DOI: 10.14309/ajg.0000000000002491 ISSN:
Chicago Classification v4.0 stratifies acid burden and abnormal impedance-pH variables better than Chicago Classification v3.0
Mentore Ribolsi, Lorenzo Marchetti, Edoardo Savarino, C. Prakash Gyawali, Michele Cicala- Gastroenterology
- Hepatology
ABSTRACT
Background:
GERD severity increases with esophageal body hypomotility, but impact of Chicago Classification (CC) v4.0 criteria on GERD diagnosis is incompletely understood.
Methods:
In GERD patients 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).
Conclusion:
CCv4.0 hypomotility criteria are more specific in supporting GERD evidence compared to CCv3.0.