What is the classic manometry presentation for achalasia?

The classic manometry presentation for achalasia is characterized by a lack of peristalsis in the esophagus and an increase in lower esophageal sphincter (LES) pressure. In achalasia, the normal esophageal peristalsis—coordinated contractions that move food down the esophagus—is disrupted. Instead, patients show absent peristaltic waves, which leads to inadequate movement of food toward the stomach.

Simultaneously, the LES does not relax appropriately during swallowing, resulting in elevated pressure in the sphincter. This combination of factors contributes to the symptoms often seen in achalasia, such as dysphagia (difficulty swallowing), regurgitation, and chest pain.

The other options do not accurately reflect the pathophysiological changes seen in achalasia. Normal peristalsis with low LES pressure would indicate a different esophageal condition. Uncoordinated contractions with normal relaxation are typical of other motility disorders rather than achalasia. Continuous high amplitude contractions may be seen in other conditions like diffuse esophageal spasm, not in achalasia where the primary issues involve the absence of coordinated movements and increased sphincter pressure.