ArticleNeurogastroenterology and motility2019
Pharmacologic interrogation of patients with esophagogastric junction outflow obstruction using amyl nitrite.
Article in Neurogastroenterology and motility, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 37 citations in OpenAlex.
- The conundrum of esophagogastric junction outflow obstruction: Answers to key clinical questions.Annals of the New York Academy of Sciences · 2025Review
- The functional lumen imaging probe contractile response pattern is the best predictor of botulinum toxin response in esophagogastric junction outflow obstruction.Neurogastroenterology and motility · 2024Article
- Esophagogastric Junction Outflow Obstruction (EGJOO): A Manometric Phenomenon or Clinically Impactful Problem.Current gastroenterology reports · 2024Review
- Chicago classification v4.0 protocol improves specificity and accuracy of diagnosis of oesophagogastric junction outflow obstruction.Alimentary pharmacology & therapeutics · 2022Article
- Achalasia.Nature reviews. Disease primers · 2022Review
- Esophageal Motility Disorders: Current Approach to Diagnostics and Therapeutics.Gastroenterology · 2022Review
- Dysphagia: Novel and Emerging Diagnostic Modalities.Gastroenterology clinics of North America · 2021Review
- Normal Values of High-resolution Manometry Parameters With Provocative Maneuvers.Journal of neurogastroenterology and motility · 2021Article
- Chicago classification version 4.0Neurogastroenterology and motility · 2021Review
- Multiple rapid swallows and rapid drink challenge in patients with esophagogastric junction outflow obstruction on high-resolution manometry.Neurogastroenterology and motility · 2021Article
- Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0Neurogastroenterology and motility · 2021Review
- Flip Technology for Assessing Esophageal Structural and Motor Disorders: a Skeptic's View.Current gastroenterology reports · 2020Review
- Motility Patterns Following Esophageal Pharmacologic Provocation With Amyl Nitrite or Cholecystokinin During High-Resolution Manometry Distinguish Idiopathic vs Opioid-Induced Type 3 Achalasia.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020Article
- Diagnosis and Management of Esophagogastric Junction Outflow Obstruction.Gastroenterology & hepatology · 2020Article
- Esophagogastric Junction Outflow Obstruction and Hiatal Hernia: Is Hernia Repair Alone Sufficient?JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe Chicago Classification of esophageal motility includes a group of patients who show evidence of esophagogastric junction outflow obstruction (EGJOO) as demonstrated by elevated integrated relaxation pressure (IRP) and preserved peristalsis. Our aim is to classify EGJOO patients based on response to amyl nitrite (AN) during high-resolution manometry.
methodsPatients were considered to have true EGJOO if elevated IRP during supine swallow persisted in the upright position and was associated with high intrabolus pressure. The EGJ response to AN was compared between patients with achalasia type 2 (A2) and normal esophageal motility. Based on the relaxation gain (deglutitive IRP-AN IRP) value that best discriminated these two groups (10 mm Hg), patients with true EGJOO were categorized as being in either the AN-responsive (AN-R) or AN-unresponsive (AN-U) subgroups. KEY
resultsIn the group of 49 patients with true EGJOO, the AN response classified 27 patients (IRP = 25 ± 10 mm Hg) with AN-R and 22 patients (IRP = 20 ± 5 mm Hg) with AN-U (P = 0.2). In AN-R, AN produced a relaxation gain and rebound after-contraction response at the EGJ comparable to A2 patients. AN-U patients had an elevated IRP after AN and a relaxation gain similar to normal esophageal motility patients. AN-U patients were obese and had higher prevalence of sleep apnea (P < 0.05).
conclusionsAmong patients with true EGJOO, only half have pharmacologic evidence of impaired LES relaxation. Pharmacologic interrogation of the EGJ is thus necessary to identify the subgroup of EGJOO patients who could be expected to benefit from LES ablative therapies.
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