The Chicago Classification of esophageal motility disorders, v3.0

Kahrilas, Peter J.; Bredenoord, Albert J.; Fox, Mark; Gyawali, C. Prakash; Roman, Sabine; Smout, Andreas J.; Pandolfino, John E.

doi:10.1111/nmo.12477

Cited by 1,655 publications

(1,453 citation statements)

References 42 publications

(68 reference statements)

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“…Currently, sHRM devices consist of 36 circumferential sensors that provide rapid response rates and allow a detailed study of the upper esophageal sphincter (UES) and the EGJ. Normal values as established by the Chicago Classification were defined using sHRM (34)(35)(36). pHRM has the advantage of a more durable probe.…”

Section: High-resolution Manometry Of the Esophagusmentioning

confidence: 99%

Impaired esophageal motor function in eosinophilic esophagitis

Santander¹,

Chavarría²,

Becerro-González³

et al. 2015

Rev Esp Enferm Dig

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Eosinophilic esophagitis is a chronic immunoallergic inflammatory disease of the esophagus that represents a major cause of digestive morbidity among the pediatric and young adult populations. Despite the fact that key symptoms in adults include dysphagia and food impaction, many patients lack structural changes in the esophagus to account for their complaints, which suggests the presence of underlying motor disorders and esophageal distensibility impairment. In the last few years the esophageal motility of these patients has been studied using various approaches, most particularly high-resolution manometry, ambulatory manometry, and impedance planimetry. This review focuses on the most relevant findings and scientific evidence regarding esophageal motor disorders in eosinophilic esophagitis.

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Section: High-resolution Manometry Of the Esophagusmentioning

confidence: 99%

Impaired esophageal motor function in eosinophilic esophagitis

Santander¹,

Chavarría²,

Becerro-González³

et al. 2015

Rev Esp Enferm Dig

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“…However, advantages have been identified in certain situations with the patient sitting (39) and using a solid bolus or standardized food (40)(41)(42). Although some studies have been published with reference values under these conditions (43,44), such conditions are not common and are not covered by the CCH, which is most commonly used to define esophageal motor disorders (3,31). The fact that the reference values vary significantly depending on the position (recumbent/sitting) at rest ( Fig.…”

Section: Current Situationmentioning

confidence: 99%

“…The standard HRM protocol is designed for a patient in a recumbent position and with liquid swallows (3,37,38). However, advantages have been identified in certain situations with the patient sitting (39) and using a solid bolus or standardized food (40)(41)(42).…”

Section: Current Situationmentioning

confidence: 99%

“…Subsequent studies suggest that a cutoff of ≤ 10 mmHg has greater clinical utility (62,63). In any case, this value should be adjusted according to the pattern of esophageal contractility, the patient's position, whether the patient has been operated on, the equipment used (perfusion systems or solid state) and aspects related to the method of analysis (e-sleeve) (3,53,(64)(65)(66)(67).…”

Section: Current Situationmentioning

confidence: 99%

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Practical aspects of high resolution esophageal manometry

Juan¹,

Ríos²,

Bueno³

et al. 2016

Rev Esp Enferm Dig

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High resolution esophageal manometry (HRM) is currently under development as can be seen in the various Chicago classifications. In order to standardize criteria in certain practical aspects with limited scientific evidence, the First National Meeting for Consensus in High Resolution Manometry of the Spanish Digestive Motility Group took place, bringing together a wide group of experts. The proposals were based on a prior survey composed of 47 questions, an exhaustive review of the available literature and the experience of the participants. Methodological aspects relating to the poorly defined analysis criteria of certain new high resolution parameters were discussed, as well as other issues previously overlooked such as spontaneous activity or secondary waves. Final conclusions were drawn with practical applications.

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“…Combining the pattern of esophageal peristaltis with the behaviour of LES during each swallow, the Chicago classification v3.0 defines achalasia, aperistaltis, distal esophageal spasm and jackhammer esophagus as major disorders (can never be seen in normal individuals), while ineffective motility (IEM) and fragmented peristaltis are considered minor disorders, (abnormal patterns, which can be found in asymptomatic individuals) (9).…”

Section: Introductionmentioning

confidence: 99%

High Resolution Manometry - A Mandatory Examination in the Pre and Postoperative Assessment of Patients with Achalasia

Dimitriu¹,

Gheorghe²

2018

chr

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RezumatManometria esofagiană cu rezoluţie înaltă este actual investigaţia gold-standard în diagnosticul acalaziei şi a bolilor esofagiene funcţionale. Această examinare este întotdeauna precedată de endoscopia digestivă superioară, care are scopul de a face diagnosticul diferenţial al acalaziei cu pseudoacalazia (formaţiuni tumorale de fornix gastric/esofag distal). La momentul actual, nu există tratament curativ pentru acalazie. Însă, cele 3 subtipuri de acalazie (conform clasificării Chicago) au răspuns diferit în ceea ce priveşte eficacitatea în tratamentului ales. Astfel, comparativ cu tipurile I şi III, tipul II de acalazie are cel mai bun răspuns la intervenţiile terapeutice invazive (dilatare pneumatică sau cardiomiotomie Heller). În schimb, în tipul III cardiomiotomia Heller este de ales ca prima abordare terapeutică. Miotomia endoscopică perorală (POEM) este o tehnică relativ recentă, care necesită însă studii pe termen lung în ceea ce priveşte siguranţa şi eficacitatea. Articolul prezent îşi propune să prezinte variantele actuale de tratament ale acalaziei, comparându-le pe baza eficacităţii şi siguranţei pe termen scurt şi lung, subliniind de asemenea rolul manometriei cu rezoluţie înaltă în diagnosticul, alegerea metodei terapeutice şi prognosticul acestor pacienţi. Review ArticleAbstract High resolution manometry (HRM) is currently the gold standard for the diagnosis of achalasia and other functional esophageal disorders. All patients accusing dysphagia should be endoscopically evaluated prior to manometric investigations in order to rule out pseudoachalasia. The Chicago HRM classification has led to a subclassification of three manometric types of achalasia that seem to have different results to treatment. None of the actual achalasia treatment options are curative. Type II achalasia patients respond best to all treatment options compared to those with types I and III. Pneumatic dilation (PD) or Heller miotomy (LHM) can be both chosen as initial therapy in type I and II as they have good outcome , while type III achalasia patients respond better to LHM as a first therapeutic option. Peroral endoscopic myotomy (POEM) is a promising new technique but long-term follow-up studies for its safety and efficacy must be performed. This article reviews the current therapeutic options in achalasia and other functional esophageal disorders, based on the differences in safety and efficacy between approaches, highlighting the impact of HRM to predict the outcome but also the role of the techinque in guiding antireflux surgery.

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The Chicago Classification of esophageal motility disorders, v3.0

Cited by 1,655 publications

References 42 publications

Impaired esophageal motor function in eosinophilic esophagitis

Impaired esophageal motor function in eosinophilic esophagitis

Practical aspects of high resolution esophageal manometry

High Resolution Manometry - A Mandatory Examination in the Pre and Postoperative Assessment of Patients with Achalasia

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