Hassan Alsabbak, MD1, Han Zhang, MD2, Eric Pasman, MD3, Matthew Skinner, MD4, Ahmad M. Mansour, MD5, Fouad J. Moawad, MD2 1Scripps Green Hospital, La Jolla, CA; 2Scripps Clinic, San Diego, CA; 3Naval Medical Center San Diego, San Diego, CA; 4Scripps Green - Scripps Clinic, San Diego, CA; 5Scripps Clinic, La Jolla, CA
Introduction: Endoscopic functional lumen imaging probe (EndoFLIP) is an emerging technology used to evaluate different esophageal motility disorders during upper endoscopy. We aimed to examine common indications for EndoFLIP, determine whether testing influenced the final diagnosis and led to changes in management.
Methods: We evaluated 150 consecutive patients referred for esophageal symptoms undergoing FLIP panometry during endoscopy. We measured esophageal diameter, pressure, and distensibility index (DI) during step-wise volumetric distention every 10 mL up to 60 mL using a 16 cm catheter. The results of EndoFLIP were compared to prior results of barium esophagram, and high-resolution manometry (HRM) when available, Descriptive statistical analysis and exact Wilcoxon signed-rank test were completed using R Studio.
Results: The patient population had a median age of 62 years (18-89). There was a slight female predominance (62%). The median duration of esophageal symptoms was 36 months. The most common indications for study were dysphagia (73%), reflux (19%), and chest pain (5%). The most common findings were normal (32%), EGJ outflow obstruction (20%), achalasia (19%), esophageal spasm (12%), and aperistalsis (4%). There was a significant difference in distensibility index (DI) at 60 mL volumetric distension between EGJ outflow (1.2 mm2/mmHg), achalasia (1.7 mm2/mmHg) and normal (4.75 mm2/mmHg ) (p< 0.001). Among patients with a normal HRM (n=19), EndoFLIP detected a motility disorder in 53% (7 had EGJ outflow obstruction and 3 had esophageal spasm). Of the 7 with EGJ outflow obstruction, all had a change in therapy performed during EGD with 4 undergoing pneumatic dilation and 3 receiving botox injection.
Discussion: EndoFLIP is an evolving diagnostic tool which can be performed during upper endoscopy. In some instances, EndoFLIP can diagnose and guide therapy in patients with persistent symptoms and non-diagnostic manometry. .
Hassan Alsabbak indicated no relevant financial relationships.
Han Zhang indicated no relevant financial relationships.
Eric Pasman indicated no relevant financial relationships.
Matthew Skinner indicated no relevant financial relationships.
Ahmad Mansour indicated no relevant financial relationships.
Fouad Moawad indicated no relevant financial relationships.
Hassan Alsabbak, MD1, Han Zhang, MD2, Eric Pasman, MD3, Matthew Skinner, MD4, Ahmad M. Mansour, MD5, Fouad J. Moawad, MD2. P2392 - Single Center Experience With EndoFLIP in the Diagnosis and Treatment of Esophageal Motility Disorders, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.