The Chicago Classification of esophageal motility disorders, v3.0

P. J. Kahrilas, A. J. Bredenoord, M. Fox, C. P. Gyawali, S. Roman, A. J P M Smout, J. E. Pandolfino, Shobna Bhatia, Guy Boeckxstaens, Serhat Bor, Do Castell, Minhu Chen, Daniel Cisternas, Jeffrey L. Conklin, Ian J. Cook, Kerry Dunbar, Geoffrey Hebbard, Ikuo Hirano, Richard H. Holloway, Phil KatzDavid Katzka, Meiyun Ke, Jutta Keller, Anthony Lembo, Ravinder K. Mittal, Taher Omari, Jeff Peters, Joel Richter, Nathalie Rommel, Renato Salvador, Edoardo Savarino, Felice Schnoll-Sussman, Daniel Sifrim, Stuart Spechler, Rami Sweis, Jan Tack, Radu Tutuian, Miguel Valdovinos, Marcelo F. Vela, Yinglian Xiao, Frank Zerbib

Research output: Contribution to journalArticle

Abstract

Background: The Chicago Classification (CC) of esophageal motility disorders, utilizing an algorithmic scheme to analyze clinical high-resolution manometry (HRM) studies, has gained acceptance worldwide. Methods: This 2014 update, CC v3.0, developed by the International HRM Working Group, incorporated the extensive clinical experience and interval publications since the prior (2011) version. Key Results: Chicago Classification v3.0 utilizes a hierarchical approach, sequentially prioritizing: (i) disorders of esophagogastric junction (EGJ) outflow (achalasia subtypes I-III and EGJ outflow obstruction), (ii) major disorders of peristalsis (absent contractility, distal esophageal spasm, hypercontractile esophagus), and (iii) minor disorders of peristalsis characterized by impaired bolus transit. EGJ morphology, characterized by the degree of overlap between the lower esophageal sphincter and the crural diaphragm and baseline EGJ contractility are also part of CC v3.0. Compared to the previous CC version, the key metrics of interpretation, the integrated relaxation pressure (IRP), the distal contractile integral (DCI), and the distal latency (DL) remain unchanged, albeit with much more emphasis on DCI for defining both hypo- and hypercontractility. New in CC v3.0 are: (i) the evaluation of the EGJ at rest defined in terms of morphology and contractility, (ii) 'fragmented' contractions (large breaks in the 20-mmHg isobaric contour), (iii) ineffective esophageal motility (IEM), and (iv) several minor adjustments in nomenclature and defining criteria. Absent in CC v3.0 are contractile front velocity and small breaks in the 20-mmHg isobaric contour as defining characteristics. Conclusions & Inferences: Chicago Classification v3.0 is an updated analysis scheme for clinical esophageal HRM recordings developed by the International HRM Working Group. View the podcast on this paper at the following sites: Youtube: https://www.youtube.com/watch?v=zHFT4mj-Yw4&feature=youtu.be iTunes: https://itunes.apple.com/gb/podcast/neurogastroenterology-motility/id955822234 The Chicago Classification (CC) of esophageal motility disorders, utilizing an algorithmic scheme to analyze clinical high-resolution manometry (HRM) studies, has gained acceptance worldwide. This 2014 update, CC v3.0, developed by the International HRM Working Group, incorporated the extensive clinical experience and interval publications since the prior (2011) version.

Original languageEnglish (US)
Pages (from-to)160-174
Number of pages15
JournalNeurogastroenterology and Motility
Volume27
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Fingerprint

Esophageal Motility Disorders
Manometry
Esophagogastric Junction
Webcasts
Peristalsis
Publications
Diffuse Esophageal Spasm
Lower Esophageal Sphincter
Esophageal Achalasia
Malus
Diaphragm
Terminology
Esophagus
Leg

Keywords

  • Achalasia
  • Dysphagia
  • Esophageal motility disorders
  • High-resolution manometry
  • Ineffective esophageal motility

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Gastroenterology
  • Physiology

Cite this

Kahrilas, P. J., Bredenoord, A. J., Fox, M., Gyawali, C. P., Roman, S., Smout, A. J. P. M., ... Zerbib, F. (2015). The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterology and Motility, 27(2), 160-174. https://doi.org/10.1111/nmo.12477

The Chicago Classification of esophageal motility disorders, v3.0. / Kahrilas, P. J.; Bredenoord, A. J.; Fox, M.; Gyawali, C. P.; Roman, S.; Smout, A. J P M; Pandolfino, J. E.; Bhatia, Shobna; Boeckxstaens, Guy; Bor, Serhat; Castell, Do; Chen, Minhu; Cisternas, Daniel; Conklin, Jeffrey L.; Cook, Ian J.; Dunbar, Kerry; Hebbard, Geoffrey; Hirano, Ikuo; Holloway, Richard H.; Katz, Phil; Katzka, David; Ke, Meiyun; Keller, Jutta; Lembo, Anthony; Mittal, Ravinder K.; Omari, Taher; Peters, Jeff; Richter, Joel; Rommel, Nathalie; Salvador, Renato; Savarino, Edoardo; Schnoll-Sussman, Felice; Sifrim, Daniel; Spechler, Stuart; Sweis, Rami; Tack, Jan; Tutuian, Radu; Valdovinos, Miguel; Vela, Marcelo F.; Xiao, Yinglian; Zerbib, Frank.

