Review
Pharmacology & Pharmacy
Sawangpong Jandee, Annelies Geeraerts, Hannelore Geysen, Nathalie Rommel, Jan Tack, Tim Vanuytsel
Summary: Esophageal hypomotility, particularly ineffective esophageal motility according to the Chicago criteria, is a common motility disorder diagnosed on high resolution manometry. Most patients present with GERD symptoms or dysphagia. Prokinetic agents are commonly prescribed but their beneficial effects are limited to certain drugs.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Gastroenterology & Hepatology
Vikram Rangan, Judy Nee, Brian Li, Anthony J. Lembo, David A. Leiman
Summary: This study aimed to identify specific HRM findings predictive of symptoms in patients with ineffective esophageal motility (IEM). The results showed that the percentage of ineffective swallows in IEM patients independently predicted the severity of dysphagia.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Michael Kurin, Syed A. Adil, Sofi Damjanovska, Samuel Tanner, Katarina Greer
Summary: Chicago classification version 4.0 introduced stricter diagnostic criteria for ineffective esophageal motility (IEM) compared to version 3.0. The new criteria resulted in a decreased prevalence of IEM and revealed differences between patients who met the criteria under version 4.0 and those who no longer met the criteria.
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Margaret Riccardi, Sven E. Eriksson, Steven Tamesis, Ping Zheng, Blair A. Jobe, Shahin Ayazi
Summary: The CCv3.0 and CCv4.0 definitions of ineffective esophageal motility (IEM) are not effective in predicting dysphagia after magnetic sphincter augmentation (MSA). However, incorporating the probability of dysphagia improves the predictive utility of the new definition.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Gastroenterology & Hepatology
C. Prakash Gyawali, Frank Zerbib, Shobna Bhatia, Daniel Cisternas, Enrique Coss-Adame, Adriana Lazarescu, Daniel Pohl, Rena Yadlapati, Roberto Penagini, John Pandolfino
Summary: Esophageal hypomotility disorders are characterized by abnormal esophageal body contractions or disrupted peristalsis while the lower esophageal sphincter function remains normal. The Chicago Classification version 4.0 distinguishes between ineffective esophageal motility (IEM) and absent contractility, with specific criteria for diagnosis including measures of esophageal contraction vigor and peristalsis integrity. Additional tests such as rapid swallows or barium radiography may be necessary to support the diagnosis in inconclusive cases. Further research is needed to refine diagnostic criteria and understand the physiology of esophageal bolus clearance in hypomotility disorders.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Wei-Yi Lei, Tso-Tsai Liu, Jen-Hung Wang, Chih-Hsun Yi, Jui-Sheng Hung, Ming-Wun Wong, Chandra Prakash Gyawali, Chien-Lin Chen
Summary: The study found significant defects in the triggering of secondary peristalsis in GERD patients, particularly those with IEM. This can be characterized by HRM to show differences in esophageal secondary peristalsis between patients with and without IEM.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Editorial Material
Medicine, Research & Experimental
Fernando A. M. Herbella, Leonardo M. Del Grande, Francisco Schlottmann, Marco G. Patti
Summary: The Chicago Classification 4.0 introduces new concepts for the diagnosis of achalasia, potentially reducing unnecessary treatment. Conditions such as esophagogastric junction outflow obstruction, distal esophageal spasm, and hypercontractile esophagus are now considered clinically significant only in certain conditions, leading to a potential decrease in treatment, especially peroral endoscopic myotomy, solely based on manometric diagnosis.
