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 Physiological and pathological roles of the accommodation response in lower esophageal sphincter relaxation during wet swallows

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Muta ◽  
Eikichi Ihara ◽  
Shohei Hamada ◽  
Hiroko Ikeda ◽  
Masafumi Wada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Relaxation Function ◽  
Esophagogastric Junction ◽  
Prospective Observational Study ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

AbstractThe preparatory accommodation response of lower esophageal sphincter (LES) before swallowing is one of the mechanisms involved in LES relaxation during wet swallows, however, the physiological and/or pathological roles of LES accommodation remain to be determined in humans. To address this problem, we conducted a prospective observational study of 38 patients with normal high-resolution manometry (HRM) and 23 patients with idiopathic esophagogastric junction outflow obstruction (EGJOO) to assess dry and wet swallows. The LES accommodation measurement was proposed for practical use in evaluating the LES accommodation response. Although swallow-induced LES relaxation was observed in both dry and wet swallows, LES accommodation (6.4, 3.1–11.1 mmHg) was only observed in wet swallows. The extent of LES accommodation was impaired in idiopathic EGJOO (0.6, − 0.6–6 mmHg), and the LES accommodation measurement of patients with idiopathic EGJOO (36.8, 29.5–44.3 mmHg) was significantly higher in comparison to those with normal HRM (23.8, 18–28.6 mmHg). Successful LES relaxation in wet swallowing can be achieved by LES accommodation in combination with swallow-induced LES relaxation. Impaired LES accommodation is characteristic of idiopathic EGJOO. In addition to the IRP value, the LES accommodation measurement may be useful for evaluating the LES relaxation function in clinical practice.

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

scholarly journals Esophageal manometry high-resolution in clinical practice.

2018 ◽  
Vol 95 (12) ◽  
pp. 1127-1136 ◽  
Author(s):  
I. V. Maev ◽  
E. V. Barkalova ◽  
M. A. Hovsepyan ◽  
Yu. A. Kucheryavy ◽  
Dmitry N. Andreyev
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Motor Function ◽  
Esophageal Manometry ◽  
Promising Method ◽  
Thoracic Esophagus ◽  
Current Clinical Practice ◽  
High Resolution Manometry ◽  
Diagnostic Capabilities

At present, esophageal manometry high-resolution (high resolution manometry, HRM) is a highly informative and promising method for diagnosing patients with different disorders of the motor function of the thoracic esophagus and disorders of tone of the sphincter apparatus. This article presents a series of observations that demonstrate the diagnostic capabilities of the methodology in current clinical practice.

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.

scholarly journals High-resolution manometry in the diagnosis and classification of achalasia in children

2020 ◽  
Vol 50 (1) ◽  
Author(s):  
Erick Toro-Monjaraz ◽  
Rubén Peña-Vélez ◽  
María José Carrillo-Quan ◽  
David Avelar-Rodríguez ◽  
Martha Cecilia Martínez-Soto ◽  
...  
Keyword(s):  
High Resolution ◽  
Pediatric Patients ◽  
Case Series ◽  
Esophageal Achalasia ◽  
Motor Disorder ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Diagnosis And Classification ◽  
Esophageal Sphincter

Esophageal achalasia is a primary motor disorder that presents with dysphagia secondary to esophageal body dysfunction and functional obstruction of the lower esophageal sphincter. High-resolution manometry is considered the gold standard for the diagnosis of achalasia and, according to the Chicago classification v3.0; it can be further divided into three different subtypes based on the pressurization patterns. Herein, we present the case series of 6 pediatric patients in whom high-resolution manometry was performed for the diagnosis and classification of esophageal achalasia.

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