{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:35:30Z","timestamp":1792510530902,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["nyaspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann NY Acad Sci"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Esophagogastric junction outflow obstruction (EGJOO) is a heterogeneous disorder characterized by abnormal esophagogastric junction residual pressures in the setting of intact esophageal body peristalsis. This manometric finding is most clinically relevant in patients with dysphagia and chest pain, and may arise from various mechanisms, including structural processes, catheter positioning artifact, and medications. Rarely, manometric EGJOO is a consequence of abnormal relaxation of the lower esophageal sphincter (LES) akin to achalasia. Thus, it is critical in the evaluation of EGJOO to determine if a true pressure gradient exists across the esophagogastric junction (EGJ) that warrants therapy. There are many unanswered questions in EGJOO diagnosis and management, which are addressed in this review in the context of the use of provocative maneuvers during high\u2010resolution manometry, complementary and alternate testing, and therapeutic options.<\/jats:p>","DOI":"10.1111\/nyas.15362","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:14:00Z","timestamp":1748823240000},"page":"5-10","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The conundrum of esophagogastric junction outflow obstruction: Answers to key clinical questions"],"prefix":"10.1111","volume":"1549","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5481-2499","authenticated-orcid":false,"given":"Kristle Lee","family":"Lynch","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Prakash","family":"Gyawali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Coss\u2010Adame","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n \u201cSalvador Zubir\u00e1n\u201d  M\u00e9xico City M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Siboni","sequence":"additional","affiliation":[{"name":"Department of General and Emergency Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3388-0660","authenticated-orcid":false,"given":"Christopher","family":"V\u00e9lez","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NYU Grossman School of Medicine NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierfrancesco","family":"Visaggi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Sloan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sravanya","family":"Gavini","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Sozzi","sequence":"additional","affiliation":[{"name":"Department of General and Emergency Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology, Department of Medicine &amp; Therapeutics The Chinese University of Hong Kong  Ma Liu Shui Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-0975-7"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14193"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16041"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13712"},{"issue":"2","key":"e_1_2_12_7_1","first-page":"108","article-title":"Esophagogastric junction outflow obstruction: A diagnosis in evolution","volume":"20","author":"Lynch K. 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