Endoscopy 2004; 36 - 8
DOI: 10.1055/s-2004-834496

New Measurements of Oesophago-Gastric Junction Function

BP McMahon 1, J Frokjaer 1, P Kunwald 1, AM Drewes 1, H Gregersen 1
  • 1Centre for Visceral Biomechanics & Pain, Aalborg Hospital and Centre for Sensory Motor Interaction, Aalborg University, Aalborg, Denmark

Aims: To develop a method to biomechanically measure the competence of the sphincteric region at the oesophago-gastric junction (OGJ), which comprises the lower oesophageal sphincter (LOS) and the diaphragmatic hiatus.

Methods: A bag-like balloon 9.5cms long and 2.5cms in diameter was mounted on a 5mm catheter, with electrodes mounted in it, suitable for measuring three cross sectional areas (CSA) in the LOS 4mm apart. The balloon was inserted orally in three volunteers and a perfused manometric system in the catheter was used to locate the LOS high-pressure zone. The system displayed balloon pressure and CSA. By calculation the distensibility of the OGJ could be represented by a plot of the circumferential tension in the junction.

Results: It was possible to place the probe in the OGJ and record CSA and balloon pressure. Higher tension measurements were seen towards the proximal end of the OGJ, e.g., rising in one volunteer from 100Nm at a distension diameter of 9mm to 400Nm at 24mm.

Conclusions: This new technique can measure tension in the OGJ and has the potential to objectively distinguish between a competent and incompetent OGJ. It may have a role in measuring sphincter competence and assessing OGJ function in patients before and after therapy.