[Chicago Classification ver. 4.0: An Overview of Esophageal Motility Disorders on High-resolution Manometry]

Area of Science:

• Gastroenterology
• Esophageal Physiology
• Diagnostic Criteria

Background:

• Esophageal motility disorders require standardized diagnostic criteria.
• High-resolution manometry (HRM) is a key tool for assessing esophageal function.
• Previous versions of the Chicago Classification have guided diagnosis.

Purpose of the Study:

• To introduce and explain the updated Chicago Classification version 4.0 for esophageal motility disorders.
• To detail the key revisions and improvements in the new classification system.
• To provide a framework for consistent and accurate diagnosis using HRM.

Main Methods:

• Development by 52 international experts over 2 years.
• Utilized validated methodologies for consensus building.
• Incorporated updated high-resolution manometry (HRM) protocols and supportive testing.

Main Results:

• Introduction of Chicago Classification version 4.0.
• A more rigorous and expansive HRM protocol including supine, upright, and provocative testing.
• Refined definition of esophagogastric junction outflow obstruction.
• Emphasis on supportive testing with barium esophagogram and functional lumen imaging probe (FLIP).

Conclusions:

• The Chicago Classification 4.0 offers an updated, expert-validated standard for diagnosing esophageal motility disorders.
• The revised HRM protocol and diagnostic criteria aim to improve diagnostic precision.
• Integration of supportive testing enhances the comprehensive evaluation of esophageal function.