Flow across the esophagogastric junction is related to opening dimensions.
In this study, physicians from the United States determined whether opening of the relaxed esophagogastric junction was altered in patients with gastroesophageal reflux disease (GERD).
The team evaluated 7 normal subjects, 9 GERD patients without hiatus hernia, and 7 with hiatus hernia.
They measured the cross-sectional area of the relaxed esophagogastric junction during low-pressure distention.
They fluoroscopically imaged swallows at a distensive pressure of 2 to 12 mm Hg.
The diameter of the narrowest point of the esophagogastric junction in PA and lateral projections was measured from digitized images.
The cross-sectional area was also determined as a function of intrabag pressure.
|Minimal esophagogastric junction opening aperture occurred at the diaphragmatic hiatus in all subjects.|
The team found that the minimal esophagogastric junction opening aperture occurred at the diaphragmatic hiatus in all subjects.
They also determined that the esophagogastric junction opening was observed only in hiatus hernia patients at pressures of 0mm Hg.
At pressures greater than 0mm Hg, there were significant increases in esophagogastric junction cross-sectional area both for hiatus hernia and without hiatus hernia, compared with normal subjects.
Dr John Pandolfinoa's team concluded, "Anatomic degradation of the esophagogastric junction distinguishes GERD patients from normal subjects".
"Therapy focused on esophagogastric junction compliance may benefit GERD patients".