{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:27:18Z","timestamp":1788413238242,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":123,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012164","name":"National High-tech Research and Development Program","doi-asserted-by":"publisher","award":["2010AA023007"],"award-info":[{"award-number":["2010AA023007"]}],"id":[{"id":"10.13039\/501100012164","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The association between reflux events and esophageal motility abnormality is unclear. We aimed to determine the relevance between reflux events and esophageal motility in proton pump inhibitor (PPI)\u2010refractory gastroesophageal reflux disease (GERD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with PPI\u2010refractory or PPI\u2010responsive GERD were enrolled. Ambulatory 24\u2010h esophageal pH\u2013impedance\u2013pressure monitoring was performed. Reflux symptoms, reflux events, and esophageal motility during acid reflux episodes were recorded and compared between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients with PPI\u2010refractory GERD and 18 with PPI\u2010responsive GERD were included, all of whom had pathological gastroesophageal reflux. There were no significant differences in the major acid reflux parameters (DeMeester score and proportion of patients with acid exposure time &gt;\u20096%) between the two groups. However, the number of long acid reflux episodes and the time length of the longest reflux episodes were significantly higher in the PPI\u2010refractory GERD group than in the PPI\u2010responsive GERD group (both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Moreover, patients with PPI\u2010refractory GERD had higher rates of ineffective primary (62.0% vs. 36.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and secondary peristalsis (83.5% vs. 57.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) during long acid exposure (LAE) than those with PPI\u2010responsive GERD. Patients with PPI\u2010refractory GERD having LAE had a significantly lower frequency of primary and secondary peristalsis per minute and required a longer time to initiate secondary peristalsis than those without during their longest acid reflux period in the upright position (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Longer acid reflux episodes in patients with PPI\u2010refractory GERD might result from frequent ineffective primary esophageal peristalsis and delayed initiation of effective secondary peristalsis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.70007","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T06:42:32Z","timestamp":1756795352000},"page":"221-229","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dynamic Relevance Between Reflux Events and Esophageal Motility in Patients With Proton Pump Inhibitor\u2010Refractory Gastroesophageal Reflux Disease"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4888-4610","authenticated-orcid":false,"given":"Si Hui","family":"Lin","sequence":"first","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"},{"name":"Department of Gastroenterology The First Affiliated Hospital of Xiamen University  Xiamen Fujian Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Xiamen University  Xiamen Fujian Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao Hong","family":"Sun","sequence":"additional","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao Qing","family":"Li","sequence":"additional","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui Jun","family":"Fei","sequence":"additional","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Guang","family":"Chen","sequence":"additional","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Guo","sequence":"additional","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei Yun","family":"Ke","sequence":"additional","affiliation":[{"name":"Departement of Gastroenterology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu 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