Esophagogastric Junction Morphology is Associated with Ambulatory Reflux Monitoring Phenotypes in Patients Evaluated for Gastroesophageal Reflux Disease

Öz

Aim: To evaluate whether high-resolution manometry-defined esophagogastric junction (EGJ) morphology is associated with objective reflux burden in adults evaluated for suspected gastroesophageal reflux disease. Materials and Methods: Consecutive adults evaluated between January 2021 and December 2025 were retrospectively screened. After exclusions, 243 patients who completed 36-channel high-resolution manometry and off-proton-pump-inhibitor pH-metry were included. Abnormal acid exposure time (AET) was defined as AET >6%. Associations were assessed using non-parametric tests and logistic regression adjusted for age, sex, hiatal hernia size, and lower esophageal sphincter pressure. Results: Mean age was 42.0 years and 146 patients (60.1%) were male. EGJ morphology was Type I in 111 patients, Type II in 81, and Type III in 51. Abnormal AET occurred in 38.7%, 22.2%, and 78.4% of Types I, II, and III, respectively (p<0.001). Median AET was 3.66%, 3.75%, and 10.79% (p<0.001). In the extended model, Type III remained associated with abnormal AET compared with Type I (OR 5.08, 95% CI 1.21-21.24; p=0.026). Conclusion: Type III EGJ morphology was associated with higher objective reflux burden, whereas Type II showed a heterogeneous pattern. EGJ morphology may complement, but should not replace, ambulatory reflux testing.

Anahtar Kelimeler

• gastroesophageal reflux disease
• esophagogastric junction
• high-resolution manometry
• acid exposure time
• pH monitoring

Kaynakça

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