Fig. 2.

Esophagogastric junction (EGJ) dysfunction revealed during contraction of the abdominal muscles in the manometric study. Increased EGJ compliance may not be apparent until intra-abdominal pressure has increased. Various physical activities performed during manometric examination may reveal EGJ dysfunction. In this case, an abdominal strengthening exercise with leg raises showed the disruption of the EGJ (c) with lower esophageal sphincter-crural diaphragm separation of a size of 2.5 cm (white arrows), and by apparent transient lower esophageal sphincter relaxation (black arrow). EGJ dysfunction was visible neither during the resting phase (a) nor during swallowing (b)