International Working Group for Disorders of GI …Chairs: Edoardo Savarino, Padua, Italy; Frank...

International Working Group for Disorders of GI Motility and Function

Chair Mark Fox

Local Organization Henriette Heinrich Hand-On Training Serhat Bor

Working Group Steering Committees Swallow John Pandolfino, Rena Yadlapati, Nathalie Rommel, Taher Omari Reflux Sabine Roman, Prakash Gyawali, Arjan Bredenoord, Edoardo Savarino Gastrointestinal Heinz Hammer, Daniel Pohl, Jutta Keller Continence Henriette Heinrich, Charlie Knowles, Mark Scott, Emma Carrington, Adil Bharucha, Satish Rao

Supported by: • Clinic for Gastroenterology and Hepatology, University Hospital Zurich (Chief: Gerhard Rogler) • University of Zurich, Swiss Federal Institute of Technology Zurich & Swiss National Science Fund • Digestive Function: Basel, Center for Integrative Gastroenterology, Klinik Arlesheim, Switzerland

Ascona III Advances in Clinical Measurement of

Gastrointestinal Motility and Function

12-17 July 2020

Congressi Stefano Franscini

Swiss Institute for Technology Conference Centre

Monte Verità

Ascona, Switzerland

Ascona III: Advances in Clinical Measurement Conference Program

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Welcome

Recent years have seen dramatic developments in the technology available for clinical investigation of swallowing, gastro-esophageal reflux and continence function. In 2011 the HRM Working Group gathered in Ascona to introduce the Chicago Classification of Esophageal Motility Disorders for High-Resolution Manometry. In 2015 the group met again to review advances in esophageal measurement, diagnosis of Gastro-Oesophageal Reflux Disease and management of Anorectal Disorders. In 2020 a world class faculty returns to Switzerland to establish the state-of-the-art in clinical measurement of digestive function from “top to tail”. Highlights will include:

• introduction of the first consensus Classification for disorders of pharyngeal function

• roll out of the Chicago Classification for Oesophageal Motility Disorders version 4.0 plus review of endo-FLIP and other advances

• initial experience with the Lyon Classification of Gastro-Oesophageal Reflux Disease

• state-of-the-art lectures focused on assessment of gastric emptying, intestinal motility and digestive function, including breath tests.

• introduction of the London Classification for disorders of anorectal function

The aim is to establish and disseminate operating procedures and classification systems for the full range of disorders of gastrointestinal motility and function This process is funded by activity grants from United European Gastroenterology and endorsed by all five international Neurogastroenterology and Motility societies: European, American, Latin American, Australasian plus the European Society for Coloproctology and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. Throughout the focus will be on clinical practice, highlighting how the information provided by advanced measurement equipment can provide an explanation for patient symptoms, establish definitive diagnosis and guide effective management. Welcome to Ascona!

Mark Fox on behalf of the International Working Group for GI Motility and Function


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Location

Congressi Stefano Franscini (CSF)

The Congressi Stefano Franscini (CSF), conference platform of the Swiss Federal Institute of Technology of Zurich, is responsible for the promotion, selection and financing of international conferences at the venue Monte Verità, a hilltop over Ascona and Lake Maggiore. The CSF provides an ideal meeting point for all members of the international scientific community who wish to discuss the state of the art and new challenges of any field of research. Since 1989 the CSF has supported 20 – 25 international conferences yearly and, since 2010, up to 10 winter doctoral schools (ETH Winter Schools@Monte Verità). A Call for Proposals is published every year at the end of Spring (deadline for applications: mid-January of the following year). Such events last 3 to 5 days and attract an international audience. Submission of a proposal for a CSF subsidized meeting is open to all researchers and university professors working in Switzerland. International collaborations are welcome. The CSF avails of the on-site facilities of Monte Verità Foundation: various conference rooms for up to 110 people, a hotel with 23 single bedrooms and 27 double bedrooms, a restaurant with panoramic view, a park with a historical heritage (former vegetarian community) and a museum about the history of Monte Verità (currently being renovated). The CSF is also open to the local public with some outreach events in the contexts of its conferences: lectures, round tables, public demonstration of new technologies, plays, and more. More information on CSF can be found on www.csf.ethz.ch.


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Ascona and Surroundings

• Ascona is a beautiful town on the Lago Maggiore, largest of the Swiss-Italian lakes

• A famous holiday destination, delegates can

− Hike in the Maggia and Verzasca mountain valleys

− Visit the Isola Bella islands in the Lago Maggiore

− Enjoy the famous ice cream

Highlights

• Borgo Old Town – beautiful Old Town of Ascona around the church of San Pietro e Paolo, an art museum with paintings by artists who spent time living here (Jawlensky, Werefkin, Klee).

• Maggiatal – natural river landscape, broad paths in an

unspoilt side valley of Ticino, with nearly 40 mountain lakes and a wealth of fauna and flora.

• Brissago Islands – worth a trip, reached by a peaceful boat

ride; thanks to the near-Mediterranean climate, 1500 different species of plants thrive here.

• Centovalli – this enchanting "Valley of a hundred valleys"

lies between Domodossola and Locarno, with deep gorges, waterfalls, chestnut woods and picturesque villages, reached by narrow-gauge railway.

• Ronco sopra Ascona – one of the most delightful places

overlooking Lake Maggiore, with an enchanting panorama of the lake and mountains, and a picturesque footpath with over 800 steps leading down to the lakeside.


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Excursion

Brissago Islands

This boat trip is ideal for nature and lake lovers, those who maybe have little time at their disposal.

The Brissago Islands date back to the Roman time

(vestiges of that time have been found on the islands),

but be-came particularly famous thanks to the

fascinating Russian Baroness Antoinette de Saint Léger

who owned the Is-lands (1885-1927) and launched an

intense cultural activity. At the same time she started

what has become a unique botanical garden in

Switzerland (today the property of the Canton Ticino),

with 1500 plant species both indigenous and from sub-

tropical zones. It takes one hour to visit the botanical

garden.

Cardada – Cimetta This excursion is ideal for hiking lovers and offers a spectacular panorama over the Lake Maggiore.

