Analysis Of Clinical Features And Esophageal Motility Characteristicsin Patients With EGJ Outflow Obstruction

Objective:The aim this study is to analyze the clinical features and esophageal motility characteristics of patients with EGJ outflow obstruction and to raise awareness of EGJ outflow obstruction.Methods:From January 2015 to January 2018,patients due to various gastrointestinal symptoms were enrlooed to the Department of Gastroenterology,Affiliated Hospital of Zunyi Medical College,Guizhou Province.The patients were examined gastroscopy andhigh resolution esophageal manometry(HRM)to exclude other gastrointestinal diseases.There were 120 cases in totaland were correctly diagnosed as EGJ outflow obstruction(Eoo group)and non-EGJ outflow obstruction(non-Eoo group)according to the 2015 of the Chicago esophageal motility disorder classification criteria,71Eoo cases and 49Eoo cases.Retrospective analysis of the clinical materials of two groups,including general data,clinical symptoms and high resolution esophageal manometric parameters(IRP,LES,LESL,LESP relaxation rate%,UESP,UESRP,IBP,DCI,CFV,DL,peristaltic wave duration)and other indicators,and to compare the differences in thetwo groupswith the statistics,to investigate the clinical features and the characteristics of esophageal motility in Eoogroup.Result:71 patients of Eoo group and 49 patients of non-Eoo group,a comprehensive analysis of the two groups,it is including age,height,weight,body mass index,symptoms,esophageal motility parameters can be drawn:1)There were 52 females and 19 males in the 71 patients of Eoo group,the average age were(45.04±10.26)years old,body weight was(54.99±7.18)Kg,height was(159.38±6.62)cm,body mass index was(21.60±2.14)Kg/m~2.There was no significant difference in age,weight,heightand body mass index between Eoo group and non-Eoo group(P>0.05).2)In the 71 patients of Eoo group,the symptoms were primarily heartburn or acid(44%),obstruction(32%),chest pain(21%)and other atypical symptoms of GERD(hiccups,bloating,etc.)(21%),Abdominal pain(6%).3)The HRM correlation parameters are compared between two groups:there was no significant difference between the two groups in the duration of UESP,UESRP,CFV and peristalsis(P>0.05).The levels of IRP,LESL,LESP,IBP in the patients with Eoo were higher than those in groupof non-Eoo group(P<0.05).LES relaxation rate and DCI in Eoo group were lower than the non-Eoo group,the difference was statistically significant(P<0.05).4)In 71 patients of EGJOO,the IRP was segmented divided three groups,into mild group(15-17.9),moderategroup(18-20.9)andsevere group(>21),respectively,and the conclusion was drawn among the three groups:the LES relaxation rate,LESL,UESP,UESRP,CFV,DL and wriggling wave were not statistically significant in three groups(P>0.05).The comparison of IBP amongthe three groups showed that the mild group lower than the moderate group(P=0.022),mild group lower than the severe group(P=0.006).The comparison of DCI among the three groups showed that the mild group lower than the moderate group(P=0.011).Conclusion:1)Among the 71 patients with EGJOO,there are more women than men,and with a good age of 30-50.2)Among the 71 patients with EGJOO,the most common symptoms are the heartburn or acid reflux and dysphagia.3)High-resolution esophageal manometry is the main diagnosis basis for patients with EGJOO,and the IRP can better reflect the function of LES relaxation.4)The LESP of EGJOO patients is higher than that of non-EGJOO patients,and the relaxation rate of LES is lower than that of non-EGJOO patients.5)The increase of IBP is an indirect expression of the relaxation disorder in EGJOO patients,and the IRP value is positively correlated with the IBP value.6)Patients with EGJOO have less DCI than non-EGJOO patients,and the weaker the peristalsis of the esophagus,the more difficulty in swallowing,and the higher the degree of dysphagia.