<prompt> On esophageal manometry, abnormal spastic contractions in esophagus 450 mmHgs cm in the body is suggestive of:Type I achalasiaType II achalasiaType III achalasiaJackhammer esophagus  <response>: ACHALASIA CARDIA Characterized by absence of LES relaxation Clinical features - MC symptom - Dysphagia weight loss Liquid Solid - Triad Dysphagia Regurgitation Weight loss IOC - Manometry On Barium Swallow Bird beak appearance Pencil tip appearance Rat tail appearance TypeI: classic achalasia,incomplete LES relaxation, aperistalsis and absence of esophageal pressurization.Elevated median IRPintegrated relaxation pressure 15 mmHg, 100 failed peristalsis DCT 100mmHg cm,premature contractions with DCT 450mmHg cm TypeII: incomplete LES relaxation, aperistalsis ,Elevated median IRPintegrated relaxation pressure 15 mmHg, 100 failed peristalsis,panesophageal pressurization in at least 20 of swallows., contractions may be masked by oesophageal pressurisation and DCT should not be calculated Type III achalasiaspastic achalasia Elevated median IRP 15 mmHg, No normal peristalsis, Premature spastic contractions with DCI 450 mmHgscm with 20 of swallows May be mixed with panoesophageal pressurisation Jackhammer esophagus : is characterized by DCI 8000 mmHgseccm in at least 20 of swallows and normal DL 