Cardada – Cimetta (1400 – 1700 m) is only 30 minutes

above Locarno and offers a spectacular 360° panoramic

view over the Lake Maggiore. During the winter Cimetta

is a skiing resort for local people and during the summer

it is a trekking paradise. The climbing is by cable car, the

new one designed by the architect Mario Botta, and by

chair lift. You can either hike up to the Cima della Trosa

(1900 m).


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Program Italics indicate authors that have yet to confirm attendance

Arrival: Sunday

15.00 Registration Desk Open. Shuttle Service from Locarno Train Station to Accommodation 18.00 Welcome Reception. 18.30 Dinner, CSF Conference Center Restaurant

Day 1: Monday Morning

Welcome 08.30 - 08.45 Welcome to Ascona III

Mark Fox, Chair International Working Group for GI Motility and Function 08.45 - 09.00 Congressi Stefano Franscini & Monte Verità Welcome Address

Oropharyngeal swallow I: Pharyngeal - High Resolution Motility (P-HRM) Paradigms: Chair: Reza Shaker, Milwaukee, USA and Pere Clave, France 09.00 - 09.30 P-HRM with videofluoroscopy

Peter Kahrilas, Chicago, USA 09.30-10.00 P-HRM with impedance

Taher Omari, Adelaide, Australia

10.00-10.30 P-HRM with videofluoroscopy & impedance Nathalie Rommel, Leuven, Belgium

10.30 – 11.00 Coffee

Oropharyngeal swallow II: Harnessing Diagnostic & Treatment Modalities Chair: Tim McCullough, London, UK and Taher Omari, Adelaide, Australia 11.00-11.30 Head & Neck Cancer and other structural pathologies

Peter Wu, Sydney, Australia and Hong Kong, China 11.30-12.00 Neurological Disease

Charles Cock, Adelaide, Australia

12.00-12.30 Biofeedback for Disorders of Pharyngeal Swallow Ashli O’Rourke, Charleston, USA

12.30 – 13.30 Lunch


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Day 1: Afternoon

Chicago IV and the Frontiers of Oesophageal Motility Disorders I Chair: Peter Kahrilas, Chicago, USA, Nathalie Rommel, Leuven, Belgium 13.30-14.00 The first 10 years of the Chicago Classification

John Pandolfino, Chicago USA, Rena Yadlapati, San Diego, USA 14.00-14.30 High-Resolution Impedance Manometry to Diagnose Achalasia

Arjan Bredenoord, Amsterdam, The Netherlands 14.30-15.00 EGJ Outflow Obstruction: How to separate physiologic from pathologic

Dustin Carlson, Chicago, USA 15.00-15.30: Break

Chicago IV and the Frontiers of Oesophageal Motility Disorders II Chair: Arjan Bredenoord, Amsterdam, The Netherlands, John Pandolfino, Chicago, USA 15.30-16.00 Manometric Features of Hypercontractile & Spastic Disorders

Yinglian Xiao, Guangzhou, China 16.00-16.30 Position and Provocative Tests in Manometry

Rami Sweis, London, UK 16.30-17.00 Optimizing the CC 4.0 HRM Protocol for Clinical Practice

Albis Hani, Bogota, Colombia & Claudia Defilippi, Santiago, Chile 17.00-17.30 The CC 4.0 HRM Protocol: Open Discussion Lead Discussants: Rena Yadlapati, San Diego, USA, Mark Fox, Zürich and Arlesheim, Switzerland


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Day 1: Monday Evening 18.30 – 20.00 Dinner with Public Event CSF Conference Center Restaurant

Too much of a good thing can be wonderful: The use of chocolate in medicine… with public tasting Chairs: Christine Feinle, Adelaide, Australia, Mark Fox, University of Zürich & Arlesheim, Switzerland

Anne-Christin Meyer & Bettina Wölnerhanssen, Clara Forschung, Basel, Switzerland Tilo Hühn, Zürich University of Applied Sciences, Wädenswil, Switzerland Mark Fox, University of Zürich & Arlesheim, Switzerland


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Day 2: Tuesday Morning GERD and Motility Disorders

Chairs: Edoardo Savarino, Padua, Italy; Frank Zerbib, Bordeaux, France 08.30-09.00 The esophago-gastric junction in health and reflux disease

Ravinder Mittal, San Diego, USA 09.00-09.20 Provocative testing maneuvers in GERD, rumination & related disorders

Roberto Penagini, Milan, Italy 09:20-09.40 Pharmacological provocative testing during HRM in motility disorders

Arash Babaei, Denver, USA 09.40-10.00 Opioid Induced Esophageal Dysfunction: A New Disorder?

Marcelo Vela, Scottsdale, USA

10.00 – 10.30 Coffee Physiologic Testing in GERD

Chairs: Justin Wu, Hong Kong, China, Roberto Penagini, Milan, Italy 10.30-10.50 Normal Thresholds for Reflux Episodes: the International Normative Study

Daniel Sifrim, London, UK 10:50-11.10 Symptom-Reflux Association: the most useful outcome of reflux monitoring?

Arjan Bredenoord, Amsterdam, Netherlands 11:10-11.30 Symptom-Reflux Association: shortcomings and solutions

Michael Vaezi, Nashville, USA 11.30-11.50 TLESRs: Do numbers of reflux episodes matter?

Radu Tutuian, Switzerland 11.50-12.10 Mucosal integrity: Does it correlate with reflux burden, sensitivity or both?

