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Esophageal motility disorders on high‐resolution manometry: Chicago classification version 4.0 ©
Author(s) -
Yadlapati Rena,
Kahrilas Peter J.,
Fox Mark R.,
Bredenoord Albert J.,
Prakash Gyawali C.,
Roman Sabine,
Babaei Arash,
Mittal Ravinder K.,
Rommel Nathalie,
Savarino Edoardo,
Sifrim Daniel,
Smout André,
Vaezi Michael F.,
Zerbib Frank,
Akiyama Junichi,
Bhatia Shobna,
Bor Serhat,
Carlson Dustin A.,
Chen Joan W.,
Cisternas Daniel,
Cock Charles,
CossAdame Enrique,
de Bortoli Nicola,
Defilippi Claudia,
Fass Ronnie,
Ghoshal Uday C.,
Gonlachanvit Sutep,
Hani Albis,
Hebbard Geoffrey S.,
Wook Jung Kee,
Katz Philip,
Katzka David A.,
Khan Abraham,
Kohn Geoffrey Paul,
Lazarescu Adriana,
Lengliner Johannes,
Mittal Sumeet K.,
Omari Taher,
Park Moo In,
Penagini Roberto,
Pohl Daniel,
Richter Joel E.,
Serra Jordi,
Sweis Rami,
Tack Jan,
Tatum Roger P.,
Tutuian Radu,
Vela Marcelo F.,
Wong Reuben K.,
Wu Justin C.,
Xiao Yinglian,
Pandolfino John E.
Publication year - 2021
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.14058
Subject(s) - high resolution manometry , supine position , esophageal motility disorder , peristalsis , expansive , classification scheme , medicine , esophagogastric junction , medical diagnosis , motility , achalasia , radiology , gastroenterology , esophagus , computer science , physics , machine learning , adenocarcinoma , compressive strength , genetics , cancer , biology , thermodynamics
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.