Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography


  • Chicago Classification Criteria of Esophageal Motility Disorders Defined in High Resolution Esophageal Pressure Topography (EPT)1

    1 Endorsed by:

     The American Neurogastroenterology and Motility Society (ANMS)

    ○ The European Society of Neurogastroenterology and Motility (ESNM) Steering Committee

    ○ The European Society of Esophagology (ESE)

    ○ The International Society for Diseases of the Esophagus (ISDE)

    ○ German Society for Neurogastroenterology and Motility

    ○ Groupe Français de Neuro-Gastroentérologie (GFNG) scientific board

    ○ Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

    ○ Working Group for Neurogastroenterology and Motility of the German Society for Digestive and Metabolic Diseases

    Statements of support from (organizations that do not endorse outside documents):

    ○ The American Gastroenterological Association Institute (AGAI)

    ○ The British Society of Gastroenterology (BSG) Oesophageal, Neurogastroenterology and Motility and Associated GI Physiologists subcommittees

    ○ The United European Gastroenterology Federation (UEGF)

Address for Correspondence
Peter J Kahrilas MD, Department of Medicine, Division of Gastroenterology & Hepatology, Feinberg School of Medicine, Northwestern University, 676 St Clair St, Suite 1400, Chicago, IL 60611-2951, USA.
Tel: +312 695 4016; fax: +312 695 3999;


Background  The Chicago Classification of esophageal motility was developed to facilitate the interpretation of clinical high resolution esophageal pressure topography (EPT) studies, concurrent with the widespread adoption of this technology into clinical practice. The Chicago Classification has been an evolutionary process, molded first by published evidence pertinent to the clinical interpretation of high resolution manometry (HRM) studies and secondarily by group experience when suitable evidence is lacking.

Purpose  This publication summarizes the state of our knowledge as of the most recent meeting of the International High Resolution Manometry Working Group in Ascona, Switzerland in April 2011. The prior iteration of the Chicago Classification was updated through a process of literature analysis and discussion. The major changes in this document from the prior iteration are largely attributable to research studies published since the prior iteration, in many cases research conducted in response to prior deliberations of the International High Resolution Manometry Working Group. The classification now includes criteria for subtyping achalasia, EGJ outflow obstruction, motility disorders not observed in normal subjects (Distal esophageal spasm, Hypercontractile esophagus, and Absent peristalsis), and statistically defined peristaltic abnormalities (Weak peristalsis, Frequent failed peristalsis, Rapid contractions with normal latency, and Hypertensive peristalsis). The Chicago Classification is an algorithmic scheme for diagnosis of esophageal motility disorders from clinical EPT studies. Moving forward, we anticipate continuing this process with increased emphasis placed on natural history studies and outcome data based on the classification.