Article
Gastroenterology & Hepatology
Mohd Ridzuan Mohd Said, Zhiqin Wong, Rafiz Abdul Rani, Chai Soon Ngiu, Raja Affendi Raja Ali, Yeong Yeh Lee
Summary: Variations in the Chicago 3.0 normative metrics exist in a healthy Asian population with different postures and provocative swallow materials. Upright posture may lead to more motility disorders.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(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)
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
Chamara Basnayake, Sawangpong Jandee, Annelies Geeraerts, Hannelore Geysen, Ans Pauwels, Lien Timmermans, Tim Vanuytsel, Nathalie Rommel, Jan Tack
Summary: This study aimed to investigate the impact of position, different volumes and consistencies of swallows, and perception of bolus passage on high-resolution esophageal manometry (HRM) metrics. The results showed significant differences in HRM metrics with different positions, volumes, and consistencies of swallows. Interpretation of HRM studies should consider normative values specific to position and bolus type.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Stefano Siboni, Carlo G. Riva, Davide Ferrari, Matteo Capuzzo, Emanuele Asti, Luigi Bonavina
Summary: This study compared the effects of different body positions on normative metrics, diagnostic yield, and patient comfort during HRM. The results indicated that the semirecumbent and sitting positions seem to offer similar advantages compared to the supine position, although body position may affect HRM metrics and the final manometric diagnosis.
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
(2021)
Article
Gastroenterology & Hepatology
Pierfrancesco Visaggi, Matteo Ghisa, Giulio Del Corso, Federica Baiano Svizzero, Lucia Mariani, Salvatore Tolone, Marzio Frazzoni, Andrea Buda, Massimo Bellini, Vincenzo Savarino, Roberto Penagini, C. Prakash Gyawali, Edoardo V. Savarino, Nicola de Bortoli
Summary: The CCv4.0 criteria significantly decreased the prevalence of EGJOO by 80%, refining the diagnosis and identifying clinically relevant outflow obstruction. Elevated RDC-IRP can predict conclusive EGJOO diagnosis per CCv4.0.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2022)
Review
Gastroenterology & Hepatology
Peter J. Kahrilas, Ravinder K. Mittal, Serhat Bor, Geoffrey P. Kohn, Johannes Lenglinger, Sumeet K. Mittal, John E. Pandolfino, Jordi Serra, Roger Tatum, Rena Yadlapati
Summary: Esophagogastric junction (EGJ) barrier function plays a critical role in gastroesophageal reflux disease, but it is complex and no single metric can fully capture its attributes. The high-resolution manometry (HRM) metrics assessing EGJ integrity remain clinically important, but there is currently no consensus on defining thresholds for some of the metrics. Recommendations were made regarding certain metrics such as LES-CD separation, but further study is needed on others like intragastric pressure.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
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)
Article
Gastroenterology & Hepatology
Morgane Sallette, Jamila Lenz, Francois Mion, Sabine Roman
Summary: This study compared the frequency of motility disorders diagnosed with CCv3.0 and CCv4.0 and evaluated the severity of symptoms. The results showed that while the diagnoses remained mainly unchanged with both versions, CCv4.0 had a lower frequency of ineffective esophageal motility (IEM) compared to CCv3.0.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Otorhinolaryngology
C. Prakash Gyawali, Peter J. Kahrilas
Summary: High-resolution esophageal manometry (HRM) combined with pressure topography allows simultaneous observation of the entire esophageal contractility, with advantages of easier recognition and better reproducibility of contractile patterns. Compared to conventional manometry, HRM is more sensitive in detecting impaired relaxation of the esophagogastric junction (EGJ) and subcategorizes achalasia into three clinically relevant subtypes. HRM and the CC process have revolutionized our understanding of esophageal motility and motility disorders.