Nicola de Bortoli, Pisa, Italy 12:10-12.30 Physiologic assessment of extra-esophageal reflux symptoms

Joel Richter, Tampa, USA

12.30 – 13.30 Lunch


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Day 2: Tuesday Afternoon

The Lyon Consensus: Discussion

Chairs: Peter Kahrilas, Chicago, USA, and Daniel Sifrim, London, UK 13.30-14.10 Debate: Strengths and Limitations of the Lyon Consensus

Sabine Roman, Lyon, France vs. Ronnie Fass, Cleveland, USA 14.10-14.35 Incorporating novel pH impedance metrics into GERD diagnostics

Edoardo Savarino, Padua, Italy 14.35-15.00 Incorporating oesophageal motility into GERD diagnostics

Prakash Gyawali, St. Louis, USA

15.00 – 15.30 Coffee

GERD Diagnostics: Future direction

Chairs: Serhat Bor, Izmir, Turkey and Joel Richter, Tampa, USA

15.30 - 15.55 Role of histopathology

Frank Zerbib, Bordeaux, France 15:55 - 16.20 Role of post-prandial manometry

Rena Yadlapati, San Diego, US 16.20 - 16:45 Role of ambulatory manometry

Alissa Jell, München, Germany 16:45 - 17.30 The Lyon Classification version 1.0: Open Discussion

Lead Discussants: Sabine Roman, Lyon, France and Prakash Gyawali, St. Louis, USA


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Day 3: Wednesday Morning

Gastric and Intestinal Function: State of the Art Chair: Jutta Keller, Hamburg, Germany and Anthony Lembo, Boston, USA 08.30-09.00 Regulation of gastro-intestinal function and appetite in health Christine Feinle-Bisset, Adelaide, Australia 09.00-09.30 Clinical assessment of gastric motility and function: state of the art Jan Tack, Leuven, Belgium 09:30-10.00 Autonomic neural function in disorders of upper gastro-intestinal function Michael Camilleri, Rochester, USA

10.00 – 10.30 Coffee

Diagnostic Tests I Chair: Daniel Pohl, Zürich, Switzerland and Silvia Salvatore, Varese, Italy 10.30 - 11.00 Breath Testing and related technologies: towards consensus international guidelines Heinz Hammer, Graz, Austria 11.00 - 11.30 Assessment of carbohydrate malabsorption:

which tests make sense and what can we learn from them Clive Wilder-Smith, Bern, Switzerland

11.30 - 12.00 Diagnosis of Small Intestinal Bacterial Overgrowth (SIBO): how can it be done? Satish Rao, Augusta, USA

12.00 – 12.30 Mistakes in breath testing and how to avoid them

Johann Hammer, Wien, Austria 12:30 – 13:30 Lunch


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Day 3: Wednesday Afternoon

Diagnostic Tests II: Chair: Heinz Hammer, Graz, Austria and Miguel Valdovinos, Mexico City, Mexico 13.30 - 13.55 Optimizing Breath Testing: Inclusion of Methane Anthony Lembo, Boston, USA 13.55 - 14.10 Optimizing Breath Testing: Inclusion of 13C measurements

Kristin Verbeke, Leuven, Belgium 14.10 - 14.35 13C-Breath Testing for gastric emptying: Current role in patient management Jutta Keller, Hamburg, Germany

14.35 - 15.00 Water and Nutrient Drink Challenge testing: what does it tell us? Hans Tornblom, Gotheborg, Sweden

15.00 – 15.30 Coffee

Diagnostic tests III Chair: Maura Corsetti, Nottingham, UK and Christine Feinle-Bisset, Adelaide, Australia 15.30-15.50 Gastro-Intestinal Manometry: New aspects

Jutta Keller, Hamburg, Germany

15.50-16.10 From Electro-Gastrography (EGG): New aspects Greg O’Grady, Auckland, New Zealand

16:10-16.30 Video Capsule, Smartpill: technology seeking an indication? Carolina Malagelada, Barcelona, Spain 16.30-17.00 EndoFLIP in Gastroparesis Guillaume Gourcerol, Rouen, France 17.00-17.30 Magnetic Resonance Imaging: state of art

Alex Menys, London, UK


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Day 3 Wednesday Afternoon:

Parallel session

Neuromodulation in Disorders of Gut-Brain Interaction: indications and mechanisms of action

Chairs: Asbjørn Drewes, Aarhus, Denmark and Greg O’Grady, Wellington, New Zealand

13:30 – 14.00 Cortical and Pharyngeal Electrical Stimulation in the management of dysphagia Shaheen Hamdy, Manchester, UK

14:00 – 14.30 Transcutaneous cervical vagal nerve stimulation Adam Farmer, London and Keele, UK

14:30 – 15.00 Neuromodulation of the stomach: Endo-Stim and Enterra Yves Borbély, Bern, Switzerland

15. 00 – 15.30 Translumbosacral Anorectal Magnetic Stimulation (TAMS) and

Neuromodulation Therapy (TNT) Satish Rao, Augusta, USA

15:30 – 16.00 Tibial nerve stimulation (PTNS) and Sacral neuromodulation Charles Knowles, London, UK

16.00 – 16.15 Coffee and Panel Discussion

16:15 – 18:00 IAPWG business meeting


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Day 3: Wednesday Evening

Gala Dinner

18.30 – 19.15 Prosecco reception, CSF Conference Center Restaurant

Presentation of Young Investigator Awards

Conference Photograph

19.15 Bus Transfer to Grotto Broggini

19.30 – 22.30 Conference Dinner

See map page 4 for location of restaurants

Grotto Broggini

Via San Materno 18

6616 Losone

22.30 Bus Transfer from Restaurant to Conference Hotels


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Day 4: Thursday Morning

Diagnostic testing of colonic and anorectal function – state of art 2020 Chairs: Satish Rao, Augusta, USA and Reuben Wong, Singapore

08:30-08.40 The long road from Chicago to London: developing a consensus classification for

diagnosis of disorders of anorectal function

Mark Fox, Zürich and Arlesheim, Basel

08:40-09.10 The London Classification: does it move the field forward?

Emma Carrington, London, UK

09:10-09.35 What is missing in the London Classification?

Adil Bharucha, Rochester, UK

09:35-10.00 Where do we go from here?

José Remes-Troche, Veracruz, Mexico

10.00 – 10.30 Coffee

Assessment of anal sphincter function Chairs: Emma Carrington, London, UK and Adil Bharucha, Rochester, USA

10:30-10.55 The internal anal sphincter

Elisabeth Bruder, Basel, Switzerland

10:55-11.20 Control of puborectalis and external anal sphincter function

Ravinder Mittal, San Diego, USA

11:20-11.40 New metrics for assessing anal sphincter function in the high-resolution era

Kee Wook Jung, Seoul, Korea

11:40-12.00 3D high-definition anorectal manometry. Improved diagnostic capability?

