Evaluation of symptomatic esophagogastric junction outflow obstruction

2018 ◽  
Vol 33 (10) ◽  
pp. 1745-1750 ◽  
Author(s):  
Andrew Ming Liang Ong ◽  
Vikneswaran Namasivayam ◽  
Yu Tien Wang
Keyword(s):  
Esophagogastric Junction ◽  
Outflow Obstruction

Esophagogastric junction outflow obstruction

2021 ◽  
Author(s):  
Albert J. Bredenoord ◽  
Arash Babaei ◽  
Dustin Carlson ◽  
Taher Omari ◽  
Jun Akiyama ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Outflow Obstruction

scholarly journals Physiological and pathological roles of the accommodation response in lower esophageal sphincter relaxation during wet swallows

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Muta ◽  
Eikichi Ihara ◽  
Shohei Hamada ◽  
Hiroko Ikeda ◽  
Masafumi Wada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Relaxation Function ◽  
Esophagogastric Junction ◽  
Prospective Observational Study ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

AbstractThe preparatory accommodation response of lower esophageal sphincter (LES) before swallowing is one of the mechanisms involved in LES relaxation during wet swallows, however, the physiological and/or pathological roles of LES accommodation remain to be determined in humans. To address this problem, we conducted a prospective observational study of 38 patients with normal high-resolution manometry (HRM) and 23 patients with idiopathic esophagogastric junction outflow obstruction (EGJOO) to assess dry and wet swallows. The LES accommodation measurement was proposed for practical use in evaluating the LES accommodation response. Although swallow-induced LES relaxation was observed in both dry and wet swallows, LES accommodation (6.4, 3.1–11.1 mmHg) was only observed in wet swallows. The extent of LES accommodation was impaired in idiopathic EGJOO (0.6, − 0.6–6 mmHg), and the LES accommodation measurement of patients with idiopathic EGJOO (36.8, 29.5–44.3 mmHg) was significantly higher in comparison to those with normal HRM (23.8, 18–28.6 mmHg). Successful LES relaxation in wet swallowing can be achieved by LES accommodation in combination with swallow-induced LES relaxation. Impaired LES accommodation is characteristic of idiopathic EGJOO. In addition to the IRP value, the LES accommodation measurement may be useful for evaluating the LES relaxation function in clinical practice.

Sa1329 Bolus Clearance in Esophagogastric Junction Outflow Obstruction Is Associated With Strength of Peristalsis

2016 ◽  
Vol 150 (4) ◽  
pp. S284-S285
Author(s):  
Anand Jain ◽  
Jason Baker ◽  
Joel H. Rubenstein ◽  
Joan W. Chen
Keyword(s):  
Esophagogastric Junction ◽  
Outflow Obstruction

scholarly journals The Clinical Relevance of Manometric Esophagogastric Junction Outflow Obstruction Can Be Determined Using Rapid Drink Challenge and Solid Swallows

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Santosh Sanagapalli ◽  
Joshua McGuire ◽  
Rupert W. Leong ◽  
Kalp Patel ◽  
Amanda Raeburn ◽  
...  
Keyword(s):  
Clinical Relevance ◽  
Esophagogastric Junction ◽  
Outflow Obstruction ◽  
Solid Swallows

scholarly journals Tu1260 – Upright and Supine Integrated Residual Pressure Across Different Etiologies of Esophagogastric Junction Outflow Obstruction

2019 ◽  
Vol 156 (6) ◽  
pp. S-1008
Author(s):  
Andrew Su ◽  
Julianna G. Gardner ◽  
Lizhou Huang ◽  
Thomas O. Kovacs ◽  
Kevin A. Ghassemi ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Residual Pressure ◽  
Outflow Obstruction

scholarly journals Esophageal peroral endoscopic myotomy (POEM) for treatment of esophagogastric junction outflow obstruction: results from the first prospective trial

2020 ◽  
Vol 08 (09) ◽  
pp. E1137-E1143
Author(s):  
Yervant Ichkhanian ◽  
Omid Sanaei ◽  
Andrew Canakis ◽  
Kia Vosoughi ◽  
Erik Almazan ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Clinical Success ◽  
Short Form ◽  
Tertiary Care ◽  
Prospective Trial ◽  
Peroral Endoscopic Myotomy ◽  
Outflow Obstruction ◽  
Impedance Planimetry ◽  
Sf 36 ◽  
Endoscopic Myotomy

Abstract Background and study aims Esophagogastric junction outflow obstruction (EGJOO) is a rare esophageal dysmotility disease that is characterized by elevated integrated relaxation pressuse (IRP) with evidence of preserved peristalsis. The role of peroral endoscopic myotomy (POEM) in management of EGJOO is currently unknown. Patients and methods This is a prospective trial conducted in a single US tertiary care center from June 2015 to June 2019. Symptomatic patients, diagnosed with EGJOO on both HRM and endoluminal functional lumen imaging probe (EndoFLIP), who were eligible for POEM were recruited. Primary outcome was clinical success, defined as Eckardt score (ES) ≤ 3, at 6 months post-POEM. Other outcomes included dysphagia score, quality of life as measured by 36-item Short Form health survey scales (SF-36), post-POEM HRM, EndoFLIP, and pH measurements, and adverse events. Results A total of 15 patients (51.8 yr. 9 F) with EGJOO underwent POEM. Pre-POEM mean IRP on HRM and Distensibility index (DI) on EndoFLIP were 24.3 ± 2.2 mmHg and 1.1 ± 0.6 mm2/mmHg, respectively. Clinical success was achieved in 93 % at 6 months post-POEM. There was significant decrease in IRP (-17.6 mmHg) post-POEM. There was significant improvement at 6 months in two of the SF-36 subscales. Ten patients underwent post-POEM pH testing, seven of whom had abnormal DeMeester score. Seven patients underwent EGD evaluation revealing esophagitis in five (2 Los Angeles grade A and 3 grade B). Conclusions POEM offers a high clinical success rate for patients with EGJOO confirmed by impedance planimetry.

How to approach esophagogastric junction outflow obstruction?

2020 ◽  
Vol 1481 (1) ◽  
pp. 210-223
Author(s):  
Tanisa Patcharatrakul ◽  
Ahmad Alkaddour ◽  
Panyavee Pitisuttithum ◽  
Sureeporn Jangsirikul ◽  
Kenneth J. Vega ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Outflow Obstruction
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