Citations 2
Esophageal motility disorders on high‐resolution manometry: Chicago classification version 4.0 ©
Yadlapati, Rena , Fox, Mark , Bredenoord, Albert J. , Gyawali, C. Prakash , Roman, Sabine , Babaei, Arash , Mittal, Ravinder K. , Rommel, Nathalie , Savarino, Edoardo , Smout, A. J. P. M. , Vaezi, Michael F. , Akiyama, Junichi, Bhatia, Shobna , Carlson, Dustin A. , Chen, Joan W. , Cisternas, Daniel , Cock, Charles , Defilippi, Claudia, Gonlachanvit, Sutep , Hebbard, Geoffrey , Jung, Kee Wook , Katz, Philip O. , Katzka, David A. , Khan, Anzalee , Kohn, Geoffrey P. , Lazarescu, Adriana , Lengliner, Johannes, Omari, Taher , Pohl, Daniel , Richter, Joel E. , Serra, Jordi , Sweis, Rami , Tack, Jan , Tatum, Roger P. , Vela, Marcelo F. , Wu, Justin C. Y. , Xiao, Yinglian , Pandolfino, John E. , Fox, Mark R , Gyawali, C P , Roman, S , Babaei, Arash , Mittal, Ravinder K , Sifrim, Daniel , Smout, André , Zerbib, Frank , Bor, Serhat , Carlson, Dustin A , Cisternas, Daniel , Cock, Charles , de Bortoli, Nicola , Fass, Ronnie , Ghoshal, Uday C , Jung, Kee Wook , Khan, Abraham , Omari, Taher , Park, Moo In , Penagini, Roberto , Serra, Jordi , Tack, Jan , Savarino, Edoardo , Kahrilas, Peter J. , Bor, Serhat , Coss‐Adame, Enrique , Bortoli, Nicola de , Fass, Ronnie , Ghoshal, Uday C. , Hani, Albis Cecilia , Mittal, Sumeet K. , Penagini, Roberto , Tutuian, Radu I. , Wong, Reuben K.
Neurogastroenterology & Motility | December 29, 2020 | Volume: 33 | Issue: 1 | Pages: No page available
Abstract 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.
Mucosal impedance for esophageal disease: evaluating the evidence
Clarke, John O. , Ahuja, Nitin K. , Chan, Walter W. , Gyawali, C. Prakash , Horsley‐Silva, Jennifer L. , Kamal, A. N. , Vela, Marcelo F. , Xiao, Yinglian , Clarke, J , Gyawali, C P , Chan, Walter , Kamal, Afrin N.
Annals of the New York Academy of Sciences | June 26, 2020 | Volume: 1481 | Issue: 1 | Pages: 247-257
AbstractImpedance has traditionally been employed in esophageal disease as a means to assess bolus flow and reflux episodes. Recent and ongoing research has provided new and novel applications for this technology. Measurement of esophageal mucosal impedance, via either multichannel intraluminal impedance catheters or specially designed endoscopically deployed impedance catheters, provides a marker of mucosal integrity. Mucosal impedance has been shown to segregate gastroesophageal reflux disease (GERD) and eosinophilic esophagitis from non‐GERD controls and may play a role in predicting response to reflux intervention. More data are needed with regard to other esophageal subgroups, outcome studies, and functional disease. Our paper reviews the history of impedance in esophageal disease, the means of assessing baseline and mucosal impedance, data with regard to the newly developed mucosal impedance probes, the clinical utility of mucosal impedance in specific clinical conditions, and limitations in our existing knowledge, along with suggestions for future studies.