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1. Good clinical practice recommendations for the diagnosis and treatment of gastroesophageal reflux disease. An expert review from the Asociación Mexicana de Gastroenterología

Author

Valdovinos Díaz, M.A., Amieva-Balmori, M., Carmona-Sánchez, R., Coss-Adame, E., Gómez-Escudero, O., González-Martínez, M., Huerta-Iga, F., Morel-Cerda, E., Remes-Troche, J.M., Tamayo-de la Cuesta, J.L., Torres-Villalobos, G., Valdovinos-García, L.R., Vázquez-Elizondo, G., Villar-Chávez, A.S., and Arenas-Martínez, J.A.

Published
2024
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2. Recomendaciones de buena práctica clínica en el diagnóstico y tratamiento de la enfermedad por reflujo gastroesofágico. Revisión por expertos de la Asociación Mexicana de Gastroenterología

Author

Valdovinos-Diaz, M.A., Amieva-Balmori, M., Carmona-Sánchez, R., Coss-Adame, E., Gómez-Escudero, O., González-Martínez, M., Huerta-Iga, F., Morel-Cerda, E., Remes-Troche, J.M., Tamayo-de la Cuesta, J.L., Torres-Villalobos, G., Valdovinos-García, L.R., Vázquez-Elizondo, G., Villar-Chávez, A.S., and Arenas-Martínez, J.S.

Published
2024
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5. Consenso mexicano sobre incontinencia fecal

Author

Remes-Troche, J.M., Coss-Adame, E., García-Zermeño, K.R., Gómez-Escudero, O., Amieva-Balmori, M., Gómez-Castaños, P.C., Charúa-Guindic, L., Icaza-Chávez, M.E., López-Colombo, A., Morel-Cerda, E.C., López, N. Pérez y, Rodríguez-Leal, M.C., Salgado-Nesme, N., Sánchez-Avila, M.T., Valdovinos-García, L.R., Vergara-Fernández, O., and Villar-Chávez, A.S.

Published
2023
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6. The Mexican consensus on fecal incontinence

Author

Remes-Troche, J.M., Coss-Adame, E., García-Zermeño, K.R., Gómez-Escudero, O., Amieva-Balmori, M., Gómez-Castaños, P.C., Charúa-Guindic, L., Icaza-Chávez, M.E., López-Colombo, A., Morel-Cerda, E.C., Pérez y López, N., Rodríguez-Leal, M.C., Salgado-Nesme, N., Sánchez-Avila, M.T., Valdovinos-García, L.R., Vergara-Fernández, O., and Villar-Chávez, A.S.

Published
2023
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8. Dietary fiber and the microbiota: A narrative review by a group of experts from the Asociación Mexicana de Gastroenterología

Author

Abreu y Abreu, A.T., Milke-García, M.P., Argüello-Arévalo, G.A., Calderón-de la Barca, A.M., Carmona-Sánchez, R.I., Consuelo-Sánchez, A., Coss-Adame, E., García-Cedillo, M.F., Hernández-Rosiles, V., Icaza-Chávez, M.E., Martínez-Medina, J.N., Morán-Ramos, S., Ochoa-Ortiz, E., Reyes-Apodaca, M., Rivera-Flores, R.L., Zamarripa-Dorsey, F., Zárate-Mondragón, F., and Vázquez-Frias, R.

Published
2021
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9. Fibra dietaria y microbiota, revisión narrativa de un grupo de expertos de la Asociación Mexicana de Gastroenterología

Author

Abreu y Abreu, A.T., Milke-García, M.P., Argüello-Arévalo, G.A., Calderón-de la Barca, A.M., Carmona-Sánchez, R.I., Consuelo-Sánchez, A., Coss-Adame, E., García-Cedillo, M.F., Hernández-Rosiles, V., Icaza-Chávez, M.E., Martínez-Medina, J.N., Morán-Ramos, S., Ochoa-Ortiz, E., Reyes-Apodaca, M., Rivera-Flores, R.L., Zamarripa-Dorsey, F., Zárate-Mondragón, F., and Vázquez-Frias, R.

