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The Reverse Red-Green-Blue Rule : A Color-Coded Approach for Simplified Achalasia Diagnosis via High-Resolution Manometry

Abdulrasak, Mohammed LU orcid ; Hootak, Sohail ; Mohrag, Mostafa and Someili, Ali M (2025) In Gastroenterology research 18(3). p.149-151
Abstract

BACKGROUND: Achalasia is a rare motility disorder of the esophagus. The diagnosis involves clinical suspicion based on history details and results of high-resolution manometry (HRM) as recommended by the Chicago classification (CCv4.0). Interpreting data obtained through HRM can be complex especially for the novice user.

METHODS: We propose therefore a color-based algorithm involving the "reversed red-green-blue (RGB)" rule as a simplified way to establish the diagnosis based on colors obtained through the HRM pressure sensors. The rule is based on the simple acknowledgment of the dominant color present in the mid-portion of the HRM figure such that, for type I (classic) achalasia, the blue color illustrates the minimal... (More)

BACKGROUND: Achalasia is a rare motility disorder of the esophagus. The diagnosis involves clinical suspicion based on history details and results of high-resolution manometry (HRM) as recommended by the Chicago classification (CCv4.0). Interpreting data obtained through HRM can be complex especially for the novice user.

METHODS: We propose therefore a color-based algorithm involving the "reversed red-green-blue (RGB)" rule as a simplified way to establish the diagnosis based on colors obtained through the HRM pressure sensors. The rule is based on the simple acknowledgment of the dominant color present in the mid-portion of the HRM figure such that, for type I (classic) achalasia, the blue color illustrates the minimal pressurization and absent peristalsis. In type II (pan-pressurized) achalasia, the green color illustrates pan-esophageal pressurization, while in type III (spastic) achalasia, red color illustrates the spastic contractions.

RESULTS: This rule, which we present as a conceptual framework and has not yet been prospectively validated, provides an intuitive tool for clinicians dealing with HRMs diagnosing achalasia.

CONCLUSION: Further studies are required to assess the diagnostic accuracy of this rule, alongside the potential for incorporating such rules into artificial intelligence (AI)-based models for manometric diagnosis of esophageal motility disorders.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Gastroenterology research
volume
18
issue
3
pages
3 pages
publisher
Elmer Press
external identifiers
  • pmid:40503192
ISSN
1918-2805
DOI
10.14740/gr2040
language
English
LU publication?
yes
additional info
Copyright 2025 Authors.
id
baddcff2-60a3-42be-98b3-d6a3126c9b59
date added to LUP
2025-06-12 18:46:00
date last changed
2025-06-13 08:52:34
@article{baddcff2-60a3-42be-98b3-d6a3126c9b59,
  abstract     = {{<p>BACKGROUND: Achalasia is a rare motility disorder of the esophagus. The diagnosis involves clinical suspicion based on history details and results of high-resolution manometry (HRM) as recommended by the Chicago classification (CCv4.0). Interpreting data obtained through HRM can be complex especially for the novice user.</p><p>METHODS: We propose therefore a color-based algorithm involving the "reversed red-green-blue (RGB)" rule as a simplified way to establish the diagnosis based on colors obtained through the HRM pressure sensors. The rule is based on the simple acknowledgment of the dominant color present in the mid-portion of the HRM figure such that, for type I (classic) achalasia, the blue color illustrates the minimal pressurization and absent peristalsis. In type II (pan-pressurized) achalasia, the green color illustrates pan-esophageal pressurization, while in type III (spastic) achalasia, red color illustrates the spastic contractions.</p><p>RESULTS: This rule, which we present as a conceptual framework and has not yet been prospectively validated, provides an intuitive tool for clinicians dealing with HRMs diagnosing achalasia.</p><p>CONCLUSION: Further studies are required to assess the diagnostic accuracy of this rule, alongside the potential for incorporating such rules into artificial intelligence (AI)-based models for manometric diagnosis of esophageal motility disorders.</p>}},
  author       = {{Abdulrasak, Mohammed and Hootak, Sohail and Mohrag, Mostafa and Someili, Ali M}},
  issn         = {{1918-2805}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{149--151}},
  publisher    = {{Elmer Press}},
  series       = {{Gastroenterology research}},
  title        = {{The Reverse Red-Green-Blue Rule : A Color-Coded Approach for Simplified Achalasia Diagnosis via High-Resolution Manometry}},
  url          = {{http://dx.doi.org/10.14740/gr2040}},
  doi          = {{10.14740/gr2040}},
  volume       = {{18}},
  year         = {{2025}},
}