CASTELL. Gut 2001;49:1 145151 doi:10.1136/gut.49.1.145