The Chicago classification of esophageal motor disorders

Rena Yadlapati*, Amit Patel, Peter J. Kahrilas

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The Chicago Classification (CC), now in its fourth iteration [CC Version 4.0 (CC v4.0)], represents the quintessential interpretation and classification scheme for the evaluation of motor function and the diagnosis of motility disorders with esophageal high-resolution manometry (HRM). This current iteration was developed by a diverse international group of esophageal motility experts representing several international motility societies and with methodologic rigor. Relative to prior CC versions, several major, clinically significant modifications have been made, largely aimed at minimizing over-diagnosis of manometrically inconclusive conditions. Specifically, CC v4.0 stipulates an ideal standardized study protocol for consistency among centers, emphasizes the need for and utility of additional supporting data in instances of inconclusive diagnoses (both manometric, with provocative maneuvers, and non-manometric studies), the importance of clinically relevant symptoms with inconclusive diagnoses, the elimination of a distinction between major and minor motility disorders, and more stringent criteria for diagnoses of EGJOO, DES, hypercontractile esophagus, and IEM. Future iterations of the CC will be inspired by fresh data and investigations focusing on therapeutic outcomes to build upon these refinements.

Original languageEnglish (US)
Title of host publicationThe AFS Textbook of Foregut Disease
PublisherSpringer International Publishing
Pages279-289
Number of pages11
ISBN (Electronic)9783031196713
ISBN (Print)9783031196706
DOIs
StatePublished - Apr 21 2023

Keywords

  • Achalasia
  • Distal esophageal spasm
  • Esophageal pressure topography
  • Heller myotomy
  • High-resolution manometry
  • Ineffective esophageal motility
  • Per-oral endoscopic myotomy

ASJC Scopus subject areas

  • General Medicine

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