François Mion, Lyon, France

12.00 – 13.30 Lunch


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Parallel session

Day 4: Thursday Morning

The Swallow Gateway Project: Using Internet-Based Communications and Novel Analytics to Modernize and Improve Research Outcomes and Clinical Diagnostic Services. Chair: Taher Omari, Adelaide, Australia

10:30-10.45 Introduction to the Swallow Gateway Project

Taher Omari, Adelaide, Australia

10:45-11.00 A Deglutologist’s Perspective

Nathalie Rommel, Leuven, Belgium

11:00-11.15 A Gastroenterologists Perspective

Charles Cock, Adelaide, Australia

11:15-12.30 Swallow Gateway: Hands-On Training

Supported by Flinders University


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Day 4: Thursday Afternoon

What is the best test available for the assessment of evacuation disorders? Chairs: Alison Malcolm, Sydney, Australia and Charles Knowles, London, UK

13:30-13.45 Overview of testing modalities

Mark Scott, London, UK

13:45-14.00 It’s manometry!

Henriette Heinrich, Zürich, Switzerland

14:00-14.15 It’s the balloon expulsion test!

Giuseppe Chiarioni, Bologna, Italy

14:15-14.30 It’s fecobionics!

Hans Gregersen, Hong Kong, China

14:30-14.45 It’s defecography!

TBA

14:45-15.00 Panel discussion

15.00 – 15.30 Coffee

Diagnostic investigations in paediatric patients Chairs: Annemaria Staiano, Naples, Italy and Rebecca Burgell, Melbourne, Australia

15:30-16:00 Should investigations of GI motility and function be the same in kids as in adults?

Silvia Salvatore, Varese, Italy

16:00-16.30 Lessons learnt from paediatric studies: what adult colleagues need to know

Marc Benninga, Amsterdam, The Netherlands

16:30-17.00 Do adult treatments work in kids?

Nikhil Thapar, London, UK & Brisbane, Australia

18.30 – 20.00 Dinner, CSF Conference Centre Restaurant


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Day 5: Friday Morning

Contemporary techniques for studying colorectal motility Chairs: Mark Scott, London, UK and Allison Malcolm, Australia

08:30 – 09.00 Colonic HR Manometry: what does it mean?

Maura Corsetti, Nottingham, UK and Phil Dinning, Adelaide, Australia

09:00 – 09.20 Coloelectrogastrography: is it possible?

Greg O’Grady, Auckland, New Zealand

09:20 – 09.50 Magnetic Resonance Imaging of Intestinal Function

Giles Major, Nottingham, UK

09:50 - 10.10 From Sitzmarkers to 3D-Transit for assessment of pan-intestinal motility

Asbjørn Drewes, Aarhus, Denmark

10.10 - 10.30 EndoFlip for assessment of anal sphincter function

Anne-Marie Leroi, Rouen, France

10:30 – 11.00 Coffee


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Day 5: Friday Morning

Putting it all together: identifying the causes of anorectal symptoms Chairs: Rebecca Burgell, Melbourne, Australia, Mark Fox, Zürich & Arlesheim, Switzerland,

Bill Whitehead, North Carolina, USA and Jose Remes-Troche, Veracruz, Mexico

11:00-11.25 Structure, Motility, Sensation: How does continence function work in health? Lessons learnt from manometry, barostat and imaging

Maura Corsetti, Nottingham, UK and Henriette Heinrich, Zürich, Switzerland

11:25-11.50 Identifying the causes of symptoms: phenotypic variation in faecal incontinence

Adil Bharucha, Rochester, USA and Charles Knowles, London, UK

11:50-12.15 Identifying the causes of symptoms: phenotypic variation in constipation

Natalia Zarate, London, UK and Satish Rao, Augusta, USA

12:15-13.00 Diagnosis and management of constipation and faecal incontinence: cases for the pelvic floor multidisciplinary team Mark Scott, London, UK (the physiologist), Allison Malcolm, Sydney, Australia (the

gastroenterologist) and Dieter Hahnloser, Lausanne, Switzerland (the surgeon)

13.00 – 14.00 Lunch

13.00 – 16.00 Departure Shuttle from CSF Conference Centre to Locarno Train Station


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Commercial Symposia: Time and dates to be confirmed

The future of esophageal motility… is in the endoscopy suite I

Chairs: Ronnie Fass, Cleveland, USA and Guillaume Gourcerol, Rouen, France

• EndoFLIP to Distinguish Esophageal Disorders John Pandolfino and Dusty Carlson, Chicago, USA

• EsoFLIP: Indications and performance Daniel Pohl, Zürich, Switzerland

Supported by Medtronic

The future of esophageal motility… is in the endoscopy suite II

Chairs: Rena Yadlapati, San Diego, USA and Edoardo Savarino, Padua, Italy

• Mucosal Impedance to Distinguish Esophageal Disorders Michael Vaezi, Nashville, USA

• Additional Talk TBA

Supported by Diversatek Healthcare

It takes your breath (test) away

Jutta Keller, Hamburg, Germany and Heinz Hammer, Graz, Austria

• The Gas Capsule: Development of a new, potentially disruptive technology Kyle Berean, Melbourne, Australia

• Potential Applications of the Gas Capsule in Clinical Practice Peter Gibson, Melbourne, Australia

Supported by Atmo

Towards a more complete assessment of anorectal function Chairs: Phil Dinning, Adelaide, Australia and Ravinder Mittal, San Diego, USA

• Fecobionics

Hans Gregersen, Hong Kong, China

• Rapid Rectal Barostat Testing: clinical experience

Henriette Heinrich, Zürich, Switzerland

Supported by Fecobionics and Mui Scientific


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European external Continuing Medical Education (CME) credits

Advances in Clinical Measurement of GI Function Venue: Ascona, Switzerland Event code: TBC The “Ascona III: Advances in Clinical Measurement of GI Function” will be accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activity for medical specialists. The EACCME is an institution of the European Union of Medical Specialists (UEMS), www.uems.net. The “Ascona III: Advances in Clinical Measurement of GI Function” will be designated for a maximum of / up to 27 hours of European external CME credits. Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity. Through an agreement between the European Union of Medical Specialists and the American Medical Association, physicians may convert EACCME credits to an equivalent number of AMA PRA Category 1 Credits™. Information on the process to convert EACCME credit to AMA credit can be found at www.ama-assn.org/go/internationalcme. Live educational activities, occurring outside of Canada, recognized by the UEMS-EACCME for ECMEC credits are deemed to be Accredited Group Learning Activities (Section 1) as defined by the Maintenance of Certification Program of The Royal College of Physicians and Surgeons of Canada.


