{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:14:33Z","timestamp":1770275673955,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Ineffective esophageal motility (IEM) on high\u2010resolution manometry (HRM) is not consistently associated with specific clinical syndromes or outcomes. We evaluated the prevalence, clinical features, management, and outcomes of pediatric IEM patients across the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical and manometric characteristics of children undergoing esophageal HRM during 2021\u22122022 were collected from 12 pediatric motility centers. Clinical presentation, test results, management strategies, and outcomes were compared between children with IEM and normal HRM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 236 children (median age 15 years, 63.6% female, 79.2% Caucasian), 62 (23.6%) patients had IEM, and 174 (73.7%) patients had normal HRM, with similar demographics, medical history, clinical presentation, and median symptom duration. Reflux monitoring was performed more often for IEM patients (25.8% vs. 8.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), but other adjunctive testing was similar. Among 101 patients with follow\u2010up, symptomatic cohorts declined in both groups in relation to the initial presentation (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.107 for each comparison) with management targeting symptoms, particularly acid suppression. Though prokinetics were used more often and behavioral therapy less often in IEM (<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.015 for each comparison), symptom outcomes were similar between IEM and normal HRM. Despite a higher proportion with residual dysphagia on follow\u2010up in IEM (64.0% vs. 39.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.043), an alternate mechanism for dysphagia was identified more often in IEM (68.8%) compared to normal HRM (27.8%, <jats:italic>p<\/jats:italic>\u2009=\u20090.017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>IEM is a descriptive manometric pattern rather than a clinical diagnosis requiring specific intervention in children. Management based on clinical presentation provides consistent symptom outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12324","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T07:24:06Z","timestamp":1721114646000},"page":"541-549","source":"Crossref","is-referenced-by-count":1,"title":["Ineffective esophageal motility: Characterization and outcomes across pediatric neurogastroenterology and motility centers in the United States"],"prefix":"10.1002","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5615-8253","authenticated-orcid":false,"given":"Trevor A.","family":"Davis","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin D.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St. 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Gastroenterology University of Washington School of Medicine Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul E.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desale","family":"Yacob","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corey","family":"Baker","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Connecticut Children's Medical Center Hartford Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana Prada","family":"Rey","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Universidad El Bosque Bogot\u00e1 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno P.","family":"Chumpitazi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Duke University School of Medicine Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kesha","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Texas Children's Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neetu B.","family":"Puri","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonel","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Yale School of Medicine New Haven Connecticut 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