In: Neurogastroenterology and Motility, Vol. 27, No. 2, 01.02.2015, p. 160-174.

Research output: Contribution to journalArticle

Kahrilas, PJ, Bredenoord, AJ, Fox, M, Gyawali, CP, Roman, S, Smout, AJPM, Pandolfino, JE, Bhatia, S, Boeckxstaens, G, Bor, S, Castell, D, Chen, M, Cisternas, D, Conklin, JL, Cook, IJ, Dunbar, K, Hebbard, G, Hirano, I, Holloway, RH, Katz, P, Katzka, D, Ke, M, Keller, J, Lembo, A, Mittal, RK, Omari, T, Peters, J, Richter, J, Rommel, N, Salvador, R, Savarino, E, Schnoll-Sussman, F, Sifrim, D, Spechler, S, Sweis, R, Tack, J, Tutuian, R, Valdovinos, M, Vela, MF, Xiao, Y & Zerbib, F 2015, 'The Chicago Classification of esophageal motility disorders, v3.0', Neurogastroenterology and Motility, vol. 27, no. 2, pp. 160-174. https://doi.org/10.1111/nmo.12477
Kahrilas PJ, Bredenoord AJ, Fox M, Gyawali CP, Roman S, Smout AJPM et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterology and Motility. 2015 Feb 1;27(2):160-174. https://doi.org/10.1111/nmo.12477
Kahrilas, P. J. ; Bredenoord, A. J. ; Fox, M. ; Gyawali, C. P. ; Roman, S. ; Smout, A. J P M ; Pandolfino, J. E. ; Bhatia, Shobna ; Boeckxstaens, Guy ; Bor, Serhat ; Castell, Do ; Chen, Minhu ; Cisternas, Daniel ; Conklin, Jeffrey L. ; Cook, Ian J. ; Dunbar, Kerry ; Hebbard, Geoffrey ; Hirano, Ikuo ; Holloway, Richard H. ; Katz, Phil ; Katzka, David ; Ke, Meiyun ; Keller, Jutta ; Lembo, Anthony ; Mittal, Ravinder K. ; Omari, Taher ; Peters, Jeff ; Richter, Joel ; Rommel, Nathalie ; Salvador, Renato ; Savarino, Edoardo ; Schnoll-Sussman, Felice ; Sifrim, Daniel ; Spechler, Stuart ; Sweis, Rami ; Tack, Jan ; Tutuian, Radu ; Valdovinos, Miguel ; Vela, Marcelo F. ; Xiao, Yinglian ; Zerbib, Frank. / The Chicago Classification of esophageal motility disorders, v3.0. In: Neurogastroenterology and Motility. 2015 ; Vol. 27, No. 2. pp. 160-174.
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T1 - The Chicago Classification of esophageal motility disorders, v3.0

AU - Kahrilas, P. J.

AU - Bredenoord, A. J.

AU - Fox, M.

AU - Gyawali, C. P.

AU - Roman, S.

AU - Smout, A. J P M

AU - Pandolfino, J. E.

AU - Bhatia, Shobna

AU - Boeckxstaens, Guy

AU - Bor, Serhat

AU - Castell, Do

AU - Chen, Minhu

AU - Cisternas, Daniel

AU - Conklin, Jeffrey L.

AU - Cook, Ian J.

AU - Dunbar, Kerry

AU - Hebbard, Geoffrey

AU - Hirano, Ikuo

AU - Holloway, Richard H.

AU - Katz, Phil

AU - Katzka, David

AU - Ke, Meiyun

AU - Keller, Jutta

AU - Lembo, Anthony

AU - Mittal, Ravinder K.

AU - Omari, Taher

AU - Peters, Jeff

AU - Richter, Joel

AU - Rommel, Nathalie

AU - Salvador, Renato

AU - Savarino, Edoardo

AU - Schnoll-Sussman, Felice

AU - Sifrim, Daniel

AU - Spechler, Stuart

AU - Sweis, Rami

AU - Tack, Jan

AU - Tutuian, Radu

AU - Valdovinos, Miguel

AU - Vela, Marcelo F.

