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Updated: Aug 6, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
MULTICHANNEL INTRALUMINAL IMPEDANCE MAY BE USEFUL TO IDENTIFY CLINICALLY RELEVANT ESOPHAGOGASTRIC JUNCTION OUTFLOW
Felipe Nelson Mendonça1, Ricardo Brandt de Oliveira1
1Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Unidade de Fisiologia GI, Divisão de Gastroenterologia, Ribeirão Preto, SP, Brasil.
Background:
A clinically relevant conclusive diagnosis of esophagogastric junction outflow obstruction (EGJOO) requires a manometric diagnosis, relevant symptoms and adjunct exams supporting outflow obstruction. Multichannel intraluminal impedance measurement provides an evaluation of esophageal clearance.
Objective:
This study aimed to evaluate the effectiveness of multichannel intraluminal impedance in providing supportive evidence of outflow obstruction and differentiating between severe and mild cases in patients suspected of having esophagogastric junction outflow obstruction.
Methods:
A cohort of fifty-nine patients presenting with Abnormal Esophagogastric Junction Relaxation (AEJR), as classified by Chicago Classification version 4.0, was selected from a retrospective, single-center study. Their data from high-resolution impedance manometry were reviewed and compared with clinical and radiologic data. Patients were classified as highly symptomatic (AEJR-HS) or moderately/mildly symptomatic (AEJR-MS) using the Eckardt score.
Results:
AEJR-HS was identified in 28 patients and AEJR-MS in 24. Incomplete liquid clearance by multichannel intraluminal impedance demonstrated a strong association with radiological incomplete esophageal clearance (OR: 14.08, 95%CI 2.93 - 87.60, P<0.001) and high diagnostic accuracy (93.2%) for EGJOO CC v4.0. Forty percent or more incomplete liquid clearance by multichannel intraluminal impedance during supine swallows showed good accuracy in separating AEJR-HS from AEJR-MS with 75% sensitivity and 83% specificity (AUC=0.825; 95%CI 0.708-0.941, P<0.001).
Conclusion:
Multichannel intraluminal impedance closely matches esophageal radiography in identifying severe obstructive symptoms and incomplete clearance in AERJ patients and may serve as an alternative to radiography in confirming EGJOO v4.0 in patients with manometric EGJOO.
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