Simple Manometric Index for Comprehensive Esophagogastric Junction Barrier Competency Against Gastroesophageal Reflux.

Journal of the American College of Surgeons
Takahiro MasudaRoss M Bremner

Abstract

The esophagogastric junction (EGJ) is an anatomic and physiologic barrier against gastroesophageal reflux. Comprehensive evaluation of EGJ barrier parameters using high-resolution manometry in patients with GERD has not been well established. We propose a simple index for comprehensive EGJ antireflux competency. Patients who underwent high-resolution manometry and 24-hour pH monitoring between January 2017 and September 2018 were included. Of these, patients with normal esophageal motility were selected. EGJ antireflux competency was assessed based on the following 3 categories: anatomic configuration of the EGJ complex (ie EGJ morphology), backflow-preventive pressure on the lower esophageal sphincter (LES) (ie LES pressure integral), and backflow-promotive pressure across the LES (ie thoracoabdominal pressure gradient). Each category was scored on a scale of 0 to 2, applying clinically meaningful divisions, and a cumulative score was calculated (EGJ index: 0 to 6 points). DeMeester score > 14.72 indicated GERD. In total, 259 patients met study criteria. Of these, GERD was noted in 109 patients (42.1%). The pH parameters were gradually exacerbated, depending on the EGJ index. Good correlations were seen between EGJ index and p...Continue Reading

Associated Clinical Trials

Citations

Aug 12, 2021·Esophagus : Official Journal of the Japan Esophageal Society·Qian-Jun ZhuangYing-Lian Xiao

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