Abstract
Mechanical Etiologies Associated with the Diagnosis of Esophageal Outflow Obstruction on High Resolution Manometry
Highlights
Considerable clinical ambiguity exists over the relevance, optimal evaluation, and treatment of the manometric diagnosis of esophagogastric junction outflow obstruction (EGJOO)
Postsurgical high-resolution impedance manometries (HRIM) findings consistent with EGJOO, likely secondary to anatomic changes, represent a higher portion of our studied population than previously described in the literature
The idiopathic form of EGJOO is defined as an elevated median integrated relaxation pressure (IRP) (≥15mmHg) with preserved peristalsis on HRIM, such that the criteria of achalasia are not met but no anatomic esophageal obstruction exists.(7, 8, 10) Many studies have focused on the idiopathic form of EGJOO but few have performed an in-depth examination of the
Summary
Considerable clinical ambiguity exists over the relevance, optimal evaluation, and treatment of the manometric diagnosis of esophagogastric junction outflow obstruction (EGJOO). Endoscopic evaluation is performed to evaluate dysphagia in adults prior to high-resolution impedance manometry (HRIM); but many times HRIM is completed prior to endoscopic evaluation. This may be a result of centers allowing open access ordering of HRIM by non-gastroenterology providers. Esophageal anatomic obstruction has been associated with the manometric diagnosis of esophagogastric junction outflow obstruction (EGJOO). Endoscopic evaluation is usually the initial step to evaluate dysphagia in adults; many high-resolution impedance manometries (HRIM) are being ordered prior to endoscopy especially in open access settings.
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