Published
2021
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13. The Mexican consensus on non-cardiac chest pain

Author

Gómez-Escudero, O., Coss-Adame, E., Amieva-Balmori, M., Carmona-Sánchez, R.I., Remes-Troche, J.M., Abreu-Abreu, A.T., Cerda-Contreras, E., Gómez-Castaños, P.C., González-Martínez, M.A., Huerta-Iga, F.M., Ibarra-Palomino, J., Icaza-Chávez, M.E., López-Colombo, A., Márquez-Murillo, M.F., Mejía-Rivas, M., Morales-Arámbula, M., Rodríguez-Chávez, J.L., Torres-Barrera, G., Valdovinos-García, L.R., Valdovinos-Díaz, M.A., Vázquez-Elizondo, G., Villar-Chávez, A.S., Zavala-Solares, M., and Achem, S.R.

Published
2019
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14. Technical position on milk and its derivatives in adult health and disease from the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría

Author

Uscanga-Domínguez, L.F., Orozco-García, I.J., Vázquez-Frias, R., Aceves-Tavares, G.R., Albrecht-Junnghans, R.E., Amieva-Balmori, M., Bazaldua-Merino, L.A., Bernal-Reyes, R., Camacho-de León, M.E., Campos-Gutiérrez, J.A., Carmona-Sánchez, R.I., Castro-Marín, L.V., Coss-Adame, E., Cuevas-Estrada, A.J., Escobedo-Martínez, J.A., González-Franco, L.R., Huerta-Iga, F.M., Lozano-Lozano, R., Martínez-Vázquez, S.E., Milke García, M.P., Nogueira-de Rojas, J.R., Padilla-González, M., Pérez y López, N., Silva-Campechano, F., Treviño-Mejía, M.C., and Velázquez-Alva, M.C.

Published
2019
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15. Consenso mexicano sobre dolor torácico no cardiaco

Author

Gómez-Escudero, O., Coss-Adame, E., Amieva-Balmori, M., Carmona-Sánchez, R.I., Remes-Troche, J.M., Abreu y Abreu, A.T., Cerda-Contreras, E., Gómez-Castaños, P.C., González-Martínez, M.A., Huerta-Iga, F.M., Ibarra-Palomino, J., Icaza-Chávez, M.E., López-Colombo, A., Márquez-Murillo, M.F., Mejía-Rivas, M., Morales-Arámbula, M., Rodríguez-Chávez, J.L., Torres-Barrera, G., Valdovinos-García, L.R., Valdovinos-Díaz, M.A., Vázquez-Elizondo, G., Villar-Chávez, A.S., Zavala-Solares, M., and Achem, S.R.

Published
2019
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16. Posición técnica sobre la leche y derivados lácteos en la salud y en la enfermedad del adulto de la Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Gerontología y Geriatría

Author

Uscanga-Domínguez, L.F., Orozco-García, I.J., Vázquez-Frias, R., Aceves-Tavares, G.R., Albrecht-Junnghans, R.E., Amieva-Balmori, M., Bazaldua-Merino, L.A., Bernal-Reyes, R., Camacho-de León, M.E., Campos-Gutiérrez, J.A., Carmona-Sánchez, R.I., Castro-Marín, L.V., Coss-Adame, E., Cuevas-Estrada, A.J., Escobedo-Martínez, J.A., González-Franco, L.R., Huerta-Iga, F.M., Lozano-Lozano, R., Martínez-Vázquez, S.E., Milke García, M.P., Nogueira-de Rojas, J.R., Padilla-González, M., Pérez y López, N., Silva-Campechano, F., Treviño-Mejía, M.C., and Velázquez-Alva, M.C.

