Examples of high-resolution manometric images of normalcy and achalasia. (A) Normal manometry: the blackbox shows 10 seconds during the post-swallow period. Integrated relaxation pressure (IRP) is defined as the median 4 seconds nadir of pressure through the esophagogastric junction in the black box. IRP is decreased during the post-swallow period in normal finding. (B) Achalasia type I: the IRP is elevated, and 100% failed peristalsis is noted. (C) Achalasia type II: the IRP is elevated, and panesophageal pressurization is noted from upper esophageal sphincter to lower esophageal sphincter. (D) Achalasia type III: the IRP is elevated, and distal esophageal spasm is noted.