The Chicago criteria for esophageal motility disorders: What has changed in the past 5 years?

Purpose of review: The Chicago Classification for esophageal motility disorders was developed to complement the enhanced characterization of esophageal motility provided by high-resolution esophageal pressure topography (HREPT) as this new technology has emerged within clinical practice. This review aims to summarize the evidence supporting the evolution of the classification scheme since its inception. Recent findings: Studies examining the specific esophageal motility disorders in regards to HREPT metrics, clinical characteristics, and responses to treatments have facilitated updates of the diagnostic scheme and criteria. These studies have demonstrated variation in treatment responses associated with subclassification of achalasia, the use of distal latency in the diagnosis of distal esophageal spasm, and the development of diagnoses including esophagogastric junction outflow obstruction and hypercontractile esophagus. Summary: The diagnostic criteria described in the Chicago Classification have evolved to demonstrate a greater focus on distinct clinical phenotypes. Future evaluation of the natural history and treatment outcomes will assist in further refinement of this diagnostic scheme and management of esophageal motility disorders.