Classification is based on the primary position in which 10 wet swallows are performed, either supine or upright. Assessment of swallows in the secondary position and with provocation provide supportive data
In addition to Chicago Classification v3.0 metrics, final report should include baseline measures of the esophagogastric junction (EGJ) and symptoms experienced during the study and within 15 seconds of a motility dysfunction.
Prior to procedure patients should fast for at least 4 hours and informed consent should be obtained. The Cv4.0 Working Group recommends using a solid state high-resolution manometry catheter with less than 2cm sensor spacing with combined impedance sensors. However, the protocol and classification can be performed with water perfused catheters if appropriate normative values are used. Although the protocol designed by the CCv4.0 working group is considered to be the optimal protocol, clinicians can modify this protocol based on limited resources and time as long as normative values are applied and other positions and provocative tests are used appropriately. Physicians choosing to begin the study in the upright position should consider performing 10 upright swallows.
Study begins in supine position use supine normative values
60 second adaptation period
30 second baseline period
Change position to upright use upright normative values]