The diagnostic criteria for achalasia evaluation utilize esophageal motility testing to determine the presence of specific motility abnormalities. The diagnostic process relies on two key measurements obtained via esophageal manometry:

- The first criterion involves the integrated relaxation pressure (IRP). If the IRP is above the established upper limit of normal, this suggests a lack of adequate relaxation of the lower esophageal sphincter (LES) during swallowing.
- The second criterion focuses on esophageal peristalsis. A finding of either 100% failed peristalsis or a spastic esophageal motility pattern indicates significant disruption in the normal movement of food through the esophagus.

To determine if the diagnostic criteria for achalasia are met, both conditions must be satisfied:

- Condition A: An IRP above the upper limit of normal.
- Condition B: 100% failed peristalsis or spastic motility.

When both conditions A and B are present, the diagnostic criteria are met, which supports a diagnosis of achalasia. If either or both conditions are absent, the criteria are not met, suggesting that the diagnosis of achalasia may not be the most appropriate. This systematic evaluation assists healthcare professionals in identifying achalasia by highlighting the characteristic motility disturbances.

The Diagnostic Criteria for Achalasia is a clinical tool designed to aid in the diagnosis of achalasia, a rare esophageal motility disorder. The target patient population includes individuals presenting with symptoms suggestive of esophageal motility disorders, such as dysphagia, regurgitation, and chest pain.

The primary components of the diagnostic criteria are derived from esophageal manometry testing. The first component is an integrated relaxation pressure above the upper limit of normal, indicating impaired relaxation of the lower esophageal sphincter. The second component is the presence of 100% failed peristalsis or spasm, reflecting the absence of normal esophageal contractions.

The diagnosis of achalasia is confirmed if both components are present. If either or both components are absent, the diagnostic criteria for achalasia are not met. The use of these criteria provides a standardized approach to the diagnosis of achalasia, facilitating early detection and appropriate management of the condition.

Diagnostic criteria for achalasia (esophageal motility testing)