Unclassified oesophageal motor disorders simulating achalasia.

Achalasia of the oesophagus is characterized by the absence of peristalsis, failure of the inferior oesophageal sphincter to relax after swallowing (Harris, 1966), and a positive mecholyl test (Kramer and Ingelfinger, 1951). This combination offeatures is regarded as specific for this disease. Nevertheless, in the literature a number of cases have been designated achalasia despite the presence of some peristalsis or inferior sphincter relaxation (Vantrappen, van Goidsenhoven, Verbeke, van den Berghe, and Vandenbroucke, 1963) or even a negative mecholyl test (Hightower, Olsen, and Moersch, 1954). Therefore, absolute diagnostic criteria for the disease seem to be incompletely defined. We have studied six patients with severe oesophageal motor abnormalities referred to us with the clinical diagnosis of achalasia. The oesophageal motility findings in these patients were, however, not characteristic for achalasia; moreover, they were