ADVANCES IN THERAPY
(2021)
Article
Gastroenterology & Hepatology
Yuichiro Ikebuchi, Hiroki Sato, Haruo Ikeda, Hirofumi Abe, Masaki Ominami, Junya Shiota, Chiaki Sato, Hisashi Fukuda, Ryo Ogawa, Tetsuya Tatsuta, Hiroshi Yokomichi, Hajime Isomoto, Haruhiro Inoue
Summary: This study found that high-resolution manometry (HRM) can diagnose esophageal hypomotility disorders such as absent contractility (AC) and ineffective esophageal motility (IEM). AC is often associated with systemic diseases, while IEM is more common. The HRM system can effectively differentiate between AC and achalasia. AC and IEM can transform into each other, but no transition to achalasia was observed.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Surgery
George N. Baison, Anee S. Jackson, Candice L. Wilshire, Reginald C. W. Bell, Veronica Lazzari, Luigi Bonavina, Shahin Ayazi, Blair A. Jobe, Sebastian F. Schoppmann, Colin P. Dunn, John C. Lipham, Christy M. Dunst, Alexander S. Farivar, Adam J. Bograd, Brian E. Louie
Summary: Objective: To evaluate and characterize outcomes of MSA in patients with IEM. The study found that although MSA improves patients with gastroesophageal reflux and normal motility, many patients with IEM have lower rates of objective GERD resolution, lower resolution of existing dysphagia, higher rates of new onset dysphagia and need for dilation, which should be counseled to the patients before surgery.
Article
Gastroenterology & Hepatology
Sawangpong Jandee, Kasemsak Jandee
Summary: This study evaluated the diagnostic yield of high-resolution manometry in Thai patients, finding the highest yield in dysphagia patients. However, the test was not as beneficial in detecting clinically relevant esophageal motor disorders in patients presenting with non-dysphagia symptoms.
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Review
Gastroenterology & Hepatology
Mark R. Fox, Rami Sweis, Rena Yadlapati, John Pandolfino, Albis Hani, Claudia Defilippi, Tack Jan, Nathalie Rommel
Summary: The Chicago Classification v4.0 introduces a more rigorous and expansive protocol for identifying esophageal motility disorders through high-resolution manometry testing. Provocative tests aim to increase diagnostic sensitivity and specificity, reducing inconclusive diagnoses and directing effective therapy for patients. The establishment of a standard manometry protocol worldwide also aims to improve procedural consistency, diagnostic reliability, and promote collaborative research.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Isis K. Araujo, Sabine Roman, Marie Napoleon, Francois Mion
Summary: The study found that using solid food swallows (SFS) during esophageal motility assessment can improve diagnostic accuracy and is important for diagnosing clinically relevant disorders. The application of solid food swallows in HRM has a significant impact on changing diagnoses and can be widely used in daily clinical practice.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Shiko Kuribayashi, Junichi Akiyama, Haruo Ikeda, Kazue Nagai, Hiroko Hosaka, Mariko Hamada, Manabu Onimaru, Noriyuki Kawami, Kunihiko Hayashi, Katsuhiko Iwakiri, Haruhiro Inoue, Motoyasu Kusano, Toshio Uraoka
Summary: This study aimed to evaluate the accuracy of a new automated diagnostic program for HREM, which showed high diagnostic accuracy and time-saving benefits in clinical practice.
JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Qian-Jun Zhuang, Nian-di Tan, Meng-Yu Zhang, Song-Feng Chen, Yu Luo, Ying-Lian Xiao
Summary: The stringent criteria of IEM in CCv4.0 demonstrated a stronger association with abnormal acid exposure compared to CCv3.0, indicating its potential for better predicting esophageal issues in GERD patients.
