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Surgical Management of Benign Esophageal Disorders pp 25–38Cite as

The Chicago Classification of Esophageal Motility Disorders

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Abstract

Esophageal high-resolution manometry with esophageal pressure topography (EPT) is now the gold standard to assess esophageal motility disorders. The Chicago Classification categorizes esophageal motility in EPT based on the analysis of ten test swallows conducted in a supine posture. An algorithm is then applied which classifies motility hierarchically as achalasia, motility disorders never observed in controls (absent peristalsis, distal esophageal spasm, jackhammer esophagus) and peristaltic abnormalities statistically different than normal (frequent failed, weak, rapid, and hypertensive peristalsis). Whereas the first categories are invariably associated with esophageal symptoms, the clinical relevance of the latter category remains to be fully defined. Going forward, future investigations will focus on the classification of esophageal motility disorders after esophagogastric surgery, on the evaluation of esophagogastric junction in a context of gastroesophageal reflux disease and on UES function.

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Abbreviations

CD:

crural diaphragm

CDP:

contractile deceleration point

CFV:

contractile front velocity

DCI:

distal contractile integral

DL:

distal latency

EGJ:

esophagogastric junction

EPT:

esophageal pressure topography

GERD:

gastroesophageal reflux disease

HRM:

high-resolution manometry

IRP:

integrated relaxation pressure

LES:

lower esophageal sphincter

UES:

upper esophageal sphincter

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Conflict of interest

SR has served as consultant for Given Imaging.

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Authors and Affiliations

  1. Center for Esophageal Disease, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 St Clair St, 14th floor, Chicago, IL, 60611-2951, USA

    Peter J. Kahrilas MD & John E. Pandolfino MD

  2. Digestive Physiology, Hospices Civils de Lyon and Claude Bernard Lyon I University, Lyon, France

    Sabine Roman MD, PhD

Authors
  1. Peter J. Kahrilas MD
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  2. Sabine Roman MD, PhD
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  3. John E. Pandolfino MD
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Corresponding author

Correspondence to Peter J. Kahrilas MD .

Editor information

Editors and Affiliations

  1. Loyola University Medical Center, Maywood, Illinois, USA

    P. Marco Fisichella

  2. Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Nathaniel J. Soper

  3. Department of Surgery, University of Washington Medical Center, Seattle, USA

    Carlos A. Pellegrini

  4. Chicago, Illinois, USA

    Marco G. Patti

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© 2014 Springer-Verlag London

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Kahrilas, P.J., Roman, S., Pandolfino, J.E. (2014). The Chicago Classification of Esophageal Motility Disorders. In: Fisichella, P., Soper, N., Pellegrini, C., Patti, M. (eds) Surgical Management of Benign Esophageal Disorders. Springer, London. https://doi.org/10.1007/978-1-4471-5484-6_3

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  • DOI: https://doi.org/10.1007/978-1-4471-5484-6_3

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5483-9

  • Online ISBN: 978-1-4471-5484-6

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