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Working Group Committees

Mark Fox

Mark Fox is Chair of the International Working Group for GI Motility and Function. He is lead physician at the Digestive Function: Basel, laboratory and clinic for motility disorders and functional GI disease in Klinik Arlesheim and Honorary Professor of Gastroenterology at the University Zürich and University of Nottingham. His research and practice are focused on the development and application of new investigations to describe the structure, function and sensitivity of the digestive tract. How the gastrointestinal tract responds to eating, digestion and toileting and how these responses break down in patients with digestive diseases.

Pharyngeal and Oesophageal Working Groups John Erik Pandolfino

Dr. Pandolfino is Hans Popper Professor and Chief of Gastroenterology and Hepatology at the Feinberg School of Medicine at Northwestern University, Chicago, IL. His career has focused on the biomechanics of bolus transport and gastrointestinal motility as it pertains to gastroesophageal reflux and swallowing disorders and is currently studying GERD and Dysphagia pathogenesis. He is Editor in Chief of Diseases of the Esophagus.

Nathalie Rommel

Nathalie Rommel is appointed at the Faculty of Medicine at University of Leuven (Translational Research Centre for Gastrointestinal disorders - Neurosciences, ExpORL). Currently, she runs the deglutology research program focusing on the development of pharyngeal, esophageal and gastric motility, on the pathophysiology of dysphagia across life span, on novel diagnostic methods to assess motility disorders and on the evaluation of currently available treatment modalities for upper GI motility disorders. Clinically, N Rommel runs the esophageal manometry clinic at University Hospitals Leuven together with Prof J Tack, offering a diagnostic service to neonatal, pediatric, adult and geriatric patients with upper gastrointestinal motility disorders such dysphagia, rumination and globus.


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Peter J Kahrilas

Dr Peter J Kahrilas is the Gilbert H. Marquardt Professor in Medicine at the Feinberg School of Medicine at Northwestern University in Chicago where he has been faculty since 1986. Dr Kahrilas' research is on esophageal and oropharyngeal physiology and pathophysiology, on which he has published about 300 original papers.

Taher Omari Taher Omari is Professor of Human Physiology, Medical Science and Technology, at the College of Medicine and Public Health Flinders University, Australia. He has devoted the last 25 years to advancing understanding of swallowing disorders and gastroesophageal reflux. He is developed techniques that can measure gut function and has used these methods extensively for translational research targeted at pathophysiology, diagnosis and treatment of motility disorders using a philosophy of inclusive, multi-disciplinary collaboration. He has deployed these methods globally through development of the Swallow Gateway™, a web-based application for analysis and communication in relation to swallowing disorders (www.swallowgateway.com).

Rena Yadlapati

Rena Yadlapati is Associate Professor of Gastroenterology and Director of the Esophageal Motility and Disorders Program at the University of California, San Diego. Her clinical practice focuses on GERD, esophageal motility disorders, and eosinophilic esophagitis. She is an actively funded health services and patient centered outcomes researcher. Dr. Yadlapati’s career focus is to translate physiologic discoveries and advancement to the development of novel care paradigms for esophageal disorders.

Albis Hani

Albis Hani is a Titular Professor of Medicine, gastroenterology and digestive endoscopy at Pontificia Universidad Javeriana in Bogotá- Colombia. She directs the Gastrointestinal motility Lab at Hospital Universitario San Ignacio. Her interest include gastrointestinal motility disorders, gastroesophageal reflux disease, anorectal disorders. She is involved in motility testing using high resolution manometry (esophageal and anorectal), esophageal ambulatory esophageal pH and impedance monitoring, smart pill.

Ashli O’Rourke

Ashli O’Rourke attended Florida State University where she received her Bachelors and Masters degrees in Speech – Language Pathology & Audiology. She practiced clinical speech-language pathology for over seven years at Emory University Hospitals in the Atlanta area, specializing in dysphagia evaluation and management.


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Dr. O’Rourke attended medical school at the Medical College of Georgia, graduating in 2005. She completed both her general surgery internship and her otolaryngology – head and neck surgery residency at the University of Virginia in Charlottesville, Virginia. She went on to complete a fellowship in Laryngology – Voice and Swallowing Disorders at the Medical College of Georgia. She is board certified through the American Board of Otolaryngology since 2012. Her career interests include swallowing disorders (dysphagia), voice disturbances, and airway concerns. She specializes in many in-office procedures including KTP laser treatment of oral and laryngeal lesions, vocal fold injection medialization, Botox injections for laryngeal spasm/spasmodic dysphonia, laryngeal biopsy, pharyngoesophageal manometry and transnasal esophagoscopy. Her research interests center on the evolving clinical application of pharyngeal high resolution manometry.

Reza Shaker

Dr. Shaker is an internationally recognized investigator of esophageal and aerodigestive tract physiology and pathophysiology at the basic and clinical level with special emphasis on sensory motor integration and cerebral cortical control. He has been continuously funded for the past 25 years by NIH and currently serves as the Principle Investigator of a Program Project Grant, a Clinical and Translational Science Award (CTSA) and a T32 training grant.

His laboratory has developed a number of innovative techniques and devices that have helped open new fields of investigation. Dr. Shaker’s work has resulted in identification of several stimulatory and inhibitory reflexes between the aerodigestive tract, the esophagus and stomach and led to the development of therapeutic modalities such as the “UES Assist Device” for prevention of esophago-pharyngeal reflux and a rehabilitative exercise, “The Shaker Exercises” for alleviating upper esophageal sphincter opening abnormalities in dysphagic patients.

