ArticleDigestive diseases and sciences2016
Esophagogastric Junction Morphology and Distal Esophageal Acid Exposure.
Article in Digestive diseases and sciences, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 26 citations in OpenAlex.
- Assessment of Esophagogastric Junction Barrier Function With the Supine-Upright Transition of the Chicago Classification Protocol.Neurogastroenterology and motility · 2025Article
- Correlation between the type of esophagogastric junction and refractory reflux esophagitis.International journal of clinical and experimental pathology · 2025Article
- Advancing high-resolution manometry: evaluating the use of multiple rapid swallows versus apple viscous swallows in clinical practice.Esophagus : official journal of the Japan Esophageal Society · 2022Article
- Preoperative measurement of the hiatal surface with MDCT: impact on surgical planning.La Radiologia medica · 2021Article
- Sliding Hiatus Hernia: A Two-Step Pressure Pump of Gastroesophageal Reflux.Gastroenterology · 2021Article
- Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0Neurogastroenterology and motility · 2021Review
- Utility of Esophageal High-Resolution Manometry in Clinical Practice: First, Do HRM.Digestive diseases and sciences · 2018Review
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Authors and funding
6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Chicago classification has recently added a morphological subclassification for the esophagogastric junction (EGJ). Our aim was to assess the distal esophageal acid exposure in patients with this new Chicago EGJ-type IIIa and IIIb classification. STUDY
designFrom a prospectively collected high-resolution manometry (HRM) database, we identified patients who underwent 24-h pH study between October 2011 and June 2015 and were diagnosed with EGJ-type III based on HRM. Chicago EGJ-type III is defined as the inter-peak nadir pressure ≤gastric pressure and a lower esophageal sphincter (LES)-crural diaphragm (CD) separation >2 cm [IIIa-pressure inversion point (PIP) remains at CD level and IIIb-PIP remains at LES level]. We classified the patients into reflux group [DeMeester score >14.72 or Fraction time pH (<4) > 4.2 %] and non-reflux group based on 24-h pH study.
resultsFifty patients were identified that satisfied the study criteria, of which 37 patients (74 %) were EGJ-type IIIa. In those with EGJ-type IIIb, abdominal LES length (AL) in reflux group was significantly shorter than the non-reflux group (0.8 vs. 1.8, p < 0.05). EGJ-type IIIa patients showed significantly higher value for DeMeester score and Fraction time pH and more often had a positive pH study than EGJ-type IIIb patients (DeMeester score: 26.7 vs. 11.7, p < 0.05; Fraction time pH: 7.9 vs. 2.6, p < 0.05; positive pH study: 81.1 vs. 30.8 %, p < 0.001). Reflux was more common in LES-CD ≥ 3 cm than that in LES-CD < 3 cm (85 vs. 56.7 %, p < 0.05).
conclusionA subset of patients with >2-cm LES-CD separation (type IIIb) maintain a physiological intra-abdominal location of the EGJ and are less likely to have reflux. A LES-CD ≥ 3 cm seems to discern a hiatus hernia of clinical significance.
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