Modern Nosologic Classification of Esophageal Disordered Motor Activity

Abstract

Since 1947 I have pointed out the difficulty of recognizing single esophageal disorder motor activity (DMA) disease in my long esophageal DMA clinical experience. This is due to the infrequency of monophenomenic events, the complex polyphenomenic ones being predominant. Besides these complex manifestations are very often associated with organic elements of causal, concomitant, or consequential significance [3, 5]. All the old classifications, including my own in 1947, had a rather theoretical concept of clinically performed DMA classification, since they lacked the right physiopathological premises, especially considering the poor reliability of manometric recording performed with the old balloon techniques [2, 3]. Alterations of the elementary components of esophageal motor activity (tone, peristalsis, and sphincteric coordination) could be reliably identified with the advent and wider use of manometric study.