Dr. Shaker is Chief of the Division of Gastroenterology and Hepatology, Director of the Digestive Disease Center and he also serves as the Associate Provost and Senior Associate Dean for Clinical and Translational research at the MCW – School of Medicine. He has served on various NIH/NIDDK study sections including GMA-2, CIGP, SBIR and DSMB. He has also served on the VA Merit Review Board. He is the founder of the Dysphagia Research Society (DRS) and has served as the society’s president for two terms. He is the current Editor-in-Chief of the Journal of Dysphagia. He is the recipient of the AGA Masters Award in Gastroenterology for Basic or Clinical Research, in Digestive Disease, and is a Masters of the American College of Physicians.

Rami Sweis

Rami Sweis acquired his Bachelor’s degree in 1994 from the University of Illinois at Chicago and his medical degree in 1999 from University of Edinburgh. He trained in gastroenterology at Guy’s & St Thomas’ Hospitals, Kings College Hospital and South


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East Thames and completed his PhD from Kings College London in 2012. He was appointed as Consultant in Upper GI Medicine and Physiology at UCLH in 2014 and is the Upper GI Physiology Lead. He also holds an Honorary Associate Professor position at University College London.

He is an active member of the international High Resolution Manometry Working Group, which is responsible for classifying esophageal disorders including the Chicago Classification. He is also President of the Association of GI Physiologists (AGIP), a member of the Neurogastroenterology & Motility and of the Oesophageal section of the British Society of Gastroenterology. He regularly organises and chairs Upper GI Symposia and Hands-on Training in Upper GI physiology in the UK (through AGIP, NGM and at UCLH) and through other societies abroad.

Rami Sweis’ research is primarily focused on trying to advance the methodology and utility of the technology used to investigate reflux and swallowing disorders, including catheter/wireless (Bravo) pH-monitoring, High Resolution Manometry, Endoscopy and Barium swallow. He continues to publish and collaborate with fellow experts and esophageal units nationally and internationally. He is currently PI in the UK (central site Leuven) of a multi-centre randomised trial comparing POEM with pneumatic dilatation.

As a member of the Upper GI Endoscopy team at UCLH, Rami Sweis has a particular interest in investigating and managing complex benign as well as malignant/pre-malignant upper GI disorders such as Achalasia (sequential pneumatic dilatation and per-oral endoscopic myotomy; POEM), Barrett’s esophagus (radio-frequency ablation and endoscopic mucosal resection), Gastric dysplasia (submucosal dissection) and upper GI cancer (dilatation, stent and laser).

Gastro-Esophageal Reflux Working Group

Sabine Roman

Sabine Roman, MD, PhD, is Professor of Digestive Physiology in Lyon University and Hospices Civils de Lyon. She is currently the ESNM representative in the UEG scientific committee. Her main research interest is focused on clinical application of esophageal functional testing including high resolution manometry and pH-impedance monitoring, motility disorders and gastro-esophageal reflux disease.

Arjan Bredenoord

Arjan Bredenoord is consultant gastroenterologist at the AMC Amsterdam, the Netherlands. His interest lies in esophageal physiology and clinical esophagology with a focus on achalasia, reflux disease and eosinophilic esophagitis.


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Edoardo Vincenzo Savarino

Edoardo Savarino received his Medical and Ph.D. degrees from University of Genoa in 2004 and 2009, respectively. From 2004 to 2011, he completed his residency in internal medicine and fellowship in Gastroenterology at the Azienda Ospedaliera-Universitaria San Martino of Genoa. Currently, he is a Professor of Gastroenterology, at University of Padua. His research is focused on gastrointestinal motility, acid-related disorders, Helicobacter Pylori, eosinophilic esophagitis, H2-breath tests, inflammatory bowel diseases and functional disorders (functional dyspepsia, irritable bowel syndrome). He received various prizes for his work from United European Gastroenterology Federation, OESO foundation, Italian Society of Gastroenterology and Internal Medicine. He is also prominently involved in education of students, residents, fellows and peers at all levels.

Prakash Gyawali Prakash Gyawali is a Professor of Medicine, Director of Neurogastroenterology and Motility, and Program Director of Gastroenterology Fellowship Training at the Division of Gastroenterology, Washington University School of Medicine, St. Louis, USA. Dr. Gyawali's academic interests include gastrointestinal motility, acid peptic disorders including gastroesophageal reflux disease, and functional bowel disorders. He directs gastrointestinal motility centers affiliated with Washington University, and is involved in motility testing using high resolution manometry (esophageal and anorectal), esophageal ambulatory esophageal pH and impedance monitoring, and wireless pH monitoring.


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Yinglian Xiao

Professor Xiao MD PhD is from the department of gastroenterology in the first affiliated hospital of Sun Yat-sen university in China. She has been trained in Northwestern University in the USA. She is currently the vice president of the Youth committee of Chinese society of gastroenterology, and also the vice president of Chinese society of neurogastroenterology and motility. Her research interest is neurogastroenterology and motility, as well as functional gastrointestinal disease, especially gastroesophageal reflux disease and esophageal motility disorders.

Reuben Kong Min Wong

Reuben Wong is Associate Professor of Medicine, and adjunct faculty at the National University of Singapore. In his 18 years of public service, he introduced High Resolution Esophageal Manometry to and grew the utility of pH-Impedence testing in Singapore. He is also actively involved in drafting the new language for both upper and lower gut motility testing, and sits on both the International Anorectal Physiology Working Group, as well as Esophageal Chicago Classification Revision Committee. With his passion for education, Reuben is actively involved in post-graduate teaching, and leads GI Motility, an internationally renowned upper and lower motility hands-on teaching course. Reuben has key publications in the field of IBS, chronic constipation and gut motility, as well as being recognised for his work on quality improvement in colon cancer screening. He also lectures actively in the realm of gut microbiota, and was part of the team that introduced Fecal Transplantation to Singapore.