Published
2019
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17. The Mexican consensus on the diagnosis and treatment of diverticular disease of the colon

Author

Raña-Garibay, R., Salgado-Nesme, N., Carmona-Sánchez, R., Remes-Troche, J.M., Aguilera-Carrera, J., Alonso-Sánchez, L., Arnaud-Carreño, C., Charúa-Guindic, L., Coss-Adame, E., de la Torre-Bravo, A., Espinosa-Medina, D., Esquivel-Ayanegui, F., Roesch-Dietlen, F., López-Colombo, A., Muñoz-Torres, J.I., Noble-Lugo, A., Rojas-Mendoza, F., Suazo-Barahona, J., Stoopen-Rometti, M., Torres-Flores, E., Vallejo-Soto, M., and Vergara-Fernández, O.

Published
2019
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18. Consenso mexicano sobre el diagnóstico y tratamiento de la enfermedad diverticular del colon

Author

Raña-Garibay, R., Salgado-Nesme, N., Carmona-Sánchez, R., Remes-Troche, J.M., Aguilera-Carrera, J., Alonso-Sánchez, L., Arnaud-Carreño, C., Charúa-Guindic, L., Coss-Adame, E., de la Torre-Bravo, A., Espinosa-Medina, D., Esquivel-Ayanegui, F., Roesch-Dietlen, F., López-Colombo, A., Muñoz-Torres, J.I., Noble-Lugo, A., Rojas-Mendoza, F., Suazo-Barahona, J., Stoopen-Rometti, M., Torres-Flores, E., Vallejo-Soto, M., and Vergara-Fernández, O.

Published
2019
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20. Clinical guidelines on the diagnosis and treatment of celiac disease in Mexico

Author

Remes-Troche, J.M., Uscanga-Domínguez, L.F., Aceves-Tavares, R.G., Calderón de la Barca, A.M., Carmona-Sánchez, R.I., Cerda-Contreras, E., Coss-Adame, E., Icaza-Chávez, M.E., Lopéz-Colombo, A., Milke-García, M.P., Morales-Arámbula, M., Peláez-Luna, M., Ramos Martínez, P., Sánchez-Sosa, S., Treviño-Mejía, M.C., Vázquez-Frías, R., Worona-Dibner, L.B., Zamora-Nava, L.E., and Rubio-Tapia, A.

Published
2018
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21. Guía clínica para diagnóstico y tratamiento de la enfermedad celíaca en México

Author

Remes-Troche, J.M., Uscanga-Domínguez, L.F., Aceves-Tavares, R.G., Calderón de la Barca, A.M., Carmona-Sánchez, R.I., Cerda-Contreras, E., Coss-Adame, E., Icaza-Chávez, M.E., Lopéz-Colombo, A., Milke-García, M.P., Morales-Arámbula, M., Peláez-Luna, M., Ramos Martínez, P., Sánchez-Sosa, S., Treviño-Mejía, M.C., Vázquez-Frías, R., Worona-Dibner, L.B., Zamora-Nava, L.E., and Rubio-Tapia, A.

Published
2018
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22. The Mexican consensus on chronic constipation

Author

Remes-Troche, J.M., Coss-Adame, E., Lopéz-Colombo, A., Amieva-Balmori, M., Carmona Sánchez, R., Charúa Guindic, L., Flores Rendón, R., Gómez Escudero, O., González Martínez, M., Icaza Chávez, M.E., Morales Arámbula, M., Schmulson, M., Tamayo de la Cuesta, J.L., Valdovinos, M.Á., and Vázquez Elizondo, G.

Published
2018
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23. Consenso mexicano sobre estreñimiento crónico

Author

Remes-Troche, J.M., Coss-Adame, E., Lopéz-Colombo, A., Amieva-Balmori, M., Carmona Sánchez, R., Charúa Guindic, L., Flores Rendón, R., Gómez Escudero, O., González Martínez, M., Icaza Chávez, M.E., Morales Arámbula, M., Schmulson, M., Tamayo de la Cuesta, J.L., Valdovinos, M.Á., and Vázquez Elizondo, G.