Article
Gastroenterology & Hepatology
Jin Hee Noh, Kee Wook Jung, In Ja Yoon, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Summary: This study aimed to compare the diagnostic accuracy and differences between Chicago classification version 3.0 (CC v3.0) and 4.0 (CC v4.0). The results showed that CC v4.0 is more rigorous in diagnosing esophagogastric junction outflow obstruction (EGJOO) and ineffective esophageal motility (IEM) compared to CC v3.0. It also diagnoses achalasia more accurately using provocative tests and functional lumen imaging probe (FLIP). Further studies on treatment outcomes with CC v4.0 diagnosis are needed.
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Rahul Deshmukh, Akash Shukla, Sanjay Chandnani, Pravin M. Rathi, Pratik Tibdewal, Shubham Jain, Nitin Ramani, Parmeshwar Junare, Partha Debnath, Leela Shinde, Asif Bagwan, Megha Meshram
Summary: This study provides normal data for high-resolution anorectal manometry (HRAM) in a healthy Indian population and evaluates the impact of gender, age, and body mass index (BMI) on anorectal functions. The results indicate that there is no significant difference in anal pressures between males and females, but rectal pressure and anal pressure during simulated evacuation without rectal distention are higher in males. Additionally, females have a lower threshold for the first sensation, and subjects under the age of 40 have higher anal residual pressure. Moreover, individuals with a BMI below 23 kg/m(2) have higher maximum anal squeeze pressure and maximum rectal pressure during push.
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Medicine, Research & Experimental
Seh Ling Kwong, Ester G. Hernandez, Katharina Winiker, Kristin Gozdzikowska, Phoebe Macrae, Maggie-Lee Huckabee
Summary: This study examined the effect of topical nasal anesthetic (TNA) on swallowing and tolerability during high-resolution impedance manometry (HRIM) with a 4.2-mm catheter. The results showed that TNA did not improve comfort or significantly affect swallowing behavior during the procedure.
Article
Chemistry, Analytical
Teodora Surdea-Blaga, Gheorghe Sebestyen, Zoltan Czako, Anca Hangan, Dan Lucian Dumitrascu, Abdulrahman Ismaiel, Liliana David, Imre Zsigmond, Giuseppe Chiarioni, Edoardo Savarino, Daniel Corneliu Leucuta, Stefan Lucian Popa
Summary: This paper presents a Machine Learning-based solution to automate the Chicago Classification algorithm for identifying esophageal motility diseases. The proposed solution preprocesses the photos, applies Deep Learning models for precise classification, and combines the results to automate the whole classification and diagnosis process. The solution achieves a top-1 accuracy of 86% without human intervention.
Review
Surgery
Dolores T. T. Mueller, Brett Parker, Reid Fletcher, Ahmed Sharata, Daniel Davila Bradley, Steven R. R. DeMeester, Kevin M. M. Reavis, Lee L. L. Swanstrom, Christy M. M. Dunst
Summary: The aim of this study was to provide a complete set of HRM data for patients with a normally functioning fundoplication. The results showed that the addition of a fundoplication significantly increased the values of the lower esophageal sphincter. The previously accepted upper limit defining esophageal outflow obstruction may not be clinically applicable after fundoplication.
Article
Gastroenterology & Hepatology
Celia Gouynou, Francois Philit, Francois Mion, Francois Tronc, Agathe Senechal, Joris Giai, Anne-Marie Rabain, Jean-Francois Mornex, Sabine Roman
CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
(2020)
Article
Gastroenterology & Hepatology
Sara Philonenko, Sabine Roman, Frank Zerbib, Guillaume Gourcerol, Nathalie Gault, Alain Ropert, Stanislas Bruley des Varannes, Maximilien Barret, Veronique Vitton, Michel Bouchoucha, Nicolas Billar, Caroline Gorbatchef, Henri Duboc, Benoit Coffin
NEUROGASTROENTEROLOGY AND MOTILITY
(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)
Article
Gastroenterology & Hepatology
Morgane Sallette, Jamila Lenz, Francois Mion, Sabine Roman
Summary: This study compared the frequency of motility disorders diagnosed with CCv3.0 and CCv4.0 and evaluated the severity of symptoms. The results showed that while the diagnoses remained mainly unchanged with both versions, CCv4.0 had a lower frequency of ineffective esophageal motility (IEM) compared to CCv3.0.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)