Distensibility of the esophagogastric junction assessed with the functional lumen imaging probe (FLIP™) in achalasia patients

Background The functional lumen imaging probe (FLIP), measures esophagogastric junction (EGJ) distensibility (cross‐sectional area/luminal pressure) during volume‐controlled distension. The aim of this study is to apply this tool to the assessment of the EGJ in untreated and treated achalasia patients and to compare EGJ distensibility with other diagnostic tools utilized in managing achalasia. Methods Findings from FLIP, high‐resolution manometry (HRM), timed barium esophagram, and symptom assessment by Eckardt Score (ES) were compared in 54 achalasia patients (23 untreated, 31 treated). Twenty healthy volunteers underwent FLIP as a comparator group. The EGJ distensibility index (EGJ‐DI) was defined at the ‘waist’ of the FLIP bag during volumetric distension, expressed in mm2 mmHg−1. The ES was used to gauge treatment outcome: good response