Joel E. Richter

Joel E. Richter, MD, is currently Professor of Medicine and the Hugh F. Culverhouse Chair for Esophagology at the University of South Florida in Tampa. Joining the faculty in September 2011, he is also Director, Division of Digestive Diseases and Nutrition and Director, Joy McCann Culverhouse Center for Swallowing Disorders. He received his MD from the University of Texas Southwestern Medical School, Dallas. He went on to complete his residency in medicine and fellowship in medicine (gastroenterology) at the National Naval Medical Center in Bethesda, Maryland. Among past academic appointments, Dr. Richter was chairman, Department of Gastroenterology, Cleveland Clinic Foundation, Ohio, for 10 years and Chairman of Medicine at Temple University School of Medicine, Philadelphia, PA for 7 years. Dr. Richter is past president of the American College of Gastroenterology (ACG) and served as director, ACG, Institute for Clinical Research and Education from 1995 to 2004. He is the recipient of several awards for his work in digestive diseases, including the Berk/Fise Lifetime Clinical Achievement Award from ACG, Joseph B. Kirsner Award in Gastroenterology (2000), the Janssen Award in Gastroenterology for Clinical Research in Digestive Diseases (2001), The Samuel Weiss Award for Outstanding Service to the ACG (2001) and Academy of Distinguished Former Students from his alma mater Texas A&M University (2019). From 2002 to 2003, he served as president of the World Organization for Specialized Studies on Diseases of the Esophagus. He


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was co-editor in chief for the American Journal of Gastroenterology from 2003-2009. He was named to the Best Doctors in America for gastroenterology multiple times. Dr. Richter is the author or coauthor of more than 600 articles including 333 original papers, 144 editorials/reviews, 15 books, and 188 book chapters. He and Don Castell are the editors of the new 5th Edition of The Esophagus. His research interests include gastroesophageal reflux disease, achalasia, Barrett’s esophagus, esophageal chest pain and eosinophilic esophagitis.

Gastrointestinal Working Group

Jutta Keller

Jutta Keller is consultant gastroenterologist at the Israelitic Hospital in Hamburg, Academic Hospital University of Hamburg, Germany. Her academic and clinical interests include motor disorders throughout the gastrointestinal tract, pancreatic exocrine insufficiency and carbohydrate intolerance. She is former president of the German Neurogastroenterology and Motility Society. Currently, she leads the steering committee Gastric and Digestive Function of the International Working Group for GI Motility and Function, and she chairs the Neurogastroenterology and Motility Certificate Course of the German Gastroenterology Society.

Daniel Pohl

Daniel Pohl is a board-certified internist and gastroenterologist and head of the Functional Diagnostics Center in the Department of Gastroenterology at the University Hospital Zurich, Switzerland. He started his career as a fellow of the GI Functional Diagnostic Center in 2005, emphasizing clinics and research on upper gut motility and more lately, disorders of brain-gut interaction. Daniel is the Past-President of the Swiss Society of Neurogastroenterology and Motility and member of the Executive Committee of the European Society of Neurogastroenterology and Motility.

Heinz Hammer

Heinz Hammer is Associate Professor of Internal Medicine and Gastroenterology at the Medical University of Graz, Austria and heads the intestinal function group in this university. He trained in internal medicine and gastroenterology at the University of Graz, at Baylor University Medical Center Dallas, USA and Mayo Medical School Rochester, USA. He has been and remains board member of national and international professional societies including Chair of the Austrian Working Group on Functional GI Disorders, secretary of EAGEN, UEMS-EBGH and was chair of UEG education committee. His main research interests are carbohydrate malabsorption and related diseases, hydrogen breath test, intestinal perception and symptom assessment, and diarrhea. He


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is currently chairing an international group for the creation of a UEG-sponsored guideline for breath tests in adult and pediatric patients.


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Anorectal Working Group Henriette Heinrich

Henriette Heinrich has persued her medical education at LMU München, Germany and has been engaged in clinical research based at the GI physiology lab of the University Hospital Zuerich since 2008 her clinical training as an internal medicine and gastroenterology specialist. Her main focus is anorectal physiology and high resolution anorectal manometry.

Charles Knowles

Charles Knowles is Professor of Surgical Research at Queen Mary University of London and Consultant Colorectal surgeon at Barts Health NHS Trust. He is Director of the NIHR Enteric Healthcare Technology Cooperative, Co-director of the National Centre for Bowel Research and Surgical Innovation. His main interests are the surgical management of benign coloproctological conditions, including the evaluation of neuromodulation and other technologies for the treatment of GI diseases, advanced in-vivo and in-vitro diagnostics for treatment stratification; and the patho-aetiology and management of GI neuromuscular diseases.

Emma Carrington Emma Carrington is a Senior Clinical Research Fellow at the National Centre for Bowel Research and Surgical Innovation in London, UK. Her research is focussed on the development and standardisation of physiological tests of rectoanal function, particularly High Resolution Anorectal Manometry. She is co-organiser of the International Anorectal Physiology Working Group.

Mark Scott Dr Mark Scott, PhD is a Principal Investigator within the Blizard Institute at Queen Mary University of London, and is Director and one of the founders of the internationally-renowned GI (Colorectal) Physiology Unit at Barts and The London School of Medicine and Dentistry / Barts Health NHS Trust. He has over 25 years’ experience, both clinical and academic, and has authored 161 original articles and 12 book chapters. Mark is one of the Leads of the International Anorectal Physiology Working Group into standardisation of diagnostic testing. His research interests are focused on pathophysiology and treatment of functional colorectal disorders (primarily constipation and faecal incontinence), including: visceral hyposensitivity; assessment of colonic motor function; diagnostic device development; and evaluation of novel therapies.


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Satish Rao

Satish Rao is Professor of Medicine, Section Chief and Founding Director of the Digestive Health Center at the Medical College of Georgia, Georgia Health Sciences University, Augusta, GA. His research interests focus on IBS, food intolerance, constipation, fecal incontinence and visceral pain. He has pioneered new techniques of evaluating digestive function and the brain-gut axis and is currently investigating the neurobiologic mechanisms of biofeedback therapy. He has received numerous international awards and is Past President of the American Neurogastroenterology & Motility Society.

