{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:19:06Z","timestamp":1791890346415,"version":"4.3.4"},"reference-count":58,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[2001,7,1]]},"abstract":"<jats:p>Manometric examination of the oesophagus frequently reveals abnormalities whose cause is unknown and whose physiological importance is not clear. A large body of literature dealing with oesophageal motility abnormalities has evolved over the past few decades but comparisons among studies have been compromised by the lack of a widely accepted system for classifying the abnormal motility patterns, and by the lack of uniform diagnostic criteria for the putative disorders. Based on an extensive review and analysis of the literature, this report suggests an operational scheme to be used for the general classification of oesophageal motility abnormalities, and proposes standardised manometric criteria for the putative oesophageal motility disorders. By applying the guidelines proposed in this report, clinicians and researchers can determine if their patients fulfil the manometric criteria for a putative motility disorder. This should facilitate and improve comparisons among patients and studies. However, it is important to emphasise that fulfilment of the proposed criteria does not establish the clinical importance of the motility abnormalities.<\/jats:p>","DOI":"10.1136\/gut.49.1.145","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:37:59Z","timestamp":1027751879000},"page":"145-151","source":"Crossref","is-referenced-by-count":539,"title":["Classification of oesophageal motility abnormalities"],"prefix":"10.1136","volume":"49","author":[{"given":"S J","family":"SPECHLER","sequence":"first","affiliation":[{"name":"Department of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D O","family":"CASTELL","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,7,1]]},"reference":[{"key":"2025121300402018000_49.1.145.1","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.1111\/j.1572-0241.1998.00687.x","article-title":"The changing use of esophageal manometry in clinical practice.","volume":"93","author":"Alrakawi","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.2","doi-asserted-by":"crossref","first-page":"593","DOI":"10.7326\/0003-4819-106-4-593","article-title":"Esophageal testing in patients with noncardiac chest pain or dysphagia: results of three years' experience with 1161 patients.","volume":"106","author":"Katz","year":"1987","journal-title":"Ann Intern Med"},{"key":"2025121300402018000_49.1.145.3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/0016-5085(87)90336-2","article-title":"Esophageal motility disorders and their response to calcium channel antagonists. The sphinx revisited.","volume":"93","author":"Cohen","year":"1987","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.7326\/0003-4819-110-1-66","article-title":"Esophageal chest pain: current controversies in pathogenesis, diagnosis, and therapy.","volume":"110","author":"Richter","year":"1989","journal-title":"Ann Intern Med"},{"key":"2025121300402018000_49.1.145.5","first-page":"167","article-title":"Nutcracker esophagus: an idea whose time has gone?","volume":"88","author":"Kahrilas","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.6","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(87)90308-8"},{"key":"2025121300402018000_49.1.145.7","unstructured":"Diamant NE (1993) Regulation and dysregulation of esophageal motor function. in Progress in understanding and management of gastrointestinal motility disorders. ed Janssens J (University of Leuven, Belgium), pp 85\u2013103."},{"key":"2025121300402018000_49.1.145.8","doi-asserted-by":"publisher","DOI":"10.1136\/gut.37.3.305"},{"key":"2025121300402018000_49.1.145.9","doi-asserted-by":"publisher","DOI":"10.1007\/BF01308186"},{"key":"2025121300402018000_49.1.145.10","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(88)90612-9"},{"key":"2025121300402018000_49.1.145.11","unstructured":"Castell DO Richter JE Dalton CB , eds (1987) Esophageal motility testing. (Elsevier Science Publishing Co., Inc. New York)."},{"key":"2025121300402018000_49.1.145.12","doi-asserted-by":"publisher","DOI":"10.1136\/gut.44.4.476"},{"key":"2025121300402018000_49.1.145.13","doi-asserted-by":"publisher","DOI":"10.1007\/BF01296157"},{"key":"2025121300402018000_49.1.145.14","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0889-8553(21)00676-2","article-title":"Achalasia.","volume":"18","author":"Reynolds","year":"1989","journal-title":"Gastroenterol Clin North Am"},{"key":"2025121300402018000_49.1.145.15","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199404000-00001"},{"key":"2025121300402018000_49.1.145.16","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/0016-5085(86)90869-3","article-title":"Integrity of cholinergic innervation to the