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Esophagogastric junction contractile integral abnormalities in patients with proton pump inhibitor‐refractory symptoms
Author(s) -
Wang Yan,
Ding Yu,
Lin Lin,
Jiang Liu Qin
Publication year - 2021
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.13038
Subject(s) - medicine , refractory (planetary science) , reflux , gastroenterology , gerd , heartburn , esophagogastric junction , proton pump inhibitor , regurgitation (circulation) , high resolution manometry , basal (medicine) , cardiology , disease , adenocarcinoma , physics , cancer , astrobiology , insulin
Objectives Esophagogastric junction contractile integral (EGJ‐CI) is a novel indicator to evaluate quantitatively the esophagogastric junction (EGJ) barrier function. We aimed to assess the role of EGJ‐CI in patients with refractory gastroesophageal reflux disease (GERD) symptoms and the correlation between EGJ‐CI and impedance‐pH monitoring characteristics. Methods In total 82 patients with proton pump inhibitors (PPIs)‐refractory gastroesophageal reflux symptoms (heartburn or regurgitation) were enrolled. These patients were further divided into two groups based on their EGJ‐CI value (39 mmHg·cm). The mean nocturnal baseline impedance (MNBI) was measured to explore its association with EGJ‐CI. Results The median EGJ‐CI in patients with PPI‐refractory symptoms was 30.8 mmHg·cm. EGJ‐CI was inversely correlated with acid exposure time and reflux episodes; while it was positively correlated with MNBI, distal contractile integral, lower esophageal sphincter basal pressure and integrated relaxation pressure. Patients were further divided into the high (n = 27) and low (n = 55) EGJ‐CI groups using a cut‐off value of 39.0 mmHg·cm. Patients with a low EGJ‐CI had a lower MNBI level than those with a high EGJ‐CI (2703 Ω vs 3545 Ω, P = 0.034). Conclusions In patients with PPIs‐refractory symptoms, EGJ‐CI is associated with acid exposure and conventional high‐resolution manometry parameters. EGJ‐CI may play an important role in the diagnosis and treatment of patients with refractory GERD.