{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:25:37Z","timestamp":1786116337702,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["003322121"],"award-info":[{"award-number":["003322121"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["242021"],"award-info":[{"award-number":["242021"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Advanced cystic fibrosis lung disease (ACFLD) remains a major cause of morbidity, particularly in individuals requiring lung transplantation. Gastrointestinal\u2010related aspiration (GRASP), including reflux and motility disorders, may contribute to adverse respiratory outcomes, yet diagnostic and management strategies vary across specialties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate practice patterns in foregut testing and pharmacologic management of GRASP among pulmonologists and gastroenterologists caring for individuals with ACFLD, with and without transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional survey of clinicians at cystic fibrosis centers was distributed via a national listserv. Respondents involved in ACFLD care were included. Descriptive statistics were generated, and comparisons by specialty were performed using Fisher's exact and Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010five complete responses were analyzed (82% pulmonologists, 18% gastroenterologists). Eighty percent reported access to gastrointestinal motility testing. Overall use of reflux, motility, and gastric emptying testing was similar between specialties; however, modality selection differed. Gastroenterologists favored pH multichannel intraluminal impedance (75%) and BRAVO capsule testing (25%), while pulmonologists demonstrated heterogeneous practices and frequently deferred testing (37.8%). High\u2010resolution manometry was universally preferred by gastroenterologists but variably used by pulmonologists. Acid suppression was widely utilized, with proton pump inhibitors most common, though pulmonologists showed greater variability, particularly post\u2010transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Substantial variability exists in GRASP evaluation and management in ACFLD. Standardized, multidisciplinary approaches may improve diagnostic consistency and optimize outcomes, especially in the transplant population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71740","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:34:08Z","timestamp":1784540048000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Divergent Management of the Foregut Between Pulmonologists and Gastroenterologists in Advanced Cystic Fibrosis Lung Disease"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4611-0814","authenticated-orcid":false,"given":"Dhiren","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Pediatrics Saint Louis University School of Medicine, Division of Pediatric Gastroenterology, Hepatology and Nutrition, SSM Cardinal Glennon Children's Medical Center St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"King","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology, National Jewish Health Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Wilder","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Saint Louis University School of Medicine, Division of Pediatric Gastroenterology, Hepatology and Nutrition, SSM Cardinal Glennon Children's Medical Center St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1742-6609","authenticated-orcid":false,"given":"Noor","family":"Al\u2010Hammadi","sequence":"additional","affiliation":[{"name":"Department of Health and Clinical Outcomes Research Saint Louis University School of Medicine St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Hejazi","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology, Hepatology &amp; Motility, University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodie","family":"Barkin","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology, University of Miami Miller School of Medicine Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Hachem","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology, Saint Louis University School of Medicine St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"V\u00e9lez","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Center for Neurointestinal Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhlto.2024.100171"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1758731"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.07.85"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2017.05.006"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2004.11.312"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i41.6322"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2021.05.016"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhlto.2025.100363"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874306401812010001"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001538"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001874"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.01.025"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2025.08.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14120"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2023-330616"},{"key":"e_1_2_10_17_1","unstructured":"N.Al\u2010Hammadi 2013 SAS\/STAT\u00ae 9.4 User's Guide (SAS Institute Inc)."},{"key":"e_1_2_10_18_1","unstructured":"N.Al\u2010Hammadi 2023 R: A Language and Environment for Statistical Computing. 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