Clinical Features, Manometry, Timed Barium Esophagram, and Treatment Outcomes of Patients With Functional and Anatomic Esophago-gastic Junction Outflow Obstruction.

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Clinical Features, Manometry, Timed Barium Esophagram, and Treatment Outcomes of Patients With Functional and Anatomic Esophago-gastic Junction Outflow Obstruction.

Clin Gastroenterol Hepatol. 2016 Jan 11;

Authors: Clayton SB, Patel R, Richter JE

Abstract
Little is known about the clinical features, radiology and manometry findings, and outcomes of treatment of patients with functional and mechanical esophago-gastic junction outflow obstruction (EGJOO). Between November 2011 and February 2015, a total of 1443 HRMs were reviewed and 49 patients (3.4%) met the manometric criteria for EGJOO. Then, we performed a retrospective chart review, collecting data from manometric studies, timed barium esophagram findings (TBE), endoscopic reports, and clinical records. Twenty-seven patients had functional EGJOO and 22 patients had an anatomic esophageal obstruction. Common causes of anatomic EGJOO included strictures (36% of patients) and hiatal hernias (31% of patients). There were no differences between groups in manometric or radiographic metrics. Each group had increased basal lower esophageal sphincter and intra-bolus pressures, compared to individuals without EGJOO, and most had abnormal findings in TBE analysis. Two patients with functional EGJOO progressed to type 3 achalasia. We conclude that patients diagnosed with EGJOO based on manometry findings can have anatomic obstruction or functional EGJOO; HRM and TBE do not distinguish between disease causes.

PMID: 26792374 [PubMed - as supplied by publisher]

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