Published
2018
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24. Mexican consensus on dyspepsia

Author

Carmona-Sánchez, R., Gómez-Escudero, O., Zavala-Solares, M., Bielsa-Fernández, M.V., Coss-Adame, E., Hernández-Guerrero, A.I., Huerta-Iga, F., Icaza-Chávez, M.E., Lira-Pedrín, M.A., Lizárraga-López, J.A., López-Colombo, A., Noble-Lugo, A., Pérez-Manauta, J., Raña-Garibay, R.H., Remes-Troche, J.M., Tamayo, J.L., Uscanga, L.F., Zamarripa-Dorsey, F., Valdovinos Díaz, M.A., and Velarde-Ruiz Velasco, J.A.

Published
2017
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25. Consenso mexicano sobre la dispepsia

Author

Carmona-Sánchez, R., Gómez-Escudero, O., Zavala-Solares, M., Bielsa-Fernández, M.V., Coss-Adame, E., Hernández-Guerrero, A.I., Huerta-Iga, F., Icaza-Chávez, M.E., Lira-Pedrín, M.A., Lizárraga-López, J.A., López-Colombo, A., Noble-Lugo, A., Pérez-Manauta, J., Raña-Garibay, R.H., Remes-Troche, J.M., Tamayo, J.L., Uscanga, L.F., Zamarripa-Dorsey, F., Valdovinos Díaz, M.A., and Velarde-Ruiz Velasco, J.A.

Published
2017
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28. The Mexican consensus on probiotics in gastroenterology

Author

Valdovinos, M.A., Montijo, E., Abreu, A.T., Heller, S., González-Garay, A., Bacarreza, D., Bielsa-Fernández, M., Bojórquez-Ramos, M.C., Bosques-Padilla, F., Burguete-García, A.I., Carmona-Sánchez, R., Consuelo-Sánchez, A., Coss-Adame, E., Chávez-Barrera, J.A., de Ariño, M., Flores-Calderón, J., Gómez-Escudero, O., González-Huezo, M.S., Icaza-Chávez, M.E., Larrosa-Haro, A., Morales-Arámbula, M., Murata, C., Ramírez-Mayans, J.A., Remes-Troche, J.M., Rizo-Robles, T., Peláez-Luna, M., Toro-Monjaraz, E.M., Torre, A., Urquidi-Rivera, M.E., Vázquez, R., Yamamoto-Furusho, J.K., and Guarner, F.

Published
2017
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29. Consenso mexicano sobre probióticos en gastroenterología

Author

Valdovinos, M.A., Montijo, E., Abreu, A.T., Heller, S., González-Garay, A., Bacarreza, D., Bielsa-Fernández, M., Bojórquez-Ramos, M.C., Bosques-Padilla, F., Burguete-García, A.I., Carmona-Sánchez, R., Consuelo-Sánchez, A., Coss-Adame, E., Chávez-Barrera, J.A., de Ariño, M., Flores-Calderón, J., Gómez-Escudero, O., González-Huezo, M.S., Icaza-Chávez, M.E., Larrosa-Haro, A., Morales-Arámbula, M., Murata, C., Ramírez-Mayans, J.A., Remes-Troche, J.M., Rizo-Robles, T., Peláez-Luna, M., Toro-Monjaraz, E.M., Torre, A., Urquidi-Rivera, M.E., Vázquez, R., Yamamoto-Furusho, J.K., and Guarner, F.

Published
2017
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30. Prevalencia de sobreposicion de trastornos funcionales digestivos: resultados de un estudio nacional (SIGAME 2)/Prevalence of overlapping functional gastrointestinal disorders: results from a national study (SIGAME 2)

Author

Ruiz-Velasco, J.A. Velarde, Morales-Arambúla, M., Coss-Adame, E., Gómez-Escudero, O., Flores-Rendón, R., Vázquez-Elizondo, G., Ramon, I. Carmona-Sánchez, Icaza-Chavéz, M.E., de la Cuesta, J.L. Tamayo, Huerta-Iga, F., Tapia-Calderón, D.K., García-Jiménez, E.S., Eliana, C. Morel-Cerda, García-Zermeño, K.R., and Remes-Troche, J.M.

