| Background and aim: Esophagogastric junction outflow obstruction (EGJOO) is a new disease entity characterized by impaired EGJ relaxation but with preserved peristalsis, causing dysphasia and dyspepsia. We have found that impaired EGJ accommodation underlies the pathogenesis of EGJOO, 50 % of which is also accompanied by impaired gastric accommodation. There seems to be similarities between EGJOO and functional dyspepsia in their pathogenesis, suggesting that acotiamide could be effective for EGJOO. The objective of the present study was to explore whether acotiamide was effective for EGJOO. Methods: Between May 2015 and Sep 2018, a total of 25 patients with EGJOO were enrolled in this study. High-resolution manometry was performed before and after the treatment of acotiamide (300 mg/day) for 4 weeks. Results: The median FSSG was 15.0 (6.5-20). Esophageal motility function was normalized in 12 patients (effective group) with efficacy rate of 48 %. In effective group, the BEGJP and IRP (28.9, 23.4-37.8 and 12.9, 9.3-13.9 mmHg) after treatment were lower than those (38.9, 31.1-48.4 and 18.5, 16.7-20.6 mmHg) before treatment, respectively. As for the factors associated with efficacy of acotiamide, the BEGJP of ineffective group (53.3, 42.1-65.7 mmHg) was higher than that of effective group (38.9, 31.1-48.4 mmHg). Conclusions: acotiamide was effective for approximately 50 % of EGJOO where elevated BEGJP could be associated with low-efficacy of acotiamide for EGJOO. |
