Dataset Information

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0^©.

ABSTRACT: Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Fifty-two diverse international experts separated into seven working subgroups utilized formal validated methodologies over two-years to develop CCv4.0. Key updates in CCv.4.0 consist of a more rigorous and expansive HRM protocol that incorporates supine and upright test positions as well as provocative testing, a refined definition of esophagogastric junction (EGJ) outflow obstruction (EGJOO), more stringent diagnostic criteria for ineffective esophageal motility and description of baseline EGJ metrics. Further, the CCv4.0 sought to define motility disorder diagnoses as conclusive and inconclusive based on associated symptoms, and findings on provocative testing as well as supportive testing with barium esophagram with tablet and/or functional lumen imaging probe. These changes attempt to minimize ambiguity in prior iterations of Chicago Classification and provide more standardized and rigorous criteria for patterns of disorders of peristalsis and obstruction at the EGJ.

SUBMITTER: Yadlapati R

PROVIDER: S-EPMC8034247 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0<sup>©</sup>.

Yadlapati Rena R Kahrilas Peter J PJ Fox Mark R MR Bredenoord Albert J AJ Prakash Gyawali C C Roman Sabine S Babaei Arash A Mittal Ravinder K RK Rommel Nathalie N Savarino Edoardo E Sifrim Daniel D Smout André A Vaezi Michael F MF Zerbib Frank F Akiyama Junichi J Bhatia Shobna S Bor Serhat S Carlson Dustin A DA Chen Joan W JW Cisternas Daniel D Cock Charles C Coss-Adame Enrique E de Bortoli Nicola N Defilippi Claudia C Fass Ronnie R Ghoshal Uday C UC Gonlachanvit Sutep S Hani Albis A Hebbard Geoffrey S GS Wook Jung Kee K Katz Philip P Katzka David A DA Khan Abraham A Kohn Geoffrey Paul GP Lazarescu Adriana A Lengliner Johannes J Mittal Sumeet K SK Omari Taher T Park Moo In MI Penagini Roberto R Pohl Daniel D Richter Joel E JE Serra Jordi J Sweis Rami R Tack Jan J Tatum Roger P RP Tutuian Radu R Vela Marcelo F MF Wong Reuben K RK Wu Justin C JC Xiao Yinglian Y Pandolfino John E JE

Neurogastroenterology and motility 20210101 1

Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Fifty-two diverse international experts separated into seven working subgroups utilized formal validated methodologies over two-years to develop CCv4.0. Key updates in CCv.4.0 consist of a more rigorous and expansive HRM protocol that incorporates supine and upright test positions as well as provocative testing, a refined definition of es ...[more]

PMID: 33373111

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Project description:Background The Chicago Classification version 4.0 (CCv4.0) of ineffective esophageal motility (IEM) is more stringent than the Chicago Classification version 3.0 (CCv3.0) definition. We aimed to compare the clinical and manometric features of patients meeting CCv4.0 IEM criteria (group 1) versus patients meeting CCv3.0 IEM but not CCv4.0 criteria (group 2). Methods We collected retrospective clinical, manometric, endoscopic, and radiographic data on 174 adults diagnosed with IEM from 2011 to 2019. Complete bolus clearance was defined as evidence of exit of the bolus by impedance measurement at all distal recording sites. Barium studies included barium swallow, modified barium swallow, and barium upper gastrointestinal series studies, and collected data from these reports include abnormal motility and delay in the passage of liquid barium or barium tablet. These data along with other clinical and manometric data were analyzed using comparison and correlation tests. All records were reviewed for repeated studies and the stability of the manometric diagnoses. Results Most demographic and clinical variables were not different between the groups. A lower mean lower esophageal sphincter pressure was correlated with greater percent of ineffective swallows in group 1 (n = 128) (r = -0.2495, P = 0.0050) and not in group 2. In group 1, increased percent of failed contractions on manometry was associated with increased incomplete bolus clearance (r = 0.3689, P = 0.0001). No such association was observed in group 2. A lower median integrated relaxation pressure was correlated with greater percent of ineffective contractions in group 1 (r = -0.1825, P = 0.0407) and not group 2. Symptom of dysphagia was more prevalent (51.6% versus 69.6%, P = 0.0347) in group 2. Dysphagia was not associated with intrabolus pressure, bolus clearance, barium delay, or weak or failed contractions in either group. In the small number of subjects with repeated studies, a CCv4.0 diagnosis appeared more stable over time. Conclusions CCv4.0 IEM was associated with worse esophageal function indicated by reduced bolus clearance. Most other features studied did not differ. Symptom presentation cannot predict if patients are likely to have IEM by CCv4.0. Dysphagia was not associated with worse motility, suggesting it may not be primarily dependent on bolus transit.

Dataset Information

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0^©.

Publications

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0<sup>©</sup>.

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Dataset Information

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0©.

Publications

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0<sup>©</sup>.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0^©.