The Chicago classification for achalasia in a French multicentric cohort

Dig Liver Dis. 2012 Dec;44(12):976-80. doi: 10.1016/j.dld.2012.07.019. Epub 2012 Aug 28.

Abstract

Background: Achalasia is divided into 3 subtypes using the Chicago classification for high-resolution manometry. Aim of this study was to apply this classification to a multicentric French cohort of achalasia and to compare clinical and manometric characteristics between the 3 subtypes.

Methods: Oesophageal symptoms were collected in a retrospective study of patients diagnosed with achalasia on high-resolution manometry. Manometry data were analyzed with oesophago-gastric junction resting and relaxation pressures, and upper oesophageal sphincter resting pressure. Achalasia was classified according to the Chicago classification.

Results: From 2007 to August 2011, achalasia was diagnosed in 169 patients, 14% classified as type I, 70% as type II and 16% as type III. Type III patients were older than types I and II (62 years vs. 52, p = 0.03). Ninety five percent of patients complained of dysphagia, 16% of chest pain (no difference between the 3 subtypes); 50% of type I patients presented regurgitations compared to 33% of type II and 22% of type III (p = 0.10). Oesophago-gastric junction and upper oesophageal sphincter pressures did not differ between the 3 groups.

Conclusion: Type II was the more prevalent subtype of achalasia in this French multicentre cohort. The older age of patients with type III achalasia suggests a different pathophysiology.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Child
  • Cohort Studies
  • Deglutition Disorders / etiology
  • Esophageal Achalasia / classification*
  • Esophageal Achalasia / complications
  • Esophageal Achalasia / diagnosis
  • Esophageal Achalasia / physiopathology
  • Esophageal Sphincter, Lower / physiopathology
  • Esophagogastric Junction / physiopathology
  • Female
  • France
  • Gastroesophageal Reflux / etiology
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Retrospective Studies
  • Young Adult