Manometric classification

Manometric classification

Oesophageal motility disorders are classified on HRM under the Chicago classification. A hierarchy diagnostic algorithm is utilised ( Figure 66.23 ). Broadly speaking, these disorders can be classified as disorders of OGJ outflow and disorders of peristalsis. Disorders of OGJ outflow are characterised by an elevated integrated relaxation pressure (IRP), which is the relaxation pressure across the OGJ in response to a swallow . Diagnoses include the three types of achalasia and OGJ outflow obstruction (OGJOO). Disorders of peristalsis include absent contractility , distal oesophageal spasm, hyper contractile oesophagus and ine ff ective oesophageal motility . All motility disorders have to be associated with symptoms or other supporting tests to make them clinically relevant. Various metrics have been developed in HRM; the details are beyond the scope of this chapter and the reader is encouraged to consult the relevant publications.