What causes EGJ outflow obstruction?
Secondary EGJ outflow obstruction is caused by a mechanical obstruction such as lack of EGJ relaxation, hiatal hernia, esophageal malignancy, esophageal stricture, external compression, mitochondrial myopathy, gastric band, or iatrogenic.
What is esophageal outflow obstruction?
Esophagogastric junction outflow obstruction (EGJOO) is an esophageal motility disorder characterized by increased pressure where the esophagus connects to the stomach at the lower esophageal sphincter. EGJOO is diagnosed by esophageal manometry.
How is EGJ outflow obstruction treated?
Oral calcium-channel blockers are the treatment of choice, but botulinum toxin injections may also be employed. Further therapeutic options include endoscopic treatment, such as dilation and endoscopic myotomy[1,3]. In only a minority of patients EGJOO may progress to achalasia[1].
Is EGJ outflow obstruction achalasia?
Abstract: Esophagogastric junction outflow obstruction (EGJOO) is an abnormal topographic pattern seen on high-resolution mano-metry. EGJOO is characterized by an elevated median integrated relaxation pressure with intact or weak peristalsis, thus not meeting the criteria for achalasia.
What Egj means?
Esophagogastric junction, see there.
How serious is achalasia?
Is achalasia serious? Yes, it can be, especially if it goes untreated. If you have achalasia, you’ll gradually experience increased trouble eating solid foods and drinking liquids. Achalasia can cause considerable weight loss and malnutrition.
How do you treat ineffective esophageal motility?
What is the treatment for esophageal dysmotility? Achalasia may be treated with drugs that relax smooth muscle and prevent spasm, such as isosorbide dinitrate or nifedipine. Pneumatic dilation is a procedure that dilates the LES with a high-pressure balloon.
What is Egj morphology?
EGJ morphology was categorized into type 1 (superimposed LES and crural diaphragm), type 2 (<3 cm separation between LES and crural diaphragm), and type 3 (≥3 cm separation). EGJ-contractile integral (EGJ-CI) and distal contractile integral (DCI) were extracted.
What is the life expectancy of achalasia?
Type 2 achalasia has the best response to treatment, with studies suggesting over 90% response to conventional treatments. Patients with treated achalasia generally do well, with a life expectancy no different than the general population.
Is esophageal dysmotility serious?
Primary esophageal spasm is rarely life threatening, and the most important element in treatment is often reassurance. However when dysphagia or chest pain is frequent or severe, drugs that decrease smooth muscle contractility are often used.
Which type of achalasia is most severe?
Type II achalasia has the best response to treatment, followed by type I achalasia, whereas type III achalasia is the most difficult to treat.
What is Type 1 Egj morphology?
This is a fundamental feature or EGJ morphology, likely pertinent to its functional integrity. With type I EGJ morphology, there is complete overlap of the CD and LES with no spatial separation evident on the Clouse plot (Figure 1) and no double peak on the associated spatial pressure variation plot.
What drugs are used to treat esophageal dysmotility?
Medication Summary Commonly used medications for patients with esophageal motility disorders include calcium channel blockers, smooth muscle relaxants, anticholinergics, and antianxiety medications.
What is esophagogastric junction outflow obstruction (egjoo)?
The diagnosis of esophagogastric junction outflow obstruction (EGJOO) is currently based on high-resolution esophageal manometry and is characterized by impaired EGJ relaxation with preserved esophageal peristalsis.
What is the pathophysiology of egjoo syndrome?
EGJOO is characterized by an elevated median integrated relaxation pressure with intact or weak peristalsis, thus not meeting the criteria for achalasia. This diagnosis has a female predominance and is associated with varying presenting symptoms. EGJOO can be idiopathic or secondary.
What is the intrabolus pressure in egjoo?
In a study of 11 patients with EGJOO, all patients who had delayed emptying on timed barium esophagram had an intrabolus pressure on manometry of greater than 24 mm Hg. 29 These aforementioned measurements of bolus transit are easily evaluated on routine manometry and are a simple way to potentially stratify patients with EGJOO.
Is high-resolution manometry of the esophagus necessary for diagnostic outflow obstruction?
The worldwide use of high-resolution manometry (HRM) of the esophagus continues on an upward trajectory. Intuitively, this leads to the continued need for refinement of diagnostic topographic patterns. Esophagogastric junction outflow obstruction (EGJOO) is a diagnosis of unclear etiology, defined solely by abnormal manometric parameters.