{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:30:54Z","timestamp":1753878654812,"version":"3.41.2"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T00:00:00Z","timestamp":1702166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Introduction<\/jats:title><jats:p>Esophagogastric junction outflow obstruction (EGJOO) is a condition characterized by poor relaxation of the lower esophageal sphincter (LES), which can manifest as dysphagia and chest pain. The best treatment of EGJOO is unknown as some patients improve without any specific therapy, whereas some patients undergo invasive therapy. Currently, prognostic factors are lacking. We aimed to assess the long\u2010term prognosis and predictors of dysphagia and chest pain by the rapid drink challenge and solid bolus swallows in EGJOO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively assessed high\u2010resolution esophageal manometries (HRM) performed at our center between 2015 and 2018. The patients completed a dysphagia and chest pain questionnaire a median of 34\u2009months after the HRM\/baseline assessment, including the Impaction dysphagia questionnaire\u201010 (IDQ\u201010) complemented with questions regarding chest pain and esophageal treatments. Symptoms were compared with HRM findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 980 HRMs were analyzed and 66 (6.5%) were identified as having HRM findings compatible with EGJOO. Of these, 27 patients with EGJOO (41%) completed the follow\u2010up questionnaires and had no exclusion criteria, and 70% of these patients had dysphagia and 44% chest pain at least once a week. Dysphagia at follow\u2010up was more common in patients with elevated integrated relaxation pressure (IRP) on all three HRM metrics (water swallows, solid bolus swallows, and rapid drink challenge) (<jats:italic>p<\/jats:italic>\u2009=\u20090.03, odds ratio: 8.4 (95% CI: 1.2\u201356.0)), but this was not seen for chest pain (<jats:italic>p<\/jats:italic>\u2009=\u20090.45). Abnormal motility patterns on rapid drink challenge or solid bolus swallows were not associated with dysphagia or chest pain at follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Having a high IRP on three HRM metrics\u2014water swallows, solid bolus swallows, and rapid drink challenge\u2014is associated with a worse prognosis in patients with EGJOO and could potentially be used to select candidates suitable for invasive procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14720","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T04:12:53Z","timestamp":1702267973000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Natural history of symptoms and prognostic information of the rapid drink challenge and solid bolus swallows in esophagogastric junction outflow obstruction defined by manometry"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7863-9822","authenticated-orcid":false,"given":"Axel","family":"Josefsson","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Simr\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Center for Functional GI and Motility Disorders University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Smolak","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nour","family":"Sabbagh","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2117-9874","authenticated-orcid":false,"given":"Hans","family":"T\u00f6rnblom","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg 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