Algorithm for Applying the Chicago Classification of Esophageal Motor Disorders - Flowchart
Algorithm for Applying the Chicago Classification of Esophageal Motor Disorders - Flowchart Achalasia Achalasia
«Flowchart»

Pressure Topography of Esophageal Motility
The Chicago Classification

Pressure Topography of Esophageal Motility
The Chicago Classification

Pressure Topography of Esophageal Motility
The Chicago Classification


The Chicago Classification The Chicago Classification

End

End

End

Achalasia


Subtypes I, II, III

Achalasia


Subtypes I, II, III

Achalasia


Subtypes I, II, III


Subtypes I, II, III

EGJ Outflow Obstruction


Achalasia variant versus mechanical obstruction

EGJ Outflow Obstruction


Achalasia variant versus mechanical obstruction

EGJ Outflow Obstruction


Achalasia variant versus mechanical obstruction


Achalasia variant versus mechanical obstruction Achalasia variant versus mechanical obstruction Achalasia variant versus mechanical obstruction

Absent Peristalsis

Distal esophageal spasm


20% of swallows with reduced DL (<4.5 s)

Jackhammer esophagus


!!getq!!20% of swallows with DCI >8000 mm Hg-s-cm and normal DL

Absent Peristalsis

Distal esophageal spasm


20% of swallows with reduced DL (<4.5 s)

Jackhammer esophagus


!!getq!!20% of swallows with DCI >8000 mm Hg-s-cm and normal DL

Absent Peristalsis

Distal esophageal spasm


20% of swallows with reduced DL (<4.5 s)


20% of swallows with reduced DL (<4.5 s)

Jackhammer esophagus


!!getq!!20% of swallows with DCI >8000 mm Hg-s-cm and normal DL


!!getq!!20% of swallows with DCI >8000 mm Hg-s-cm and normal DL

Rapid contraction


20% of swallows with rapid CFV (>9 cm/s) and normal DL

Hypertensive Peristalsis


20% of swallows with DCI >5000 mm Hg-s-cm and normal DL

Weak Peristalsis


30% of swallows with small (2-5 cm) breaks in the 20-mm Hg IBC
20% of swallows with large (>5 cm) breaks in the 20-mm Hg IBC

Frequent Failed Peristalsis


30% of absent swallows

Rapid contraction


20% of swallows with rapid CFV (>9 cm/s) and normal DL

Hypertensive Peristalsis


20% of swallows with DCI >5000 mm Hg-s-cm and normal DL

Weak Peristalsis


30% of swallows with small (2-5 cm) breaks in the 20-mm Hg IBC
20% of swallows with large (>5 cm) breaks in the 20-mm Hg IBC

Frequent Failed Peristalsis


30% of absent swallows

Rapid contraction


20% of swallows with rapid CFV (>9 cm/s) and normal DL


20% of swallows with rapid CFV (>9 cm/s) and normal DL

Hypertensive Peristalsis


20% of swallows with DCI >5000 mm Hg-s-cm and normal DL


20% of swallows with DCI >5000 mm Hg-s-cm and normal DL

Weak Peristalsis


30% of swallows with small (2-5 cm) breaks in the 20-mm Hg IBC
20% of swallows with large (>5 cm) breaks in the 20-mm Hg IBC


30% of swallows with small (2-5 cm) breaks in the 20-mm Hg IBC
20% of swallows with large (>5 cm) breaks in the 20-mm Hg IBC

Frequent Failed Peristalsis


30% of absent swallows


30% of absent swallows

Normal

Normal

Normal

CFV, contractile front velocity; DCI, distal contractile interval; DL, distal latency; EGJ, esophagogastric junction; IBC, isobar contour; IRP, integrated relaxation pressure

CFV, contractile front velocity; DCI, distal contractile interval; DL, distal latency; EGJ, esophagogastric junction; IBC, isobar contour; IRP, integrated relaxation pressure

CFV, contractile front velocity; DCI, distal contractile interval; DL, distal latency; EGJ, esophagogastric junction; IBC, isobar contour; IRP, integrated relaxation pressure

CFV DCI DL EGJ IBC IRP

IRP upper limit of normal AND absent peristalsis

IRP upper limit of normal AND absent peristalsis

IRP upper limit of normal AND absent peristalsis

AND

Yes

Yes

Yes

No

No

No

IRP upper limit of normal AND some instances of intact or weak peristalsis

IRP upper limit of normal AND some instances of intact or weak peristalsis

IRP upper limit of normal AND some instances of intact or weak peristalsis

AND

Yes

Yes

Yes

No

No

No

IRP is normal AND absent peristalsis OR reduced distal latency OR DCI >8000 mm Hg-cm-s

IRP is normal AND absent peristalsis OR reduced distal latency OR DCI >8000 mm Hg-cm-s

IRP is normal AND absent peristalsis OR reduced distal latency OR DCI >8000 mm Hg-cm-s

AND OR OR

Yes

Yes

Yes

No

No

No

IRP is normal AND minor peristaltic abnormalities

IRP is normal AND minor peristaltic abnormalities

IRP is normal AND minor peristaltic abnormalities

AND

Yes

Yes

Yes

No

No

No