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We aimed to: 1) calculate the probability of a random association between reflux and PSPW; 2) characterize factors that could underlie triggering of PSPW and 3) assess the chemical clearance effect of PSPW in healthy asymptomatic subjects.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 251 impedance\u2013pH tracings from healthy asymptomatic subjects were analysed. Twenty consecutive tracings from this pool with 20\u201340 reflux episodes\/24\u00a0h and a PSPW index higher than 50% were separately analyzed to evaluate the probability of a random association between reflux and PSPW. The characteristics of reflux episodes followed by a PSPW were compared with those not associated with PSPW.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A mean time interval of 29.3\u00a0s between a reflux episode and the first swallow captured 71% of total reflux episodes, and 67% of accompanying swallows were non-random. Compared to reflux without PSPW, reflux episodes with PSPW were more frequently acidic (<jats:italic>P<\/jats:italic>\u2009=\u20090.048), mixed with gas (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), of high proximal extent (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), while awake (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), and with shorter chemical clearance time (<jats:italic>P<\/jats:italic>\u2009=\u20090.040). High proximal extent, gas presence and occurring while awake were independent factors associated with PSPW (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Using a time window between reflux and PSPW of around 30\u00a0s, the probability of a chance association is around 30%. Reflux episodes with high proximal extent, containing gas and occurring while awake are important factors associated with PSPW in healthy subjects. Reflux episodes with PSPW have a shorter chemical clearance time.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00535-020-01732-5","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T20:03:00Z","timestamp":1601409780000},"page":"1109-1118","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Post-reflux swallow-induced peristaltic wave (PSPW): physiology, triggering factors and role in reflux clearance in healthy subjects"],"prefix":"10.1007","volume":"55","author":[{"given":"Mengyu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Busra","family":"Yaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Roman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Savarino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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C. Sabine Roman: consulting Medtronic, research support Diversatek Healthcare, Medtronic; Edoardo Savarino: Lecture Fee: Medtronic, Takeda, Janssen, MSD, Abbvie, Malesci; Consulting: Medtronic, Takeda, Janssen, MSD, Reckitt Bencikser, Sofar, Unifarco, SILA, Oftagest. C. Prakash Gyawali consults for Medtronic, Diversatek, Ironwood, IsoThrive and Quintiles. Mengyu Zhang, Busra Yaman and Jerry D. Gardner have no conflict of interest related to this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}