AU - Xiao, Yinglian

AU - Zerbib, Frank

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background: The Chicago Classification (CC) of esophageal motility disorders, utilizing an algorithmic scheme to analyze clinical high-resolution manometry (HRM) studies, has gained acceptance worldwide. Methods: This 2014 update, CC v3.0, developed by the International HRM Working Group, incorporated the extensive clinical experience and interval publications since the prior (2011) version. Key Results: Chicago Classification v3.0 utilizes a hierarchical approach, sequentially prioritizing: (i) disorders of esophagogastric junction (EGJ) outflow (achalasia subtypes I-III and EGJ outflow obstruction), (ii) major disorders of peristalsis (absent contractility, distal esophageal spasm, hypercontractile esophagus), and (iii) minor disorders of peristalsis characterized by impaired bolus transit. EGJ morphology, characterized by the degree of overlap between the lower esophageal sphincter and the crural diaphragm and baseline EGJ contractility are also part of CC v3.0. Compared to the previous CC version, the key metrics of interpretation, the integrated relaxation pressure (IRP), the distal contractile integral (DCI), and the distal latency (DL) remain unchanged, albeit with much more emphasis on DCI for defining both hypo- and hypercontractility. New in CC v3.0 are: (i) the evaluation of the EGJ at rest defined in terms of morphology and contractility, (ii) 'fragmented' contractions (large breaks in the 20-mmHg isobaric contour), (iii) ineffective esophageal motility (IEM), and (iv) several minor adjustments in nomenclature and defining criteria. Absent in CC v3.0 are contractile front velocity and small breaks in the 20-mmHg isobaric contour as defining characteristics. Conclusions & Inferences: Chicago Classification v3.0 is an updated analysis scheme for clinical esophageal HRM recordings developed by the International HRM Working Group. View the podcast on this paper at the following sites: Youtube: https://www.youtube.com/watch?v=zHFT4mj-Yw4&feature=youtu.be iTunes: https://itunes.apple.com/gb/podcast/neurogastroenterology-motility/id955822234 The Chicago Classification (CC) of esophageal motility disorders, utilizing an algorithmic scheme to analyze clinical high-resolution manometry (HRM) studies, has gained acceptance worldwide. This 2014 update, CC v3.0, developed by the International HRM Working Group, incorporated the extensive clinical experience and interval publications since the prior (2011) version.

AB - Background: The Chicago Classification (CC) of esophageal motility disorders, utilizing an algorithmic scheme to analyze clinical high-resolution manometry (HRM) studies, has gained acceptance worldwide. Methods: This 2014 update, CC v3.0, developed by the International HRM Working Group, incorporated the extensive clinical experience and interval publications since the prior (2011) version. Key Results: Chicago Classification v3.0 utilizes a hierarchical approach, sequentially prioritizing: (i) disorders of esophagogastric junction (EGJ) outflow (achalasia subtypes I-III and EGJ outflow obstruction), (ii) major disorders of peristalsis (absent contractility, distal esophageal spasm, hypercontractile esophagus), and (iii) minor disorders of peristalsis characterized by impaired bolus transit. EGJ morphology, characterized by the degree of overlap between the lower esophageal sphincter and the crural diaphragm and baseline EGJ contractility are also part of CC v3.0. Compared to the previous CC version, the key metrics of interpretation, the integrated relaxation pressure (IRP), the distal contractile integral (DCI), and the distal latency (DL) remain unchanged, albeit with much more emphasis on DCI for defining both hypo- and hypercontractility. New in CC v3.0 are: (i) the evaluation of the EGJ at rest defined in terms of morphology and contractility, (ii) 'fragmented' contractions (large breaks in the 20-mmHg isobaric contour), (iii) ineffective esophageal motility (IEM), and (iv) several minor adjustments in nomenclature and defining criteria. Absent in CC v3.0 are contractile front velocity and small breaks in the 20-mmHg isobaric contour as defining characteristics. Conclusions & Inferences: Chicago Classification v3.0 is an updated analysis scheme for clinical esophageal HRM recordings developed by the International HRM Working Group. View the podcast on this paper at the following sites: Youtube: https://www.youtube.com/watch?v=zHFT4mj-Yw4&feature=youtu.be iTunes: https://itunes.apple.com/gb/podcast/neurogastroenterology-motility/id955822234 The Chicago Classification (CC) of esophageal motility disorders, utilizing an algorithmic scheme to analyze clinical high-resolution manometry (HRM) studies, has gained acceptance worldwide. This 2014 update, CC v3.0, developed by the International HRM Working Group, incorporated the extensive clinical experience and interval publications since the prior (2011) version.

KW - Achalasia

KW - Dysphagia

KW - Esophageal motility disorders

KW - High-resolution manometry

KW - Ineffective esophageal motility

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