J Neurogastroenterol Motil.  2019 Oct;25(4):521-524. 10.5056/jnm19025.

Elevated Intrabolus Pressure Predicts Abnormal Timed Barium Esophagram in Esophagogastric Junction Outflow Obstruction

Affiliations
  • 1Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA. matthew.j.hoscheit@gmail.com
  • 2Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, OH, USA.

Abstract

BACKGROUND/AIMS
Timed barium esophagram (TBE) is used the classification of esophageal motility disorders and assessing esophageal function. Currently, there are no published studies examining the relationship between high-resolution manometry and TBE in patients with esophagogastric junction outflow obstruction (EGJOO). This study seeks to evaluate this relationship and identify manometric variables that may indicate further evaluation using TBE.
METHODS
Retrospective review of medical records identified patients with a diagnosis of EGJOO per the Chicago classification version 3.0. TBE was performed using standard protocol. Patients were divided into 2 groups based on complete emptying or persistence of standing barium column at 5 minutes.
RESULTS
Eleven patients were identified with EGJOO who underwent both high-resolution manometry and TBE within 3 months. Five patients had no standing barium column at 5 minutes, while 6 patients had a persistent barium column. Mean age of each group was 54.0 years and 57.8 years, respectively. Patients with abnormal TBE were found to have significantly elevated intrabolus pressure (IBP) compared with patients who had a normal TBE.
CONCLUSIONS
In our study, we found significant differences in IBP between these patient groups. These findings suggest that patients with EGJOO and elevated IBP may prompt further clinical evaluation with TBE in order to clarify clinical diagnosis and guide therapeutic intervention.

Keyword

Chicago; Esophageal motility disorders; Gastrointestinal transit; Humans; Manometry

MeSH Terms

Barium*
Classification
Diagnosis
Esophageal Motility Disorders
Esophagogastric Junction*
Gastrointestinal Transit
Humans
Manometry
Medical Records
Retrospective Studies
Barium
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