Korean Medicine Treatment for Esophagogastric Junction Outflow Obstruction (EGJOO): A Case Report

Background: Esophagogastric junction outflow obstruction (EGJOO) is characterized by increased resistance at the esophagogastric junction due to insufficient lower esophageal sphincter relaxation, while esophageal peristalsis is preserved. Because the clinical course and treatment response of EGJOO vary, less invasive supportive approaches may be considered, particularly when invasive procedures are difficult to perform. This case report describes the clinical course of an older patient with EGJOO who received Korean medicine treatment.Case Presentation: A 77-year-old man was admitted with persistent dyspepsia, nausea, and dysphagia. High-resolution esophageal manometry demonstrated elevated lower esophageal sphincter basal respiratory pressure and integrated relaxation pressure, partially preserved esophageal peristalsis, and reduced bolus clearance, supporting a clinical diagnosis of EGJOO. Korean medicine treatment consisted of <i>Hyangsapyeongwi-san</i>, modified <i>Bojungikgi-tang</i>, acupuncture, indirect moxibustion, cupping, and infrared therapy. Botulinum toxin injection at the lower esophageal sphincter was also performed. Gastrointestinal symptoms, including epigastric fullness, nausea, heartburn, and abdominal pain, were assessed using the Numerical Rating Scale, and dietary intake and body weight were monitored.Results: During Korean medicine treatment, patient-reported symptoms gradually decreased, and food intake improved. After botulinum toxin injection, gastrointestinal symptoms temporarily worsened, and body weight decreased; however, symptoms subsequently improved with continued Korean medicine treatment. At discharge, the primary gastrointestinal symptoms were reduced, and body weight had partially recovered.Conclusion: This case suggests that Korean medicine treatment may help manage symptoms and support nutritional recovery in patients with EGJOO. Further studies incorporating objective follow-up assessments are needed.