Ineffective esophageal motility in Chicago Classification version 4.0 better predicts abnormal acid exposure

Zhuang, Qianjun; Tan, Niandi; Zhang, Mengyu; Chen, Songfeng; Luo, Yu; Xiao, Yinglian

doi:10.1007/s10388-021-00867-5

Cited by 9 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our research defined the IEM based on CCv4.0, which is more stringent than CCv3.0. This significant difference may be explained by the fact that IEM in our study was defined with CCv4.0, while CCv3.0 definition showed no significant relation between IEM and GERD 8,18 . Increased acid exposure time caused by IEM in GERD patients may further impair esophageal mucosa 5 .…”

Section: Discussioncontrasting

confidence: 59%

“…This significant difference may be explained by the fact that IEM in our study was defined with CCv4.0, while CCv3.0 definition showed no significant relation between IEM and GERD. 8,18 Increased acid exposure time caused by IEM in GERD patients may further impair esophageal mucosa. 5 The z5 and z6 F I G U R E 5 Correlation between gastric electric parameters and reflux parameters.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of reflux and gastric electrical activity in gastroesophageal reflux disease with ineffective esophageal motility

Chen

Feng

et al. 2023

J of Digest Diseases

View full text Add to dashboard Cite

Objectives: The impact of ineffective esophageal motility (IEM) on gastroesophageal reflux disease (GERD) remains unknown, and abnormal esophageal motility often coexists with abnormal gastric motility. We aimed to investigate the role of IEM in GERD and its relationship with gastric electrical activity.Methods: Patients diagnosed as GERD based on GERD-questionnaire score ≥8 in our hospital from January 2020 to June 2022 were included. All patients underwent 24-h multichannel intraluminal impedance-pH monitoring, high-resolution manometry, and electrogastrogram and were categorized into the normal esophageal motility (NEM) and IEM groups, respectively. Reflux characteristics and gastric electric activity were compared between the two groups, and the correlation between gastric electric activity and reflux was analyzed.Results: Acid exposure time, total reflux episodes, and DeMeester score in the IEM group were higher than those in the NEM group. Distal mean nocturnal baseline impedance was significantly lower in the IEM group. Compared with the NEM group, the power ratio (PR) of fundus, antrum and pylorus and premeal and postmeal normal wave ratio of antrum were significantly lower in IEM. The total reflux episodes were negatively correlated with the PR of fundus and pylorus, and the DeMeester score was negatively correlated with the PR of corpus and pylorus.Conclusions: IEM may lead to increased reflux, resulting in esophageal mucosal damage.There may be consistency between abnormal esophageal motility and gastric motility.

show abstract

Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Characteristics of reflux and gastric electrical activity in gastroesophageal reflux disease with ineffective esophageal motility

Chen

Feng

et al. 2023

J of Digest Diseases

View full text Add to dashboard Cite

show abstract

“…Our aims were to identify if differences among these data between the two groups and whether underlying comorbidities or medications were more prevalent in group 1. At the time of this study, there had only been one published peer-reviewed study (n = 93) comparing the clinical characteristics of IEM patients by CCv3.0 and CCv4.0, and that study largely examined abnormal acid exposure [ 12 ]. A very recent publication showed that IEM was less frequent with CCv4.0 compared to CCv3.0, which is to be expected given the new criteria [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing Patients Diagnosed With Ineffective Esophageal Motility by the Chicago Classification Version 3.0 and Version 4.0 Criteria

et al. 2023

View full text Add to dashboard Cite

“…1 However, IEM poses a challenge for clinicians due to its unclear clinical significance and inconsistent association with antireflux surgery (ARS) outcomes. [2][3][4] Since its initial description almost 30 years ago, the specific criteria used to define IEM have evolved numerous times in attempts to create a more precise diagnosis with distinct clinical relevance. 5,6 Recently, the Chicago Classification of esophageal motility disorders on high-resolution manometry (HRM) was updated from Chicago Classification version 3.0 (CCv3.0) to Chicago Classification version 4.0 (CCv4.0).…”

Section: Introductionmentioning

confidence: 99%

“…This diagnosis is commonly associated with gastroesophageal reflux disease (GERD), affecting up to 49.4% of reflux patients 1 . However, IEM poses a challenge for clinicians due to its unclear clinical significance and inconsistent association with antireflux surgery (ARS) outcomes 2–4 . Since its initial description almost 30 years ago, the specific criteria used to define IEM have evolved numerous times in attempts to create a more precise diagnosis with distinct clinical relevance 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Ineffective esophageal motility: The impact of change of criteria in Chicago Classification version 4.0 on predicting outcome after magnetic sphincter augmentation

Riccardi

Eriksson

Tamesis

et al. 2023

Neurogastroenterology Motil

View full text Add to dashboard Cite

BackgroundThe most recent update of the Chicago Classification (CCv4.0) attempts to provide a more clinically relevant definition for ineffective esophageal motility (IEM). The impact of this new definition on predicting outcome after antireflux surgery is unknown. The aim of this study was to compare utility of IEM diagnosis based on CCv4.0 to CCv3.0 in predicting surgical outcome after magnetic sphincter augmentation (MSA) and to assess any additional parameters that hold value in future definitions.MethodsRecords of 336 patients who underwent MSA at our institution between 2013 and 2020 were reviewed. Preoperative manometry files were re‐analyzed using both Chicago Classification version 3.0 (CCv3.0) and CCv4.0 definitions of IEM. The utility of each IEM definition in predicting surgical outcome was then compared. Individual manometric components and impedance data were also assessed.Key ResultsImmediate dysphagia was reported by 186 (55.4%) and persistent dysphagia by 42 (12.5%) patients. CCv3.0 IEM criteria were met by 37 (11%) and CCv4.0 IEM by 18 (5.4%) patients (p = 0.011). CCv3.0 and CCv4.0 IEM were equally poor predictors of immediate (AUC = 0.503 vs. 0.512, p = 0.7482) and persistent (AUC = 0.519 vs. 0.510, p = 0.7544) dysphagia. The predicted dysphagia probability of less than 70% bolus clearance (BC) was 17.4%, higher than CCv4.0 IEM at 16.7%. When BC was incorporated into CCv4.0 IEM criteria, the probability increased significantly to 30.0% (p = 0.0042).Conclusions & InferencesThe CCv3.0 and CCv4.0 of IEM are poor predictors of dysphagia after MSA. Adding BC to the new definition improves its predictive utility and should be considered in future definitions.

show abstract

Ineffective esophageal motility in Chicago Classification version 4.0 better predicts abnormal acid exposure

Cited by 9 publications

References 28 publications

Characteristics of reflux and gastric electrical activity in gastroesophageal reflux disease with ineffective esophageal motility

Characteristics of reflux and gastric electrical activity in gastroesophageal reflux disease with ineffective esophageal motility

Comparing Patients Diagnosed With Ineffective Esophageal Motility by the Chicago Classification Version 3.0 and Version 4.0 Criteria

Ineffective esophageal motility: The impact of change of criteria in Chicago Classification version 4.0 on predicting outcome after magnetic sphincter augmentation

Contact Info

Product

Resources

About