Chicago Classification update (V4.0): Technical review on diagnostic criteria for ineffective esophageal motility and absent contractility

Esophageal hypomotility disorders manifest with abnormal esophageal body contraction vigor, breaks in peristaltic integrity, or failure of peristalsis in the context of normal lower esophageal sphincter relaxation on esophageal high‐resolution manometry (HRM). The Chicago Classification version 4.0...

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Bibliographic Details
Published in:Neurogastroenterology and motility 2021-08, Vol.33 (8), p.e14134-n/a
Main Authors: Gyawali, C. Prakash, Zerbib, Frank, Bhatia, Shobna, Cisternas, Daniel, Coss‐Adame, Enrique, Lazarescu, Adriana, Pohl, Daniel, Yadlapati, Rena, Penagini, Roberto, Pandolfino, John
Format: Article
Language:English
Subjects:
absent contractility
Achalasia
Barium
Classification
Contractility
Contraction
Diagnosis
Dysphagia
Esophageal Motility Disorders - diagnosis
Esophageal Motility Disorders - physiopathology
Esophageal sphincter
Esophagus
Esophagus - physiopathology
Gastrointestinal Transit - physiology
high‐resolution manometry
Humans
ineffective esophageal motility
Manometry
Motility
Peristalsis
Radiography
Sphincter
Vigor
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Summary:Esophageal hypomotility disorders manifest with abnormal esophageal body contraction vigor, breaks in peristaltic integrity, or failure of peristalsis in the context of normal lower esophageal sphincter relaxation on esophageal high‐resolution manometry (HRM). The Chicago Classification version 4.0 recognizes two hypomotility disorders, ineffective esophageal motility (IEM) and absent contractility, while fragmented peristalsis has been incorporated into the IEM definition. Updated criteria for ineffective swallows consist of weak esophageal body contraction vigor measured using distal contractile integral (DCI, 100–450 mmHg·cm·s), transition zone defects >5 cm measured using a 20 mmHg isobaric contour, or failure of peristalsis (DCI 
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.14134