{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T15:54:49Z","timestamp":1790956489951,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peroral endoscopic myotomy (POEM) effectively treats achalasia but confers a significant risk of postoperative gastroesophageal reflux. Studies demonstrate poor short-term correlation between reflux symptoms and objective findings, but long-term outcomes remain unclear. We evaluated long-term GERD Health-Related Quality of Life (GERD-HRQL) scores, Bravo pH results, and proton pump inhibitor (PPI) use after POEM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective survey study of adults who underwent POEM at our institution from 2011 to 2024 with\u2009&gt;\u20091\u00a0year of follow-up. Standardized surveys included the validated GERD-HRQL questionnaire and questions regarding PPI use and post-POEM interventions. Chart review verified medication use, Bravo results, and endoscopic findings. The primary endpoint was reflux symptom control, defined as GERD-HRQL score\u2009&lt;\u200910. Secondary endpoints included chronic PPI use (&gt;\u20096\u00a0months), Bravo results, and the reflux\u2013dysphagia relationship. Multivariable logistic regression identified predictors of reflux symptom control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy-nine patients completed the questionnaire at a median follow-up of 68\u00a0months. The median GERD-HRQL score was 10 (IQR 4\u201317), with 42 patients (53.2%) reporting clinically significant reflux (GERD-HRQL\u2009\u2265\u200910). Most (58; 73.4%) had chronic PPI use, 55.2% of whom reported poor symptom control. Among patients with GERD-HRQL\u2009\u2265\u200910, 52.4% had Eckardt scores\u2009&gt;\u20093, suggesting concurrent dysphagia. Thirty-one patients underwent post-POEM Bravo; results were negative in 13 (41.9%), positive in 13 (41.9%), and inconclusive in 5 (16.1%). Six of 10 Bravos performed for reflux symptoms were negative. Endoscopy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200956) demonstrated esophagitis in 16 patients (28.6%). Older age (OR 1.04; 95% CI 1.01\u20131.08) and preoperative weight loss\u2009\u2265\u20095\u00a0kg (OR 6.72; 95% CI 1.57\u201328.74) predicted reflux control on multivariable analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At long-term follow-up, over half of patients reported clinically significant reflux, and most required chronic PPI therapy. Reflux symptoms correlated inconsistently with objective findings, mirroring short-term data and highlighting the need for ongoing surveillance and targeted reflux mitigation after POEM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13205-6","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:34:47Z","timestamp":1785767687000},"page":"9041-9049","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reflux symptom burden and objective findings at long-term follow-up after peroral endoscopic myotomy"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3281-5134","authenticated-orcid":false,"given":"Natalie N.","family":"Chakraborty","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily F.","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Specht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Lyons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Siddiq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maham","family":"Babur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayvan","family":"Barekatain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Lal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina S.","family":"Boutros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Wieland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saher-Zahra","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Chatha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Benson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette","family":"Winder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"issue":"20","key":"13205_CR1","doi-asserted-by":"publisher","first-page":"1961","DOI":"10.1056\/NEJMra2000328","volume":"383","author":"R Mittal","year":"2020","unstructured":"Mittal R, Vaezi MF (2020) Esophageal motility disorders and gastroesophageal reflux disease. 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Chakraborty, Emily F. Simon, Julia Specht, Joshua Lyons, Ayesha Siddiq, Maham Babur, Kayvan Barekatain, Trisha Lal, Christina S. Boutros, Patrick Wieland, Saher-Zahra Khan, Hamza Chatha, Jamie Benson, Nicolette Winder, and Jeffrey M. Marks have no conflicts of interest or financial ties to disclose.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}