| Esophageal motility disorders in terms of pressure topography: the Chicago Classification. | |
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MedLine Citation:
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PMID: 18364587 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Two recent advances have revolutionized the performance of clinical esophageal manometry; the introduction of practical high resolution manometry (HRM) systems and the development of sophisticated algorithms to display the expanded manometric dataset as pressure topography plots. We utilized a large clinical experience of 400 consecutive patients and 75 control subjects to develop a systematic approach to analyzing esophageal motility using HRM and pressure topography plots. The resultant classification scheme has been named as the Chicago Classification of esophageal motility. Two strengths of pressure topography plots compared with conventional manometric recordings were the ability to (1) delineate the spatial limits, vigor, and integrity of individual contractile segments along the esophagus and (2) to distinguish between loci of compartmentalized intraesophageal pressurization and rapidly propagated contractions. Making these distinctions objectified the identification of distal esophageal spasm, vigorous achalasia, functional obstruction, and nutcracker esophagus subtypes. Applying these distinctions made the diagnosis of spastic disorders quite rare: spasm in 1.5% of patients, vigorous achalasia in 1.5%, and a newly defined entity, spastic nutcracker, in 1.5%. Ultimately, further clinical experience will be the judge, but it is our expectation that pressure topography analysis of HRM data, along with its well-defined functional implications, will prove valuable in the clinical management of esophageal motility disorders. |
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Authors:
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Peter J Kahrilas; Sudip K Ghosh; John E Pandolfino |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 42 ISSN: 0192-0790 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2008 May-Jun |
Date Detail:
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Created Date: 2008-04-22 Completed Date: 2008-08-05 Revised Date: 2010-12-03 |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 627-35 Citation Subset: IM |
Affiliation:
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Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-2951, USA. p-kahrilas@northwestern.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Esophageal Motility Disorders
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classification*,
physiopathology Esophagus / physiopathology* Humans Image Processing, Computer-Assisted / methods* Manometry / methods* Peristalsis / physiology* Pressure Reproducibility of Results |
| Grant Support | |
ID/Acronym/Agency:
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DC00646/DC/NIDCD NIH HHS; R01 DC000646-09/DC/NIDCD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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