Published
2018

34. The Mexican consensus on irritable bowel syndrome

Author

Carmona-Sánchez, R., Icaza-Chávez, M.E., Bielsa-Fernández, M.V., Gómez-Escudero, O., Bosques-Padilla, F., Coss-Adame, E., Esquivel-Ayanegui, F., Flores-Rendón, Á.R., González-Martínez, M.A., Huerta-Iga, F., López-Colombo, A., Méndez-Gutiérrez, T.H., Noble-Lugo, A., Nogueira-de Rojas, J.R., Raña-Garibay, R.H., Remes-Troche, J.M., Roesch-Dietlen, F., Schmulson, M.J., Soto-Pérez, J.C., Tamayo, J.L., Uscanga, L.F., Valdovinos, M.Á., Valerio-Ureña, J., and Zavala-Solares, M.R.

Published
2016
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35. Consenso mexicano sobre el síndrome de intestino irritable

Author

Carmona-Sánchez, R., Icaza-Chávez, M.E., Bielsa-Fernández, M.V., Gómez-Escudero, O., Bosques-Padilla, F., Coss-Adame, E., Esquivel-Ayanegui, F., Flores-Rendón, Á.R., González-Martínez, M.A., Huerta-Iga, F., López-Colombo, A., Méndez-Gutiérrez, T.H., Noble-Lugo, A., Nogueira-de Rojas, J.R., Raña-Garibay, R.H., Remes-Troche, J.M., Roesch-Dietlen, F., Schmulson, M.J., Soto-Pérez, J.C., Tamayo, J.L., Uscanga, L.F., Valdovinos, M.Á., Valerio-Ureña, J., and Zavala-Solares, M.R.

Published
2016
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38. Is the Sars‐CoV‐2 virus a possible trigger agent for the development of achalasia?

Author

Janette Furuzawa-Carballeda, María Eugenia Icaza-Chávez, Diana Aguilar-León, Norma Uribe-Uribe, María del Carmen Nuñez-Pompa, Alonso Trigos-Díaz, Rodrigo Areán-Sanz, Dheni A. Fernández-Camargo, Coss-Adame E Enrique, Miguel A. Valdovinos, Eduardo Briceño-Souza, Luis A. Chi-Cervera, Miriam Olivares-Flores, and Gonzalo Torres-Villalobos

Subjects
Endocrine and Autonomic Systems, Physiology, Gastroenterology
Abstract

BACKGROUNDPrevious studies have suggested that achalasia is an autoimmune disease whose probable causal agent is a neurotropic virus that chronically infects the myenteric plexus of the esophagus and, in a genetically susceptible host, induces the disease. The association between achalasia and coronaviruses has not been reported in the literature.AIMSTo evaluate the presence of the SARS-CoV-2 virus, the ACE2 expression, the tissue architecture, and immune response in the lower esophageal sphincter muscle (LESm) of achalasia patients who had SARS-CoV-2 (achalasia-COVID-19) infection before laparoscopic Heller myotomy (LHM) and compare the findings with type II achalasia patients and transplant donors (controls) without COVID-19.METHODSThe LESm of 7 achalasia-COVID-19 patients (diagnosed by PCR), ten achalasia patients, and ten controls without COVID-19 were included. The presence of the virus was evaluated by in situ PCR and immunohistochemistry. ACE2 receptor expression and effector CD4 T cell and regulatory subsets were determined by immunohistochemistry.RESULTSCoronavirus was detected in 6/7 patients-COVID-19. The SARS-CoV-2 was undetectable in the LESm of the achalasia patients and controls. The ACE2 receptor was expressed in all the patients and controls. One patient developed achalasia type II post-COVID-19. The percentage of Th22/Th17/Th1/pDCreg was higher in achalasia and achalasia-COVID-19 pre-HLM vs. controls. The Th2/Treg/Breg cell percentages were higher only in achalasia vs. controls.CONCLUSIONThe presence of the SARS-CoV2 and its receptor in the LESm of type II achalasia-COVID-19 patients but not in the controls suggests that it could affect the myenteric plexus. Unlike achalasia, patients-COVID-19 have an imbalance between effector CD4 T cells and the regulatory mechanisms.