Article
Medicine, General & Internal
Daniel L. Cohen, Anton Bermont, Vered Richter, Narjes Azzam, Haim Shirin, Ram Dickman, Amir Mari
Summary: The study found that integrated relaxation pressure (IRP) can distinguish between the reflux-predominant and dysphagia-predominant phenotypes in patients with absent contractility (AC). This may have important clinical implications, as procedures such as fundoplication may benefit patients with reflux and a low IRP, while procedures like peroral endoscopic myotomy (POEM) may benefit patients with dysphagia and a relatively high IRP.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Gastroenterology & Hepatology
Dustin A. Carlson, C. Prakash Gyawali, Sabine Roman, Marcelo Vela, Tiffany H. Taft, Michael D. Crowell, Karthik Ravi, Joseph R. Triggs, Farhan Quader, Jacqueline Prescott, Frederick T. J. Lin, Francois Mion, Dario Biasutto, Laurie Keefer, Peter J. Kahrilas, John E. Pandolfino
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2020)
Article
Surgery
Lucie Bernardot, Sabine Roman, Maximilien Barret, Veronique Vitton, Timothee Wallenhorst, Mathieu Pioche, Stanislas Chaussade, Jean-Michel Gonzalez, Thierry Ponchon, Frederic Prat, Marc Barthet, Julien Vergniol, Edouard Chabrun, Frank Zerbib
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2020)
Article
Gastroenterology & Hepatology
Wei-Yi Lei, C. Prakash Gyawali, Wei-Chuan Chang, Sabine Roman, Ming Wun Wong, Chih-Hsun Yi, Tso-Tsai Liu, Jui-Sheng Hung, Shu-Wei Liang, Chien-Lin Chen
Summary: The study showed that performing water swallows during straight leg raise can improve esophageal peristaltic performance and predict esophageal contraction reserve.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Jan Tack, Ans Pauwels, Sabine Roman, Edoardo Savarino, Andre Smout
Summary: A European consensus was developed on the clinical application of esophageal high-resolution manometry (HRM), providing guidance on when to consider HRM, how to perform it, and how to interpret the results. Areas of uncertainty and lack of consensus were identified, particularly in terms of treatment implications, highlighting the need for future research in this area.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Isis K. Araujo, Sabine Roman, Marie Napoleon, Francois Mion
Summary: The study found that using solid food swallows (SFS) during esophageal motility assessment can improve diagnostic accuracy and is important for diagnosing clinically relevant disorders. The application of solid food swallows in HRM has a significant impact on changing diagnoses and can be widely used in daily clinical practice.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Frank Zerbib, Albert J. Bredenoord, Ronnie Fass, Peter J. Kahrilas, Sabine Roman, Edoardo Savarino, Daniel Sifrim, Michael Vaezi, Rena Yadlapati, C. Prakash Gyawali
Summary: The term refractory GERD is not as clear-cut as it may seem, with distinctions needed between different types of symptoms and objective evidence of GERD. Objective evaluation, including endoscopy and esophageal physiologic testing, is essential for understanding mechanisms of symptom generation and true refractory GERD. Attention should also be paid to potential contributors such as supragastric belching and rumination syndrome.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Rena Yadlapati, Peter J. Kahrilas, Mark R. Fox, Albert J. Bredenoord, C. Prakash Gyawali, Sabine Roman, Arash Babaei, Ravinder K. Mittal, Nathalie Rommel, Edoardo Savarino, Daniel Sifrim, Andre Smout, Michael F. Vaezi, Frank Zerbib, Junichi Akiyama, Shobna Bhatia, Serhat Bor, Dustin A. Carlson, Joan W. Chen, Daniel Cisternas, Charles Cock, Enrique Coss-Adame, Nicola de Bortoli, Claudia Defilippi, Ronnie Fass, Uday C. Ghoshal, Sutep Gonlachanvit, Albis Hani, Geoffrey S. Hebbard, Kee Wook Jung, Philip Katz, David A. Katzka, Abraham Khan, Geoffrey Paul Kohn, Adriana Lazarescu, Johannes Lengliner, Sumeet K. Mittal, Taher Omari, Moo In Park, Roberto Penagini, Daniel Pohl, Joel E. Richter, Jordi Serra, Rami Sweis, Jan Tack, Roger P. Tatum, Radu Tutuian, Marcelo F. Vela, Reuben K. Wong, Justin C. Wu, Yinglian Xiao, John E. Pandolfino
