How are non Progressive contraction of Esophagus classed?
Non-progressive contractions of the esophagus, also known as ineffective esophageal motility (IEM), are classified based on the pattern and coordination of contractions observed during esophageal manometry studies. Esophageal manometry is a diagnostic test used to assess the function of the muscles and nerves in the esophagus.
The Chicago Classification system is commonly used to classify esophageal motility disorders, including non-progressive contractions of the esophagus. According to this classification system, non-progressive contractions are further classified into several subtypes based on specific criteria:
- Fragmented Peristalsis (Fragmented Contractions):
- Fragmented peristalsis is characterized by the presence of premature contractions or contractions with low amplitude that fail to propagate fully along the length of the esophagus.
- In this subtype, there may be frequent breaks in the peristaltic sequence, resulting in a fragmented or discontinuous pattern of contractions.
- Simultaneous Contractions:
- Simultaneous contractions refer to contractions that occur simultaneously in multiple segments of the esophagus, rather than propagating sequentially in a coordinated manner.
- In this subtype, there is a lack of normal peristaltic coordination, with contractions occurring simultaneously or in close succession without proper propagation.
- Multipeaked Contractions:
- Multipeaked contractions are characterized by contractions with multiple peaks or peaks of varying amplitudes within a single contraction wave.
- In this subtype, the contractions may appear “sawtooth” or irregular in shape, indicating disorganized or dyscoordinated esophageal motility.
These subtypes of non-progressive contractions are identified based on specific criteria outlined in the Chicago Classification system, including the amplitude, duration, and propagation of esophageal contractions observed during manometry studies. Proper classification of esophageal motility disorders helps guide clinical management and treatment decisions for patients with symptoms related to esophageal dysfunction.