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Dysphagia: Novel and Emerging Diagnostic Modalities

Amanda J Krause1, Dustin A Carlson2

  • 1Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University, Feinberg School of Medicine, 676 St Clair Street, Suite 1400, Chicago, IL 60611-2951, USA; Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Diego, 9500 Gillman Drive, MC 0956, La Jolla, CA 92093-0956, USA.

Gastroenterology Clinics of North America
|October 31, 2021
PubMed

Insights

The Chicago Classification for esophageal motility disorders was updated to version 4.0, integrating complementary tests like provocative maneuvers and barium esophagram or functional luminal imaging probe (FLIP) panometry for clearer diagnoses.

Area of Science:

  • Gastroenterology
  • Esophageal Physiology
  • Diagnostic Imaging

Background:

  • Dysphagia and esophageal motility disorders require accurate diagnostic methods.
  • High-resolution manometry (HRM) is a key diagnostic tool.
  • Previous classifications may have limitations in complex cases.

Purpose of the Study:

  • To summarize the updates in the Chicago Classification (version 4.0) for esophageal motility disorders.
  • To highlight the integration of complementary diagnostic strategies with HRM.
  • To introduce emerging technologies for esophageal evaluation.

Main Methods:

  • Review and interpretation of the updated Chicago Classification (version 4.0) guidelines.
  • Incorporation of complementary testing strategies during high-resolution manometry (HRM).
  • Consideration of barium esophagram and functional luminal imaging probe (FLIP) panometry for inconclusive HRM findings.

Main Results:

  • The Chicago Classification version 4.0 provides updated criteria for diagnosing esophageal motility disorders using HRM.
  • Provocative HRM maneuvers are recommended to enhance diagnostic accuracy.
  • Barium esophagram and FLIP panometry are suggested for clarifying ambiguous HRM results.

Conclusions:

  • The updated Chicago Classification (v4.0) enhances the diagnosis of esophageal motility disorders.
  • Complementary testing strategies improve the interpretation of HRM findings.
  • Emerging technologies like FLIP panometry offer new avenues for esophageal function assessment.

Keywords:
AchalasiaEsophagusImpedanceManometryMotility

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