Chicago Classification v4.0 Stratifies Acid Burden and Abnormal Impedance-pH Variables Better Than Chicago Classification v3.0 Chicago Classification v4.0 and GERD

Mentore Ribolsi, Lorenzo Marchetti, Edoardo Savarino, C. Prakash Gyawali, Michele Cicala

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: Gastroesophageal reflux disease (GERD) severity increases with esophageal body hypomotility, but the impact of Chicago Classification (CC) v4.0 criteria on GERD diagnosis is incompletely understood. METHODS: In patients with GERD evaluated with high-resolution manometry and pH-impedance monitoring, CCv3.0 and CCv4.0 diagnoses were compared. RESULTS: In 247 patients, hypomotility diagnosis decreased from 45.3% (CCv3.0) to 30.0% (CCv4.0, P < 0.001). In contrast, within patients with ineffective esophageal motility, proportions with pathological acid exposure increased from 38% (CCv3.0) to 88% (CCv4.0); baseline impedance and esophageal clearance demonstrated similar findings (P < 0.05 for each comparison). DISCUSSION: CCv4.0 hypomotility criteria are more specific in supporting GERD evidence compared with CCv3.0.

Original languageEnglish
Pages (from-to)206-209
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume119
Issue number1
DOIs
StatePublished - Jan 1 2024

Keywords

  • Chicago Classification v3.0
  • Chicago Classification v4.0
  • GERD
  • high-resolution manometry
  • pH-impedance

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