Upper esophageal sphincter metrics on high-resolution manometry differentiate etiologies of esophagogastric junction outflow obstruction

Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society
P BlaisC Prakash Gyawali

Abstract

Upper esophageal sphincter (UES) metrics on high-resolution manometry (HRM), particularly nadir UES residual pressure (UES-RP), are abnormal in achalasia and may help characterize the underlying mechanism or predict management outcome in esophagogastric junction outflow obstruction (EGJOO). A database of consecutive patients undergoing esophageal HRM from 2008 to 2013 yielded 134 patients (59.8 ± 1.4 years, 68% F) with EGJOO. Final clinical diagnoses and treatment response were extracted from chart review. Esophageal body, UES, and lower esophageal sphincter (LES) metrics were compared between EGJOO and asymptomatic healthy controls (n = 16, 27.7 ± 0.7 years, 56% F). Logistic regression evaluated differences between HRM metrics amongst etiologies of EGJOO grouped into motor versus mechanical disorders. Distal contractile integral, distal latency, and nadir UES-RP were significantly different between EGJOO subgroups (P ≤ 0.01 for each comparison), but only nadir UES-RP remained independently predictive of subgroups (adjusted odds ratio 1.15, 95% confidence intervals 1.05-1.27, P < 0.01). Nadir UES-RP was highest in achalasia variants, and lowest in mechanical EGJOO and controls (P < 0.001). Of 19 patients who underwent LES myoto...Continue Reading

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Citations

Aug 14, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Alisara DamrongmaneeAjay Kaul
Apr 25, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Frank ZerbibC Prakash Gyawali
Aug 23, 2020·Revista de gastroenterología de México·D C Godoy-SalgadoJ A Ramírez-Mayans
Jul 3, 2021·Revista De Gastroenterología De México·D C Godoy-SalgadoJ A Ramírez-Mayans
Jul 3, 2021·Journal of Neurogastroenterology and Motility·Songfeng ChenYinglian Xiao

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