Summary: CCv4.0 is an updated classification scheme for esophageal motility disorders using HRM, developed by fifty-two international experts in seven subgroups over two years. Key updates include a more rigorous and expansive HRM protocol, refined definition of EGJOO, stricter criteria for ineffective esophageal motility, and description of baseline EGJ metrics. These changes aim to provide more standardized criteria for disorders of peristalsis and obstruction at the EGJ.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Kelli DeLay, John E. Pandolfino, Sabine Roman, C. Prakash Gyawali, Edoardo Savarino, Michael Tye, Alexander Kaizer, Rena Yadlapati
Summary: Supragastric belching (SGB) and rumination are behavioral disorders associated with proton pump inhibitor (PPI) non-response. This pilot study compared the diagnostic yield and inter-rater agreement for SGB and rumination using multichannel intraluminal impedance-pH (MII-pH) and post-prandial high-resolution impedance manometry (PPHRIM). Results showed that diagnostic accuracy and inter-rater agreement are higher for MII-pH than PPHRIM, and behavioral disorders are more frequently identified on PPHRIM. Clinical context is essential for accurate interpretation of the studies.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Review
Gastroenterology & Hepatology
Sabine Roman, Geoff Hebbard, Kee Wook Jung, Phil Katz, Radu Tutuian, Reuben Wong, Justin Wu, Rena Yadlapati, Daniel Sifrim
Summary: Distal esophageal spasm (DES) is characterized by premature contractions in the esophagus, often causing dysphagia or non-cardiac chest pain. Treatments for DES can be challenging, with endoscopic options like botulinum toxin and peroral endoscopic myotomy currently being evaluated. Further research is needed to understand the role of contractile vigor and lower esophageal sphincter hypercontractility in DES symptoms.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Letter
Gastroenterology & Hepatology
Jamila Lenz, Berenice Rault, Sabine Roman, Mathieu Pioche, Francois Mion
CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY
(2021)
Article
Otorhinolaryngology
Sabine Roman, Livia Anna Guadagnoli, Audrey Hastier, Estelle Becam, Meredith Ruth Ann Craven, John E. Pandolfino, Marie Napoleon, Dustin A. Carlson, Francois Mion, Tiffany Taft
Summary: The study found that the esophageal dysphagia questionnaire (BEDQ) is a valid clinical assessment tool in French, accurately reflecting the frequency and intensity of dysphagia in patients, and showing good correlation with other scoring tools. For patients undergoing examination, the BEDQ score is significantly higher in the dysphagia group compared to the GERD or other symptom groups.
Article
Gastroenterology & Hepatology
Barrett Rogers, Benjamin Rogers, Marzio Frazzoni, Edoardo Savarino, Sabine Roman, Daniel Sifrim, C. Prakash Gyawali
Summary: In pH-impedance studies, acidic reflux episodes in upright position with high proximal extent and longer acid clearance times have the highest concordance for identification by expert reviewers. Reflux episode identification may be influenced by reviewer opinions despite the availability of established criteria.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
Sabine Roman, Livia Anna Guadagnoli, Audrey Hastier, Estelle Becam, Meredith Ruth Ann Craven, Marie Napoleon, John E. Pandolfino, Dustin A. Carlson, Francois Mion, Tiffany Taft
Summary: The study validated a French version of the esophageal hypervigilance and anxiety scale (EHAS), showing good internal consistency and reliability. The EHAS score was consistent between groups, demonstrating its utility in assessing psychological processes in patients with esophageal disorders. Further research is needed to explore its application in patient management.
CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Pauline Riviere, Blandine Vauquelin, Emiliane Rolland, Chloe Melchior, Sabine Roman, Stanislas Bruley des Varannes, Francois Mion, Guillaume Gourcerol, Sylvie Sacher-Huvelin, Frank Zerbib
Summary: The study found that both a low FODMAP diet and usual dietary advice had similar but limited beneficial effects on symptoms in patients with PPI refractory GERD.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)