lower esophageal sphincter in achalasia.","volume":"90","author":"Holloway","year":"1986","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.17","first-page":"A259","article-title":"Nature of neuronal loss in human achalasia.","volume":"110","author":"Singaram","year":"1996","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.18","first-page":"G115","article-title":"Role of chloride ions in lower esophageal sphincter tone and relaxation.","volume":"263","author":"Saha","year":"1992","journal-title":"Am J Physiol"},{"key":"2025121300402018000_49.1.145.19","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91113-I"},{"key":"2025121300402018000_49.1.145.20","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/0016-5085(91)90534-R","article-title":"Classic and vigorous achalasia: a comparison of manometric, radiographic, and clinical findings.","volume":"101","author":"Goldenberg","year":"1991","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.21","first-page":"1119","article-title":"The spectrum of esophageal motor disorders in Chagas' disease.","volume":"90","author":"De Oliveira","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.22","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90443-8"},{"key":"2025121300402018000_49.1.145.23","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S0016-5085(99)70573-1","article-title":"AGA technical review on treatment of patients with dysphagia caused by benign disorders of the distal esophagus.","volume":"117","author":"Spechler","year":"1999","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.24","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S0016-5085(79)80210-3","article-title":"Achalasia, diffuse esophageal spasm, and related motility disorders.","volume":"76","author":"Vantrappen","year":"1979","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.25","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v111.pm8780569"},{"key":"2025121300402018000_49.1.145.26","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(86)90876-0"},{"key":"2025121300402018000_49.1.145.27","first-page":"1712","article-title":"Abnormal upper esophageal sphincter function in achalasia.","volume":"87","author":"Dudnick","year":"1992","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.28","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/BF00262753","article-title":"Repetitive contractions of the upper esophageal body and sphincter in achalasia.","volume":"9","author":"Zhang","year":"1994","journal-title":"Dysphagia"},{"key":"2025121300402018000_49.1.145.29","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1016\/0016-5085(92)91180-C","article-title":"Alteration of the upper esophageal sphincter belch reflex in patients with achalasia.","volume":"103","author":"Massey","year":"1992","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.30","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v110.pm8613045"},{"key":"2025121300402018000_49.1.145.31","doi-asserted-by":"publisher","DOI":"10.1136\/gut.41.1.87"},{"key":"2025121300402018000_49.1.145.32","doi-asserted-by":"crossref","first-page":"242","DOI":"10.7326\/0003-4819-100-2-242","article-title":"Diffuse esophageal spasm: a reappraisal.","volume":"100","author":"Richter","year":"1984","journal-title":"Ann Intern Med"},{"key":"2025121300402018000_49.1.145.33","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1007\/BF01297441","article-title":"Diffuse esophageal spasm. A rare motility disorder not characterized by high-amplitude contractions.","volume":"36","author":"Dalton","year":"1991","journal-title":"Dig Dis Sci"},{"key":"2025121300402018000_49.1.145.34","unstructured":"Achem SR Benjamin SB (1995) Esophageal dysmotility (spastic dysmotility). in The esophagus, ed Castell DO (Little, Brown and Company, Boston), 2nd edn. pp 247\u2013268."},{"key":"2025121300402018000_49.1.145.35","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1007\/BF02088558","article-title":"Manometric diagnosis of diffuse esophageal spasm.","volume":"41","author":"Allen","year":"1996","journal-title":"Dig Dis Sci"},{"key":"2025121300402018000_49.1.145.36","first-page":"623","article-title":"The changing faces of the nutcracker esophagus.","volume":"83","author":"Dalton","year":"1988","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.37","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/0016-5085(79)90008-8","article-title":"High amplitude, peristaltic esophageal contractions associated with chest pain and\/or dysphagia.","volume":"77","author":"Benjamin","year":"1979","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.38","first-page":"G1098","article-title":"Topography of normal and high-amplitude esophageal peristalsis.","volume":"265","author":"Clouse","year":"1993","journal-title":"Am J Physiol"},{"key":"2025121300402018000_49.1.145.39","first-page":"847","article-title":"Segmental