Prichard Blaine, Pattison Zachary, Stern Benjamin, Kim Myunghoon, Demian Ereny, Ahmed Gaser, Desai Meeta, Kong Lan, Ouyang Ann
Department of Medicine, Penn State College of Medicine, Hershey, USA.
Department of Medicine, Division of Gastroenterology and Hepatology, Penn State College of Medicine, Hershey, USA.
Cureus. 2024 Nov 30;16(11):e74868. doi: 10.7759/cureus.74868. eCollection 2024 Nov.
Background Our aim was to assess the clinical presentation and outcomes of patients with a manometric diagnosis of esophagogastric junction outflow obstruction (EGJOO) using standardized symptom surveys and comparison to a cohort who were referred for manometry but who had a normal study. Methods We followed a cohort of adult patients without a mechanical obstruction who underwent high-resolution manometry at our medical center from 9/12/19 to 10/4/21 for 16 months. Results Thirty-seven patients with EGJOO (age: 60.8 ± 13.3; female: 25/37) were compared to 33 patients with normal manometry (age: 57.6 ± 13.7; female: 21/33). For the untreated normal manometry group, there was a decrease in dysphagia scores at the six-month follow-up (10.8 ± 10.5 vs. 6.4 ± 10.4, P = 0.009) and a decrease in reflux scores at the 16-month follow-up (11.2 ± 3.0 vs. 7.8 ± 2.8, P = 0.042). For the untreated EGJOO group, there were no statistically significant changes in symptom scores. For both cohorts, dysphagia scores at the time of manometry had an inverse relationship with the change in dysphagia scores (EGJOO: r = -0.446, P = 0.033) (normal manometry: r = -0.464, P = 0.045). Conclusions Patients with EGJOO have a prognosis distinct from patients referred for manometry but who have a normal study and are likely to improve. However, even in patients with EGJOO, severe symptoms are likely to improve. Further investigation of therapies is warranted.
背景 我们的目的是使用标准化症状调查问卷评估经测压诊断为食管胃交界部流出道梗阻（EGJOO）的患者的临床表现和预后，并与一组接受测压但检查结果正常的队列进行比较。方法 我们对一组无机械性梗阻的成年患者进行了随访，这些患者于2019年9月12日至2021年10月4日在我们的医疗中心接受了高分辨率测压，为期16个月。结果 将37例EGJOO患者（年龄：60.8±13.3；女性：25/37）与33例测压正常的患者（年龄：57.6±13.7；女性：21/33）进行比较。对于未经治疗的测压正常组，在6个月随访时吞咽困难评分降低（10.8±10.5对6.4±10.4，P=0.009），在16个月随访时反流评分降低（11.2±3.0对7.8±2.8，P=0.042）。对于未经治疗的EGJOO组，症状评分无统计学显著变化。对于两个队列，测压时的吞咽困难评分与吞咽困难评分的变化呈负相关（EGJOO：r=-0.446，P=0.033）（测压正常：r=-0.464，P=0.045）。结论 EGJOO患者的预后与接受测压但检查结果正常的患者不同，且可能会改善。然而，即使是EGJOO患者，严重症状也可能会改善。有必要对治疗方法进行进一步研究。