Published
2022
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40. Is the Sars-CoV-2 virus a possible trigger agent for the development of achalasia?

Author

Furuzawa-Carballeda, Janette, primary, Icaza-Chávez, María Eugenia, additional, Aguilar-León, Diana, additional, Uribe-Uribe, Norma, additional, del Carmen Nuñez-Pompa, María, additional, Trigos-Díaz, Alonso, additional, Areán-Sanz, Rodrigo, additional, Fernández-Camargo, Dheni A., additional, Enrique, Coss-Adame E, additional, Valdovinos, Miguel A., additional, Briceño-Souza, Eduardo, additional, Chi-Cervera, Luis A., additional, Olivares-Flores, Miriam, additional, and Torres-Villalobos, Gonzalo, additional

Published
2022
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43. Autoantigen characterization in the lower esophageal sphincter muscle of patients with achalasia

Author

Priego-Ranero A, Diego F. Hernández-Ramírez, D. Aguilar-León, Olivares-Martinez E, Torres-Villalobos G, Valdovinos Ma, Janette Furuzawa-Carballeda, Uribe-Uribe N, Nunez-Alvarez Ca, Ghislain Opdenakker, and Coss-Adame E

Subjects
Autoimmune disease, Pathology, medicine.medical_specialty, business.industry, Autoantibody, Achalasia, medicine.disease, Interstitial cell of Cajal, symbols.namesake, Esophageal motility disorder, Fibrosis, otorhinolaryngologic diseases, symbols, Medicine, Immunohistochemistry, Ectopic expression, business
Abstract

OBJECTIVETo characterize in sera anti-myenteric autoantibody profiles and in tissues MMP-9 proteoforms towards the identification of possible autoantigenic proteins in the muscle of the lower esophageal sphincter (LES) of achalasia patients.METHODSBiopsies of the LES muscle from 36 achalasia patients, 6 esophagogastric junction outflow obstruction (EGJOO) patients, and 16 transplant donors (TD) were compared in a blind cross-sectional study. Histological characteristics such as inflammation, fibrosis, presence of ganglion cells, cells of Cajal, GAD65, PNMA2, S100, P substance, and MMP-9 proteforms in tissue were assessed by H&E and Picro-Sirius Red stainings, and immunohistochemistry analysis. Antineuronal antibodies (amphiphysin, CV2, and PNMA2 (Ma2/Ta)), onconeural antigens (Ri, Yo, and Hu), recoverin, SOX-1, titin, zic4, GAD65, and Tr (DNER) were evaluated by immunoblot/line assay.RESULTSTissue of achalasia patients had heterogeneous inflammatory infiltrates with fibrosis and contrasting higher levels of activated MMP-9 compared with EGJOO and TD. Moreover, lower ganglion cell percentages and cell of Cajal percentages were determined in esophageal tissues of achalasia patients vs. TD. In addition, tissue of achalasia patients had higher GAD65 and PNMA2 protein expression vs. EGJOO. Unexpectedly, these proteins were absent in TD tissue. S100 and P substance had similar expression levels in tissues of achalasia patients vs.TD and EGJOO. Most of the achalasia sera had anti-GAD65 (83%) and anti-PNMA2 (90%) autoantibodies vs. EGJOO (17% and 33%, respectively) and healthy volunteers (10% and 0%, respectively).CONCLUSIONTissue-specific ectopic expression of GAD65 and PNMA/Ta2 and active MMP-9, associated with the presence of specific autoantibodies directed against these proteins, might participate in the pathophysiology of achalasia triggering and/or perpetuating autoimmune disease.WHAT YOU NEED TO KNOW?BACKGROUND AND CONTEXTAchalasia is a primary esophageal motility disorder associated with a selective loss of inhibitory neurons in the myenteric esophageal plexus.An inflammatory/autoimmune response seems involved in pathophysiology.NEW FINDINGSMost of the achalasia sera have anti-GAD65 and anti-PNMA2 autoantibodies vs. EGJOO and healthy volunteers.Esophageal tissues of achalasia patients have higher ectopic GAD65 and PNMA2 protein expression vs. EGJOO. These proteins are absent in healthy donors with non-inflamed muscle of the LES.Activated MMP-9 is detected in situ together with GAD65 and PNMA2 substrates.LIMITATIONSBy its design, our study does not shed light on the mechanisms that induce the ectopic expression of the GAD65 and PNMA/Ta2 proteins in LES muscle tissue. It remains impossible to firmly state the sequence of events, e.g. whether the expression of ectopic antigens is due to tissue destruction or the presence of autoantibodies. Whether serum autoantibodies react with autoantigens of the LES muscle tissue of the patients with achalasia also remains unknown.IMPACTThis information yields new insights into pathophysiological mechanisms of achalasia for better disease understanding and possible design of novel therapeutic strategies.LAY SUMMARYMost of the achalasia sera have anti-GAD65 and anti-PNMA2. Esophageal tissues of achalasia patients have ectopic GAD65 and PNMA2. This information yields new insights into pathophysiological mechanisms of achalasia for better disease understanding.

