title: High-resolution manometry classifications for idiopathic achalasia in patients with Chagas' disease esophagopathy.
abstract: BACKGROUND
  Idiopathic achalasia (IA) and Chagas' disease esophagopathy (CDE) share several similarities. The comparison between IA and CDE is important to evaluate whether treatment options and their results can be accepted universally. High-resolution manometry (HRM) has proved a better diagnostic tool compared to conventional manometry. This study aims to evaluate HRM classifications for idiopathic achalasia in patients with CDE.
  
  
  METHODS
  We studied 98 patients: 52 patients with CDE (52 % females, mean age, 57 ± 14 years) and 46 patients with IA (54 % females; mean age 48 ± 19 years). All patients underwent a HRM and barium esophagogram.
  
  
  RESULTS
  The Chicago classification was distributed in IA as Chicago I, 35 %; Chicago II, 63 %; and Chicago III, 2 %, and in CDE as Chicago I, 52 %; Chicago II, 48 %; and Chicago III, 0 % (p = 0.1, 0.1, and 0.5, respectively). All patients had the classic Rochester type. CDE patients had more pronounced degrees of esophageal dilatation (p < 0.002). The degree of esophageal dilatation did not correlate with Chicago classification (p = 0.08). In nine (9 %) patients, the HRM pattern changed during the test from Chicago I to II.
  
  
  CONCLUSIONS
  Our results show that (a) HRM classifications for IA can be applied in patients with CDE and (b) HRM classifications did not correlate with the degree of esophageal dilatation. HRM classifications may reflect esophageal repletion and pressurization instead of muscular contraction. The correlation between manometric findings and treatment outcomes for CDE needs to be answered in the near future.
authors.affiliation: Department of Surgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Fernando P P
authors.initials: FP
authors.lastname: Vicentine
authors.forename: Fernando A M
authors.initials: FA
authors.lastname: Herbella
authors.forename: Marco E
authors.initials: ME
authors.lastname: Allaix
authors.forename: Luciana C
authors.initials: LC
authors.lastname: Silva
authors.forename: Marco G
authors.initials: MG
authors.lastname: Patti
mesh_terms: D000328:Adult; D000368:Aged; D014355:Chagas Disease / Q000150:complications*; D004108:Dilatation, Pathologic / Q000469:parasitology; D004931:Esophageal Achalasia / Q000145:classification* / Q000469:parasitology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged