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Rapid drink challenge test during esophageal high resolution manometry in patients with esophago‐gastric junction outflow obstruction
Author(s) -
Biasutto D.,
Mion F.,
Garros A.,
Roman S.
Publication year - 2018
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13293
Subject(s) - medicine , achalasia , esophagogastric junction , outflow , high resolution manometry , esophagus , dysphagia , gastroenterology , surgery , adenocarcinoma , physics , cancer , meteorology
Background Esophago‐gastric junction ( EGJ ) outflow obstruction is of unclear significance. Rapid drink challenge ( RDC ) test is easy to perform during esophageal high resolution manometry. We aimed to assess the yield of RDC test in patients with EGJ outflow obstruction. Methods Manometry studies of patients with EGJ outflow obstruction according to the Chicago Classification v3.0 were retrospectively reviewed. Pan‐esophageal pressurization ( PEP ), esophageal shortening, and pressure gradient across the EGJ were analyzed during RDC test (200‐mL free drinking in sitting position) and compared according to the causes of EGJ outflow obstruction determined by charts review. Key Results Seventy‐five patients (29 males, mean age 62 years) were included. Causes of EGJ outflow obstruction were previous esophago‐gastric surgery (40%), incomplete form of achalasia (7%), mediastinal neoplasia (7%), other associated conditions (21%), and undetermined (25%). Rapid drink challenge test was successfully performed in 70 patients and associated with PEP and shortening in 41% and 13%, respectively. The causes of EGJ outflow obstruction were similarly distributed in patients with and without PEP during RDC test. Esophageal shortening tended to be more likely in patients with definitive findings of obstruction (achalasia, previous surgery, neoplasia) than in the others. Dysphagia was more severe in patients with PEP and/or shortening during RDC test compared to those without. Conclusions & Inferences Pan‐esophageal pressurization and esophageal shortening were associated with symptoms severity but did not predict the cause of this disorder. Further prospective studies are necessary to determine if RDC test could help to select patients who might benefit from treatment.