{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:48:40Z","timestamp":1791474520721,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T00:00:00Z","timestamp":1495497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Although major manometric abnormalities, the significance of esophagogastric junction outflow obstruction (EGJOO<\/jats:styled-content>) and hypercontractile esophagus (HE<\/jats:styled-content>) is poorly understood. We sought to determine long term outcomes for EGJOO<\/jats:styled-content> and HE<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>High\u2010resolution impedance manometry (HRIM<\/jats:styled-content>) studies conducted from 5\/30\/2012 to 8\/1\/2014 consistent with EGJOO<\/jats:styled-content> and HE<\/jats:styled-content> and normal studies from 5\/30\/12 to 11\/1\/12 were identified. Standardized follow up was conducted with a phone survey utilizing the impact dysphagia questionnaire (IDQ<\/jats:styled-content>\u201010).<\/jats:p><\/jats:sec>Key Results<\/jats:title>56 EGJOO<\/jats:styled-content>, 40 HE<\/jats:styled-content> patients and 33 controls were identified. Structural evaluation with EGD<\/jats:styled-content> and esophagram did not differ among groups. Use of opiates in EGJOO<\/jats:styled-content> (P<\/jats:italic><.05) and of anticholinergics in EGJOO<\/jats:styled-content> and HE<\/jats:styled-content> patients was more prevalent than in controls (P<\/jats:italic><.005). Dysphagia was more common in EGJOO<\/jats:styled-content> (P<\/jats:italic><.05) and chest pain more common in HE<\/jats:styled-content> (P<\/jats:italic><.005) at presentation. While HE<\/jats:styled-content> patients were more likely to be symptomatic (P<\/jats:italic><.05), the majority of EGJOO<\/jats:styled-content> and HE<\/jats:styled-content> patients overall were asymptomatic at a mean 2.8\u00a0years follow up without medical or procedural intervention in the majority (72.5%). Symptom persistence at follow up was predicted by maximum distal contractile integral (DCI<\/jats:styled-content>) and IRP<\/jats:styled-content> in both EGJOO<\/jats:styled-content> and HE<\/jats:styled-content> (P<\/jats:italic><.05).<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>The majority of patients with EGJOO<\/jats:styled-content> and HE<\/jats:styled-content> appear to have a benign clinical course similar to controls in the absence of specific treatment. However, the combination of abnormal IRP<\/jats:styled-content> and DCI<\/jats:styled-content> in both HE<\/jats:styled-content> and EGJOO<\/jats:styled-content> appears to discriminate an important subset of patients who may benefit from treatment. Further refinement of manometric criteria may therefore provide more useful clinical definitions of EGJOO<\/jats:styled-content> and HE<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13105","type":"journal-article","created":{"date-parts":[[2017,5,24]],"date-time":"2017-05-24T00:37:48Z","timestamp":1495586268000},"page":"1-9","source":"Crossref","is-referenced-by-count":92,"title":["The clinical significance of esophagogastric junction outflow obstruction and hypercontractile esophagus in high resolution esophageal manometry"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8952-4577","authenticated-orcid":false,"given":"D.","family":"Schupack","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Katzka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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