Classification of Gastroesophageal Motor Disorders
| Demonstrable abnormality | Clinical entity | Associated disorder |
|---|---|---|
| 1. Esophageal dysmotility | ||
| Category 1: Well-defined entities | ||
| 1.1.1 Excessive acid exposure | GERD | Scleroderma, diabetes mellitus |
| 1.1.2 Manometric pattern of achalasia | Achalasia | Chagas’ disease, enteric neuropathy |
| 1.1.3 Spastic manometric pattern | Esophageal spasm | Diabetes mellitus, enteric neuropathy |
| Category 2: Entities with variable dysfunction-symptom relationship | ||
| 1.2.1 High-amplitude peristalsis | Nutcracker esophagus | Enteric neuropathy |
| 1.2.2Low-amplitude peristalsis Failed peristalsis Low-amplitude simultaneous contractions | Ineffective esophageal motility | Scleroderma, enteric myopathy, diabetes mellitus, amyloidosis, GERD |
| 1.2.3 Low LES pressure | Hypotensive LES | Scleroderma, diabetes mellitus, GERD |
| 1.2.4 Incomplete LES relaxation | LES dysrelaxation | After fundoplication |
| Category 3: Questionable entities | ||
| 1.3.1 High LES pressure | Hypertensive LES | |
| Category 4: Entities associated with behavioral disorders | ||
| 1.4.1 Forced regurgitation | Rumination syndrome | Anorexia nervosa (purging type), bulimia nervosa (purging type) |
| 1.4.2 Excessive air swallowing Excessive belching | Aerophagia | GERD |
| 2. Gastric dysmotility | ||
| Category 1: Well-defined entities | ||
| 2.1.1 Accelerated gastric emptying | Dumping syndrome | After resection dumping, or vagotomy dumping |
| Category 2: Entities with variable dysfunction-symptom relationship | ||
| 2.2.1 Delayed gastric emptying | Gastroparesis | GERD, diabetes mellitus, scleroderma, after vagotomy, enteric neuropathy, enteric myopathy, anorexia nervosa (restricting type) |
Modified from (39).