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.
Ambulatory reflux monitoring for diagnosis of gastro‐esophageal reflux disease: Update of the Porto consensus and recommendations from an international consensus group
Roman, Sabine , Gyawali, C. Prakash , Savarino, Edoardo , Wu, Justin C. Y. , Vela, Marcelo F. , Tatum, Roger P. , Fox, Mark , Pandolfino, John E. , Bredenoord, Albert J. , group, the GERD consensus, Tack, Jan , Penagini, Roberto , Mion, François , Bor, Serhat , Patel, Amit , Cicala, Michele , Bortoli, Nicola de , Azpiroz, Fernando , Roman, S , Gyawali, C P , Yadlapati, Rena , Zerbib, Frank , Tutuian, Radu I. , Sifrim, Daniel , Keller, Jutta , group, the GERD consensus, Patel, A , Penagini, Roberto , Tack, Jan , Bor, Serhat , de Bortoli, Nicola , Savarino, Edoardo
Neurogastroenterology & Motility | March 31, 2017 | Volume: 29 | Issue: 10 | Pages: 1-15
AbstractBackgroundAn international group of experts evaluated and revised recommendations for ambulatory reflux monitoring for the diagnosis of gastro‐esophageal reflux disease (GERD).MethodsLiterature search was focused on indications and technical recommendations for GERD testing and phenotypes definitions. Statements were proposed and discussed during several structured meetings.Key ResultsReflux testing should be performed after cessation of acid suppressive medication in patients with a low likelihood of GERD. In this setting, testing can be either catheter‐based or wireless pH‐monitoring or pH‐impedance monitoring. In patients with a high probability of GERD (esophagitis grade C and D, histology proven Barrett's mucosa >1 cm, peptic stricture, previous positive pH monitoring) and persistent symptoms, pH‐impedance monitoring should be performed on treatment. Recommendations are provided for data acquisition and analysis. Esophageal acid exposure is considered as pathological if acid exposure time (AET) is greater than 6% on pH testing. Number of reflux episodes and baseline impedance are exploratory metrics that may complement AET. Positive symptom reflux association is defined as symptom index (SI) >50% or symptom association probability (SAP) >95%. A positive symptom‐reflux association in the absence of pathological AET defines hypersensitivity to reflux.Conclusions and InferencesThe consensus group determined that grade C or D esophagitis, peptic stricture, histology proven Barrett's mucosa >1 cm, and esophageal acid exposure greater >6% are sufficient to define pathological GERD. Further testing should be considered when none of these criteria are fulfilled.