Tu1973 Esophageal Dysmotility Is Highly Prevalent in Persons With SCI Compared to Able-Bodied Controls As Identified With High-Resolution Manometry and the Use of the Chicago Classification

2014 ◽  
Vol 146 (5) ◽  
pp. S-886
Author(s):  
Miroslav Radulovic ◽  
Christina Yen ◽  
Gregory J. Schilero ◽  
Joshua Hobson ◽  
Brian Lyons ◽  
...  
Keyword(s):  
High Resolution ◽  
Esophageal Dysmotility ◽  
High Resolution Manometry ◽  
Chicago Classification

scholarly journals Elevated Average Maximum Intrabolus Pressure on High-Resolution Manometry is Associated with Esophageal Dysmotility and Delayed Esophageal Emptying on Timed Barium Esophagram

2021 ◽  
Author(s):  
Katelyn Madigan ◽  
J. Shawn Smith ◽  
Joni Evans ◽  
Steven Clayton
Keyword(s):  
High Resolution ◽  
Esophagogastric Junction ◽  
Esophageal Dysmotility ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Average Maximum ◽  
Barium Esophagram ◽  
Esophageal Emptying ◽  
Liquid Bolus

Abstract Background Intrabolus pressure (IBP) recorded by high-resolution manometry (HRM) portrays the compartmentalized force on a bolus during esophageal peristalsis. HRM may be a reliable screening tool for esophageal dysmotility in patients with elevated average maximum IBP (AM-IBP). Timed barium esophagram (TBE) is a validated measure of esophageal emptying disorders, such as esophagogastric junction outflow obstruction and achalasia. This study aimed to determine if an elevated AM-IBP correlates with esophageal dysmotility on HRM and/or delayed esophageal emptying on TBE. Methods A retrospective analysis of all HRM (unweighted sample n=155) performed at a tertiary referral center from 09/2015-03/2017 yielded a case group (n=114) with abnormal AM-IBP and a control group (n=41) with a normal AM-IBP (pressure<17mmHg) as consistent with Chicago Classification 3. All patients received a standardized TBE, with abnormalities classified as greater than 1 cm of retained residual liquid barium in the esophagus at 1 and 5 minutes or as tablet retention after 5 minutes. Results AM-IBP was significantly related to liquid barium retention (p=0.003) and tablet arrest on timed barium esophagram (p=0.011). A logistic regression model correctly predicted tablet arrest in 63% of cases. Tablet arrest on AM-IBP correlated with an optimal prediction point at 20.1 mmHg on HRM. Patients with elevated AM-IBP were more likely to have underlying esophageal dysmotility (95.6% vs. 70.7% respectively; p<0.001), particularly esophagogastric junction outflow obstruction disorders. Elevated AM-IBP was associated with incomplete liquid bolus transit on impedance analysis (p=0.002). Conclusions Our findings demonstrate that an elevated AM-IBP is associated with abnormal TBE findings of esophageal tablet retention and/or bolus stasis. An abnormal AM-IBP (greater than 20.1 mm Hg) was associated with a higher probability of retaining liquid bolus or barium tablet arrest on TBE and esophageal dysmotility on HRM. This finding supports the recent incorporation of IBP in Chicago Classification v4.0.

scholarly journals How Updates in Chicago Classification Impact Clinical Practice

2021 ◽  
pp. 263451612110398
Author(s):  
Rena Yadlapati ◽  
Peter J. Kahrilas
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Patient Outcomes ◽  
Clinical Application ◽  
High Resolution Manometry ◽  
Chicago Classification

Chicago Classification version 4.0 (CC v4.0), published in 2021, presents several modifications largely aimed at minimizing over-diagnosis of inconclusive patterns on high-resolution manometry (HRM). These include: (1) introduction of a standardized HRM protocol for consistency among centers, (2) emphasis on the need for supportive data in instances of inconclusive manometric patterns, (3) required presence of relevant symptoms in certain instances to reduce over-diagnosis and inappropriate interventions, and (4) classification as disorders of EGJ outflow or disorders of peristalsis. These updates aim to improve the clinical application of HRM and patient outcomes.

scholarly journals Manometric Characteristics of Opioid Esophageal Dysmotility Disorder by High-Resolution Manometry

2011 ◽  
Vol 140 (5) ◽  
pp. S-229 ◽  
Author(s):  
Kee Wook Jung ◽  
Robert E. Kraichely ◽  
Amindra S. Arora ◽  
David A. Katzka ◽  
Yvonne Romero ◽  
...  
Keyword(s):  
High Resolution ◽  
Esophageal Dysmotility ◽  
High Resolution Manometry

Sa1320 Manometric Correlates of Radiographic Esophageal Spasm: A Comparison Between the Chicago Classification and Conventional Criteria Using High Resolution Manometry

2013 ◽  
Vol 144 (5) ◽  
pp. S-261-S-262
Author(s):  
Kunjal Gandhi ◽  
Elizabeth S. Rosenblatt ◽  
Sameer Dhalla ◽  
Victor Chedid ◽  
Ellen M. Stein ◽  
...  
Keyword(s):  
High Resolution ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Esophageal Spasm

Esophageal dysmotility associated with systemic sclerosis: a high-resolution manometry study

2010 ◽  
Vol 24 (5) ◽  
pp. 299-304 ◽  
Author(s):  
S. Roman ◽  
A. Hot ◽  
N. Fabien ◽  
J.-F. Cordier ◽  
P. Miossec ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
High Resolution ◽  
Esophageal Dysmotility ◽  
High Resolution Manometry

scholarly journals Novedades acerca de los trastornos motores del esófago tras la reciente clasificación de chicago 4.0

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Claudia Córdoba ◽  
Agustina Rodil ◽  
Daniel Cisternas
Keyword(s):  
High Resolution ◽  
Incidental Findings ◽  
Esophagogastric Junction ◽  
Outlet Obstruction ◽  
Motor Disorders ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Provocation Tests ◽  
Aggressive Management ◽  
Standardized Diagnostic

The Chicago Classification includes esophageal motor disorders diagnosed by high-resolution manometry. Of the manometric patterns, some are always clinically relevant and require treatment (eg, the achalasia), while others may be incidental findings requiring no intervention in which aggressive management would be counterproductive. One of the goals of the new version of the recently published Chicago Classification (CCv4.0) was to distinguish between clinically relevant and non-clinically relevant disorders. With this in mind, the study protocol was modified to include liquid swallows in the supine and sitting positions and provocation tests were standardized. Diagnostic criteria were modified, incorporating the presence of symptoms and the support of complementary studies other than manometry. In this review, we will comment the diagnosis and treatment of esophagogastric junction outlet obstruction and hypomotility disorders based on CCv4.0.

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