Changes in the esophagogastric junction outflow obstruction manometric feature based on the Chicago Classification...

Area of Science:

• Gastroenterology
• Esophageal Physiology
• Diagnostic Manometry

Background:

• Esophagogastric junction outflow obstruction (EGJOO) diagnosis relies on Chicago Classification v4.0 (CCv4.0) criteria.
• CCv4.0 includes elevated integrated relaxation pressure (IRP) in supine and upright positions, and elevated intrabolus pressure.
• The impact of these updated criteria on manometric features of EGJOO requires further investigation.

Purpose of the Study:

• To characterize esophageal motility in EGJOO patients under CCv4.0.
• To identify manometric parameters crucial for confirming EGJOO diagnosis.

Main Methods:

• Retrospective analysis of 370 patients undergoing high-resolution manometry (HRM) and rapid drink challenge (RDC).
• Comparison of esophageal body and esophagogastric junction parameters between EGJOO, isolated supine IRP elevation, and normal HRM groups.
• Multivariate and ROC analyses to identify diagnostic parameters.

Main Results:

• EGJOO patients showed reduced proximal esophageal contractile integral (PECI) and proximal esophageal length (PEL) compared to normal HRM.
• EGJOO patients exhibited greater esophagogastric junction dysfunction, including elevated LES resting pressure (LESP) and IRP on RDC.
• PEL, LESP, and IRP on RDC were identified as factors associated with EGJOO.

Conclusions:

• CCv4.0 criteria indicate EGJOO involves severe esophagogastric junction dysfunction and proximal esophageal abnormalities.
• Proximal esophageal length, LES resting pressure, and IRP on RDC are valuable parameters for confirming EGJOO diagnosis.