Jose M Remes-Troche

Jose M Remes-Troche is a Full Time Researcher and Associate Professor of Gastroenterology, and since 2019 is the Director of the Medical Biological Research Institute at the Universidad Veracruzana, in Veracruz, Mexico. He is a Level II National Researcher in Mexico and member of the International Anorectal Working Groupm. Also, he is member of multiple national and international professional associations and currently serves on several Editorial Boards and national professional committees. Dr. Remes-Troche is committed to patient-care, research and education. He has written numerous articles and book chapters, and his clinical and research interests include functional gastrointestinal disorders, functional constipation and anorectal disorders.

Giuseppe Chiarioni

Dr Giuseppe Chiarioni is senior staff at the Gastroenterology Division of the University of Verona, Verona, Italy and Adjunct Associate Professor of Medicine at the Gastroenterology and Hepatology Division of the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. He is member of: the Anorectal Committee of the Rome Foundation, the Committee for Assessment and Conservative Management of Faecal Incontinence and Quality of Life in Adults of the International Consultation on Continence, and the International Anorectal Physiology Working Party Group (IAPWG). He trained at Johns Hopkins University on GI Motility and Rehabilitation with Prof MM Schuster and Prof WE Whitehead on 1987. Since then he developed a number of cooperative research projects focused on diagnosis and treatment of functional gastrointestinal disorders which have been mostly published on leading Gastroenterology Journals as Gastroenterology, Gut and The American Journal of Gastroenterology. His major includes biofeedback therapy for defecation disorders and hypnotherapy for functional gastrointestinal disorders.


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Hans Gregersen

Dr. Gregersen is Chief of the Division of Bioengineering in the Department of Surgery, the Chinese University of Hong Kong and associated faculty of the Bioengineering Institute at the Chinese University of Hong Kong. He served as the Chief Executive of the Sino-Danish University in Beijing from 2010-2013 where he also served as Vice-Dean at the Chinese Academy of Sciences. Professor Gregersen established the GIOME network in 2008 that has facilities in USA, Denmark, Ireland, China, and Hong Kong. Dr. Gregersen is the recipient of the AGA Masters Award in Gastroenterology for Basic Research and the Irish Walton Award named after Nobel Laureate ETS Walton. He is also recipient of the Chinese National Friendship Award Dr. Gregersen is an internationally recognized investigator of gastrointestinal mechanics and mechanosensation. He has applied engineering and mechanical principles in gastroenterology and developed several bioengineering models for predicting behavior of gastrointestinal function. Professor Gregersen is the author of the books Gastrointestinal Biomechanics (2002) and An Introduction to Gastrointestinal Mechanics (2016). He authored a large number of original research papers and reviews Professor Gregersen’ team has developed a number of innovative techniques and devices. He developed impedance planimetry and co-invented the multimodal probe and the Functional Luminal Imaging probe (FLIP). The latter was commercialized in 2009. A new invention named Fecobionics, a simulated stool, that integrates several technologies used in clinical laboratories, is currently being explored for its clinical potential.

Kee Wook Jung

Kee Wook Jung is a Clinical Professor of Gastroenterology at Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. He performed his GI fellow training at Asan Medical Center, Seoul, Korea and Mayo Clinic in Rochester, Minnesota. He serves as the director of education of Korean Society of Neurogastroenterology and Motility and editorial committee of Journal of Neurogastroenterology and Motility. His research interest is functional gastrointestinal disorder. He has written numerous articles and book chapters including novel parameters in high-resolution manometry in anorectum and esophagus, behavioral therapy in functional GI disorders, achalasia and eosinophilic esophagitis.

Anne-Marie Leroi

Anne-Marie Leroi is full Professor of Physiology at the Faculty of Medicine of Rouen Normandy since 2000. She holds an Habilitation for research direction, a PhD in Physiology and a MD in Neurology from Rouen University. She is currently head of the clinical research center and biological resources center at Rouen University Hospital. She is the coordinator of a french medical network about faecal incontinence which will allows better opportunities for recruiting patients suffering from faecal incontinence.


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Professor Leroi research interests include the evaluation of new technologies for the treatment of chronic bowel diseases (especially neuromodulation and cell therapies) and she has a track record of trial delivery in the field of faecal incontinence as chief Investigator to 4 major trials in France: (i) Efficacy of sacral nerve stimulation for faecal incontinence (published Ann Surg 2015); (ii) Outcome and cost analysis of modulation for treating urinary and faecal incontinence (published Ann Surg 2011); (iv) Transcutaneous electrical tibial nerve stimulation in the treatment of faecal incontinence; a randomized trial (Consort 1a) (published Am J Gastroenterol 2012); (v) Effect and tolerance of botulinum toxin rectal injections on faecal incontinence: a randomized double-blind controlled study (ongoing). Professor Leroi has authored over 130 peer reviewed publications including 24 scientific publications in top-ranked journal about faecal incontinence during the last ten years.

François Mion

François Mion was born in Montpellier, France in 1962. He graduated from the Medical School of Medicine Alexis Carrel in Lyon in 1991, with a specialization in Hepatology and Gastroenterology. After 2 years of research on the physiology of prostaglandins production by the liver at Tufts Medical Center in Boston, USA, he was recruited as Professor of Physiology at the Medical School of Medicine Lyon-Nord (Université Lyon 1) in 1999, and developed an activity of clinical research on the use of stable isotopes and high resolution manometry in the field of functional digestive diseases diagnostic at Hôpital E. Herriot, Lyon, France. He was involved during 8 years (2008-2016) in the administrative management of this hospital. He is now professor of physiology at Lyon-Sud Medical University, head of the functional digestive diseases lab of Hospices Civils de Lyon, with a specific interest in the field of esophageal and anorectal disorders. He is a member of the International Working group of GI motility and function, member of the board of the Groupe Français de Neuro-Gastroentérologie, and of the French association of medical education in gastroenterology (FMC-HGE). He is also a member of the scientific committee of the French Association of patients suffering of IBS (APSSII).

International Working Group for Disorders of GI …Chairs: Edoardo Savarino, Padua, Italy; Frank...

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