Document Detail


Esophageal motility disorders in terms of pressure topography: the Chicago Classification.
MedLine Citation:
PMID:  18364587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Peter J Kahrilas; Sudip K Ghosh; John E Pandolfino
Related Documents :
922807 - Morphological alterations and functional changes of interhepatocellular junctions induc...
4029557 - Gastric distention: a mechanism for postprandial gastroesophageal reflux.
15916627 - Facilitation of gastric compliance and cardiovascular reaction by repeated isobaric dis...
2379867 - Control of belching by the lower oesophageal sphincter.
4005497 - An experimental model of detrusor instability in the obstructed pig.
15833887 - Fluticasone inhalation in moderate cases of bronchopulmonary dysplasia.
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  42     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-04-22     Completed Date:  2008-08-05     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  627-35     Citation Subset:  IM    
Affiliation:
Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-2951, USA. p-kahrilas@northwestern.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Esophageal Motility Disorders / classification*,  physiopathology
Esophagus / physiopathology*
Humans
Image Processing, Computer-Assisted / methods*
Manometry / methods*
Peristalsis / physiology*
Pressure
Reproducibility of Results
Grant Support
ID/Acronym/Agency:
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


Previous Document:  Clinical importance of impedance measurements.
Next Document:  Pathophysiology of gastroesophageal reflux disease.