{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:58:42Z","timestamp":1779400722498,"version":"3.53.1"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec><jats:label\/><jats:p>Self\u2010diagnosis of retrograde cricopharyngeus dysfunction (RCPD) or abelchia has been increasing over the past 5\u2009years with patients seeking treatment for lifelong symptoms of inability to burp, neck gurgling, bloating, and flatulence. There is a distinct paucity of objective data in diagnosis and underlying pathophysiology of this disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to prospectively evaluate patients with abelchia using standardized investigations to explore possible underlying mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients presenting with clinical scenario consistent with RCPD were recruited into the study after informed consent. All patients underwent standardized investigations: Self reporting questionnaires EAT\u201010, VHI\u201010, and RSI scores, as well as esophagogastroscopy, barium swallow, and high\u2010resolution esophageal manometry (HRM), were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RCPD patients demonstrated a minor increase in the mean EAT\u201010 (5.2 \u00b1\u20091.2) and normal RSI\/VHI\u201010 scores. Barium swallow revealed 53% (CI 38%\u201364%) were abnormal with reflux with hiatus hernia (37%) and dysmotility (16%) as most common findings.<\/jats:p><jats:p>HRM showed that 67% (CI 54%\u201378%) were abnormal. Ineffective motility was found in 41%, a further 23% showed a complete absence of peristalsis, whereas 33% were normal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RCPD is a clinical condition of lifelong inability to belch and associated symptoms. The underlying pathophysiology is poorly understood. This study demonstrates that a significant number of RCPD patients have abnormal esophageal neural network with high proportion of abnormal or absent esophageal peristalsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 135:758\u2013762, 2025<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31811","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T11:58:39Z","timestamp":1727783919000},"page":"758-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Prospective Evaluation of Abelchia\/<scp>RCPD<\/scp> Patients: Abnormalities in High\u2010Resolution Esophageal Manometry"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7080-9567","authenticated-orcid":false,"given":"Jennifer","family":"Anderson","sequence":"first","affiliation":[{"name":"St Michaels Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huixin","family":"Hu","sequence":"additional","affiliation":[{"name":"St Michaels Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Bakhsh","sequence":"additional","affiliation":[{"name":"St Michaels Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Liu","sequence":"additional","affiliation":[{"name":"University Health Network, University of Toronto Canada  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(87)90445-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X19834553"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X21989587"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14250"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00043.2013"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14328"},{"key":"e_1_2_6_8_1","first-page":"27","article-title":"A histological and histochemical study of the cricopharyngeus muscle in man","volume":"156","author":"Bonington A","year":"1988","journal-title":"J Anat"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.255"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00009"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(02)00097-8"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701210"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-0170-0576-7"},{"issue":"10","key":"e_1_2_6_14_1","first-page":"468","article-title":"Chicago classification version 4.0 and its impact on current clinical practice","volume":"17","author":"Richter JE","year":"2021","journal-title":"Gastroenterol Hepatol (NY)"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gh.2020.10.052"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119599692.ch18"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31811","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T06:05:55Z","timestamp":1736748355000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31811"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/lary.31811"],"URL":"https:\/\/doi.org\/10.1002\/lary.31811","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2024-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}