A mechanics-based perspective on the function of the esophagogastric junction during functional luminal imaging probe manometry

Guy Elisha, Sourav Halder, Shashank Acharya, Dustin A. Carlson, Wenjun Kou, Peter J. Kahrilas, John E. Pandolfino, Neelesh A. Patankar*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

The esophagogastric junction (EGJ) is located at the distal end of the esophagus and acts as a valve allowing swallowed food to enter the stomach and preventing acid reflux. Irregular weakening or stiffening of the EGJ muscles results in changes to its opening and closing patterns which can progress into esophageal disorders. Therefore, understanding the physics of the opening and closing cycle of the EGJ can provide mechanistic insights into its function and can help identify the underlying conditions that cause its dysfunction. Using clinical functional lumen imaging probe (FLIP) data, we plotted the pressure-cross-sectional area loops at the EGJ location and distinguished two major loop types—a pressure dominant loop and a tone dominant loop. In this study, we aimed to identify the key characteristics that define each loop type and determine what causes the inversion from one loop to another. To do so, the clinical observations are reproduced using 1D simulations of flow inside a FLIP device located in the esophagus, and the work done by the EGJ wall over time is calculated. This work is decomposed into active and passive components, which reveal the competing mechanisms that dictate the loop type. These mechanisms are esophageal stiffness, fluid viscosity, and the EGJ relaxation pattern.

Original languageEnglish (US)
Pages (from-to)905-923
Number of pages19
JournalBiomechanics and Modeling in Mechanobiology
Volume22
Issue number3
DOIs
StatePublished - Jun 2023

Keywords

  • Elastic tube flow
  • Esophagogastric junction
  • Esophagus
  • Functional lumen imaging probe
  • Peristalsis
  • Pressure-area hysteresis
  • Reduced-order model

ASJC Scopus subject areas

  • Mechanical Engineering
  • Biotechnology
  • Modeling and Simulation

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