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Types of achalasia of the cardia

Medical expert of the article

Gastroenterologist
, medical expert
Last reviewed: 04.07.2025

There are two types of achalasia of the cardia.

  • In type I, the tone of the walls and the shape of the esophagus are preserved.
  • In type II, the tone of the esophagus walls is lost, it is curved and significantly widened.

There is no single classification of achalasia cardia. Most gastroenterologists classify achalasia cardia by stages depending on the severity of clinical manifestations and the presence of complications. Here is one of the classifications as presented by Ts. G. Masevich (1995).

  • Stage I (functional) - temporary disruption of food passage through the cardiac section of the esophagus due to the cessation of relaxation of the lower esophageal sphincter during swallowing and some increase in its tone. There is no expansion of the esophagus yet, so food retention in it is short-lived.
  • Stage II - food retention is observed for a longer period of time and this leads to moderate dilation of the esophagus.
  • Stage III - stable expansion of the esophagus and its narrowing in the lower part due to cicatricial changes.
  • Stage IV - pronounced clinical picture of achalasia of the cardia, stable expansion of the esophagus, presence of complications - esophagitis, periesophagitis.


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