Abstract
BACKGROUND: Esophagogastric junction outflow obstruction (EGJOO) is a manometric diagnosis based on Chicago Classification version 4.0 (CC4.0) that requires confirmatory testing for clinical relevancy. However, it is still unclear which patients will respond to therapy. OBJECTIVES: To evaluate manometric and clinical predictors of abnormal confirmatory testing for patients with EGJOO. DESIGN: This was a prospective observational study of patients with manometric EGJOO and chest pain or dysphagia who underwent confirmatory testing. METHODS: Patients with EGJOO on manometry were enrolled and underwent timed barium esophagram or endoFLIP. A subset of patients was given validated surveys, including Eckardt scores (ES) and PROMIS-10. RESULTS: For patients with a CC4.0 EGJOO diagnosis, abnormal peristalsis (OR = 7.0, 95% CI = 1.01-44.6, p = 0.04) and increases in ES (OR = 2.34 95% CI = 1.13-4.86, p = 0.02) were associated with positive confirmatory testing. CONCLUSION: Patients with potentially actionable EGJOO were more likely to have an abnormal peristaltic subtype of EGJOO or higher ES.