Oesophagogastric junction morphology as depicted in HRM

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Obesity: A Challenge to Esophagogastric Junction Integrity

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Presentation transcript:

Oesophagogastric junction morphology as depicted in HRM Oesophagogastric junction morphology as depicted in HRM. With type 1 morphology the crural diaphragm (CD) component, evident during inspiration (I), is completely superimposed of the lower oesophageal sphincter (LES) component such that the magnitude of the actual LES pressure is not discernible. Oesophagogastric junction morphology as depicted in HRM. With type 1 morphology the crural diaphragm (CD) component, evident during inspiration (I), is completely superimposed of the lower oesophageal sphincter (LES) component such that the magnitude of the actual LES pressure is not discernible. With type 2 morphology, there is partial separation of the LES and CD constituents, but the respiratory inversion point (RIP) remains at the level of the CD, evident by the decrease observed in the LES pressure band during inspiration. Other characteristics of type 2 morphology are that the LES-CD separation is <3 cm and that the pressure trough between the LES and CD is greater than intragastric pressure. With type 3 morphology, there is ≥3 cm separation between the LES and CD and the pressure trough between the two is equal to intragastric pressure during expiration (E). However, the RIP remains at the level of the CD in type 3a and elevated to the level of the LES pressure band with type 3b. This is evident by the decreases in LES pressure during inspiration in type 3a and increases in LES pressure during inspiration in type 3b. C Prakash Gyawali et al. Gut 2018;67:1351-1362 Copyright © BMJ Publishing Group Ltd & British Society of Gastroenterology. All rights reserved.