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

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

doi:https://doi.org/10.1111/nmo.14058

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

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

Research output: Contribution to journal › Article › Academic › peer-review

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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.

Original language	English
Article number	e14058
Journal	Neurogastroenterology and Motility
Volume	33
Issue number	1
DOIs	https://doi.org/10.1111/nmo.14058
Publication status	Published - 1 Jan 2021

Keywords

achalasia
esophageal spasm
integrated relaxation pressure
lower esophageal sphincter
peroral endoscopic myotomy

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Yadlapati, R., Kahrilas, P. J., Fox, M. R., Bredenoord, A. J., Prakash Gyawali, C., Roman, S., Babaei, A., Mittal, R. K., Rommel, N., Savarino, E., Sifrim, D., Smout, A., Vaezi, M. F., Zerbib, F., Akiyama, J., Bhatia, S., Bor, S., Carlson, D. A., Chen, J. W., ... Pandolfino, J. E. (2021). Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0©. Neurogastroenterology and Motility, 33(1), Article e14058. https://doi.org/10.1111/nmo.14058

@article{53fadd1e2c2e42fe8d27ebd8fbe1f1c0,

title = "Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0{\textcopyright}",

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.",

keywords = "achalasia, esophageal spasm, integrated relaxation pressure, lower esophageal sphincter, peroral endoscopic myotomy",

author = "Rena Yadlapati and Kahrilas, {Peter J.} and Fox, {Mark R.} and Bredenoord, {Albert J.} and {Prakash Gyawali}, C. and Sabine Roman and Arash Babaei and Mittal, {Ravinder K.} and Nathalie Rommel and Edoardo Savarino and Daniel Sifrim and Andr{\'e} Smout and Vaezi, {Michael F.} and Frank Zerbib and Junichi Akiyama and Shobna Bhatia and Serhat Bor and Carlson, {Dustin A.} and Chen, {Joan W.} and Daniel Cisternas and Charles Cock and Enrique Coss-Adame and {de Bortoli}, Nicola and Claudia Defilippi and Ronnie Fass and Ghoshal, {Uday C.} and Sutep Gonlachanvit and Albis Hani and Hebbard, {Geoffrey S.} and {Wook Jung}, Kee and Philip Katz and Katzka, {David A.} and Abraham Khan and Kohn, {Geoffrey Paul} and Adriana Lazarescu and Johannes Lengliner and Mittal, {Sumeet K.} and Taher Omari and Park, {Moo In} and Roberto Penagini and Daniel Pohl and Richter, {Joel E.} and Jordi Serra and Rami Sweis and Jan Tack and Tatum, {Roger P.} and Radu Tutuian and Vela, {Marcelo F.} and Wong, {Reuben K.} and Wu, {Justin C.} and Yinglian Xiao and Pandolfino, {John E.}",

note = "Funding Information: National Institute of Diabetes and Digestive and Kidney Diseases, Grant/Award Number: P01 DK092217 Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons Ltd",

year = "2021",

month = jan,

day = "1",

doi = "https://doi.org/10.1111/nmo.14058",

language = "English",

volume = "33",

journal = "Neurogastroenterology and Motility",

issn = "1350-1925",

publisher = "Wiley-Blackwell",

number = "1",

}

Yadlapati, R, Kahrilas, PJ, Fox, MR, Bredenoord, AJ, Prakash Gyawali, C, Roman, S, Babaei, A, Mittal, RK, Rommel, N, Savarino, E, Sifrim, D, Smout, A, Vaezi, MF, Zerbib, F, Akiyama, J, Bhatia, S, Bor, S, Carlson, DA, Chen, JW, Cisternas, D, Cock, C, Coss-Adame, E, de Bortoli, N, Defilippi, C, Fass, R, Ghoshal, UC, Gonlachanvit, S, Hani, A, Hebbard, GS, Wook Jung, K, Katz, P, Katzka, DA, Khan, A, Kohn, GP, Lazarescu, A, Lengliner, J, Mittal, SK, Omari, T, Park, MI, Penagini, R, Pohl, D, Richter, JE, Serra, J, Sweis, R, Tack, J, Tatum, RP, Tutuian, R, Vela, MF, Wong, RK, Wu, JC, Xiao, Y & Pandolfino, JE 2021, 'Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0©', Neurogastroenterology and Motility, vol. 33, no. 1, e14058. https://doi.org/10.1111/nmo.14058

TY - JOUR

T1 - Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0©

AU - Yadlapati, Rena

AU - Kahrilas, Peter J.

AU - Fox, Mark R.

AU - Bredenoord, Albert J.

AU - Prakash Gyawali, C.

AU - Roman, Sabine

AU - Babaei, Arash

AU - Mittal, Ravinder K.

AU - Rommel, Nathalie

AU - Savarino, Edoardo

AU - Sifrim, Daniel

AU - Smout, André

AU - Vaezi, Michael F.

AU - Zerbib, Frank

AU - Akiyama, Junichi

AU - Bhatia, Shobna

AU - Bor, Serhat

AU - Carlson, Dustin A.

AU - Chen, Joan W.

AU - Cisternas, Daniel

AU - Cock, Charles

AU - Coss-Adame, Enrique

AU - de Bortoli, Nicola

AU - Defilippi, Claudia

AU - Fass, Ronnie

AU - Ghoshal, Uday C.

AU - Gonlachanvit, Sutep

AU - Hani, Albis

AU - Hebbard, Geoffrey S.

AU - Wook Jung, Kee

AU - Katz, Philip

AU - Katzka, David A.

AU - Khan, Abraham

AU - Kohn, Geoffrey Paul

AU - Lazarescu, Adriana

AU - Lengliner, Johannes

AU - Mittal, Sumeet K.

AU - Omari, Taher

AU - Park, Moo In

AU - Penagini, Roberto

AU - Pohl, Daniel

AU - Richter, Joel E.

AU - Serra, Jordi

AU - Sweis, Rami

AU - Tack, Jan

AU - Tatum, Roger P.

AU - Tutuian, Radu

AU - Vela, Marcelo F.

AU - Wong, Reuben K.

AU - Wu, Justin C.

AU - Xiao, Yinglian

AU - Pandolfino, John E.

PY - 2021/1/1

Y1 - 2021/1/1

N2 - 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.

AB - 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.

KW - achalasia

KW - esophageal spasm

KW - integrated relaxation pressure

KW - lower esophageal sphincter

KW - peroral endoscopic myotomy

UR - http://www.scopus.com/inward/record.url?scp=85098240896&partnerID=8YFLogxK

U2 - https://doi.org/10.1111/nmo.14058

DO - https://doi.org/10.1111/nmo.14058

M3 - Article

C2 - 33373111

SN - 1350-1925

VL - 33

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

IS - 1

M1 - e14058

ER -

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

Abstract

Keywords

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