versus diffuse nutcracker esophagus: an intermittent motility pattern.","volume":"88","author":"Achem","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.40","first-page":"619","article-title":"Segmental high amplitude peristaltic contractions in the distal esophagus.","volume":"84","author":"Freidin","year":"1989","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.41","doi-asserted-by":"publisher","DOI":"10.1007\/BF01317054"},{"key":"2025121300402018000_49.1.145.42","first-page":"391","article-title":"Hypertensive gastroesophageal sphincter.","volume":"35","author":"Code","year":"1960","journal-title":"Proc Mayo Clin"},{"key":"2025121300402018000_49.1.145.43","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/00004836-199206000-00004","article-title":"Isolated hypertensive lower esophageal sphincter. Clinical and manometric aspects of an uncommon esophageal motor abnormality.","volume":"14","author":"Bassotti","year":"1992","journal-title":"J Clin Gastroenterol"},{"key":"2025121300402018000_49.1.145.44","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1969.03160060062006"},{"key":"2025121300402018000_49.1.145.45","doi-asserted-by":"publisher","DOI":"10.1007\/BF01536375"},{"key":"2025121300402018000_49.1.145.46","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0002-9610(96)00219-X","article-title":"The hypertensive lower esophageal sphincter.","volume":"172","author":"Katada","year":"1996","journal-title":"Am J Surg"},{"key":"2025121300402018000_49.1.145.47","first-page":"280","article-title":"Hypertensive lower esophageal sphincter pressures and gastroesophageal reflux: an apparent paradox that is not unusual.","volume":"90","author":"Katzka","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.48","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/00004836-198904000-00006","article-title":"Hypertensive lower esophageal sphincter: what does it mean?","volume":"11","author":"Waterman","year":"1989","journal-title":"J Clin Gastroenterol"},{"key":"2025121300402018000_49.1.145.49","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1002\/art.1780401222","article-title":"Esophageal dysfunction in scleroderma. Relationship with disease subsets.","volume":"40","author":"Bassotti","year":"1997","journal-title":"Arthritis Rheum"},{"key":"2025121300402018000_49.1.145.50","first-page":"763","article-title":"Gastrointestinal manifestations of progressive systemic sclerosis.","volume":"92","author":"Lock","year":"1997","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.51","first-page":"217","article-title":"Relationship of radionuclide liquid bolus transport and esophageal manometry.","volume":"109","author":"Richter","year":"1987","journal-title":"J Lab Clin Med"},{"key":"2025121300402018000_49.1.145.52","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/00000441-197303000-00002","article-title":"Esophageal dysfunction in collagen disease.","volume":"265","author":"Turner","year":"1973","journal-title":"Am J Med Sci"},{"key":"2025121300402018000_49.1.145.53","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/0016-5085(80)90091-8","article-title":"The gastrointestinal manifestations of scleroderma: pathogenesis and management.","volume":"79","author":"Cohen","year":"1980","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.54","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197907263010404"},{"key":"2025121300402018000_49.1.145.55","first-page":"870","article-title":"Esophageal function in systemic sclerosis: a prospective evaluation of motility and acid reflux in 36 patients.","volume":"88","author":"Yarze","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2025121300402018000_49.1.145.56","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/0016-5085(87)90137-5","article-title":"Esophagitis in scleroderma. Prevalence and risk factors.","volume":"92","author":"Zamost","year":"1987","journal-title":"Gastroenterology"},{"key":"2025121300402018000_49.1.145.57","doi-asserted-by":"crossref","first-page":"848","DOI":"10.7326\/0003-4819-100-6-848","article-title":"Scleroderma esophagus: a nonspecific entity.","volume":"100","author":"Schneider","year":"1984","journal-title":"Ann Intern Med"},{"key":"2025121300402018000_49.1.145.58","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018802908358"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.49.1.145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T08:40:33Z","timestamp":1765615233000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.49.1.145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,7,1]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2001,7,1]]},"published-print":{"date-parts":[[2001,7,1]]}},"alternative-id":["10.1136\/gut.49.1.145"],"URL":"https:\/\/doi.org\/10.1136\/gut.49.1.145","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,7,1]]}}}