Published
2021
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45. Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0(C)

Author

Yadlapati, R, Kahrilas, PJ, Fox, MR, Bredenoord, AJ, Prakash Gyawali, C, Roman, S, Babaei, A, Mittal, RK, Rommel, N, Savarino, E, Sifrim, D, Smout, A, Vaezi, MF, Zerbib, F, Akiyama, J, Bhatia, S, Bor, S, Carlson, DA, Chen, JW, Cisternas, D, Cock, C, Coss-Adame, E, de Bortoli, N, Defilippi, C, Fass, R, Ghoshal, UC, Gonlachanvit, S, Hani, A, Hebbard, GS, Wook Jung, K, Katz, P, Katzka, DA, Khan, A, Kohn, GP, Lazarescu, A, Lengliner, J, Mittal, SK, Omari, T, Park, MI, Penagini, R, Pohl, D, Richter, JE, Serra, J, Sweis, R, Tack, J, Tatum, RP, Tutuian, R, Vela, MF, Wong, RK, Wu, JC, Xiao, Y, Pandolfino, JE, Yadlapati, R, Kahrilas, PJ, Fox, MR, Bredenoord, AJ, Prakash Gyawali, C, Roman, S, Babaei, A, Mittal, RK, Rommel, N, Savarino, E, Sifrim, D, Smout, A, Vaezi, MF, Zerbib, F, Akiyama, J, Bhatia, S, Bor, S, Carlson, DA, Chen, JW, Cisternas, D, Cock, C, Coss-Adame, E, de Bortoli, N, Defilippi, C, Fass, R, Ghoshal, UC, Gonlachanvit, S, Hani, A, Hebbard, GS, Wook Jung, K, Katz, P, Katzka, DA, Khan, A, Kohn, GP, Lazarescu, A, Lengliner, J, Mittal, SK, Omari, T, Park, MI, Penagini, R, Pohl, D, Richter, JE, Serra, J, Sweis, R, Tack, J, Tatum, RP, Tutuian, R, Vela, MF, Wong, RK, Wu, JC, Xiao, Y, and Pandolfino, JE

Abstract

Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Fifty-two diverse international experts separated into seven working subgroups utilized formal validated methodologies over two-years to develop CCv4.0. Key updates in CCv.4.0 consist of a more rigorous and expansive HRM protocol that incorporates supine and upright test positions as well as provocative testing, a refined definition of esophagogastric junction (EGJ) outflow obstruction (EGJOO), more stringent diagnostic criteria for ineffective esophageal motility and description of baseline EGJ metrics. Further, the CCv4.0 sought to define motility disorder diagnoses as conclusive and inconclusive based on associated symptoms, and findings on provocative testing as well as supportive testing with barium esophagram with tablet and/or functional lumen imaging probe. These changes attempt to minimize ambiguity in prior iterations of Chicago Classification and provide more standardized and rigorous criteria for patterns of disorders of peristalsis and obstruction at the EGJ.

Published
2021

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