Loyola University Medical Center Maywood, IL, United States
Lauren I. Bloomberg, MD, Arouj Bajwa, MD, Matthew Hoscheit, MD, Nikhil Shastri, MD, Brian Liem, DO, Mukund Venu, MD, FACG Loyola University Medical Center, Maywood, IL
Introduction: Endolumenal Functional Lumen Imaging Probe (EndoFLIP) has emerged as a novel diagnostic tool in evaluating esophageal and gastroesophageal junction (GEJ) disorders. The utility of EndoFLIP as a primary or secondary diagnostic tool requires further investigation. We sought to determine if abnormal EndoFLIP led to less diagnostic testing.
Methods: Single-center, retrospective, cohort study of 149 patients that underwent EndoFLIP testing at Loyola University Medical Center from 2018-2020. Manual chart review was performed to identify findings reported on all procedures related to the evaluation or intervention for esophageal diseases including EndoFLIP, endoscopy, manometry, barium esophagram, pH impedance, and Bravo. All therapeutic surgical or endoscopic interventions performed to treat the esophageal disease were also manually identified.
Results: We identified 119 patients with an abnormal EndoFLIP (Image One). Of these patients, 78% presented with a chief complaint of dysphagia. 36 patients with an abnormal EndoFLIP subsequently had a therapeutic intervention for their esophageal motility disorder. When EndoFLIP was the first diagnostic study (n=11), patients had an average of 0.45 total additional tests and 0.36 additional abnormal tests prior to intervention. When EndoFLIP was a secondary diagnostic study (n=25), patients had an average of 1.92 total additional tests and 1.72 additional abnormal tests prior to intervention. T-test analysis revealed a significant difference in the average number of total tests (p=< 0.001) and average number of abnormal tests (p=< 0.001) when EndoFLIP was the primary diagnostic test compared to a secondary diagnostic test.
Discussion: This study evaluated dysphagia patients who underwent therapeutic intervention to determine if a positive EndoFLIP study would reduce additional diagnostic testing. Patients who underwent EndoFLIP as the primary testing modality had fewer subsequent diagnostic tests prior to intervention compared to patients who had EndoFLIP as a secondary diagnostic modality. EndoFLIP may not add significant information in patients who have completed other esophageal function tests. Utilization of EndoFLIP after initial esophageal function testing should be made on a case-by-case basis.
Figure: Image One
Lauren Bloomberg indicated no relevant financial relationships.
Arouj Bajwa indicated no relevant financial relationships.
Matthew Hoscheit indicated no relevant financial relationships.
Nikhil Shastri indicated no relevant financial relationships.
Brian Liem indicated no relevant financial relationships.
Mukund Venu indicated no relevant financial relationships.
Lauren I. Bloomberg, MD, Arouj Bajwa, MD, Matthew Hoscheit, MD, Nikhil Shastri, MD, Brian Liem, DO, Mukund Venu, MD, FACG. P2382 - Utility of EndoFLIP as a Diagnostic Tool for Patients With Dysphagia, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.