{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:35:01Z","timestamp":1792510501812,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009396","name":"Universit\u00e4tsSpital Z\u00fcrich","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009396","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Standard high\u2010resolution manometry (HRM) protocols are based on 10\u00a0single water swallows acquired in the supine position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the impact of position, rapid drink challenge and solid test meal on the diagnosis of oesophageal motility disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010two healthy volunteers (20\u201076\u00a0years) and 366 consecutive patients (18\u201090\u00a0years) completed HRM with 10 single water swallows in the supine and upright positions. Rapid drink challenge was performed twice, before and after the solid test meal. Diagnosis based on single water swallows in the supine position (Chicago Classification v3.0) was compared with results in the upright position and with provocative tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, diagnostic agreement in the supine and upright positions was present in 296\/438 (67.6%) subjects. This increased to 90.0% when ineffective oesophageal motility was considered with normal motility. Integrated relaxation pressure was 4\u00a0mm Hg higher in the supine position. There was a higher prevalence of inconsistent, likely\u00a0false positive, diagnoses of outlet obstruction in the supine compared to the upright position (16\/20 vs 1\/4 patients, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0007). Similarly,\u00a0the difference in concordance for the\u00a0diagnosis of oesophago\u2010gastric junction obstruction or achalasia\u00a0between single water swallows in the supine and upright positions with solid test meal was significant (12\/29 (41.4%) vs 12\/14 (85.7%), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0087).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diagnostic agreement for oesophageal motility disorders based on single water swallows in the upright and supine positions was moderate, with frequent discordant findings for ineffective motility and outlet obstruction. HRM studies can be performed in either position, using appropriate reference values. Rapid drink challenge or solid test meal can resolve diagnostic discrepancies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15658","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T07:31:33Z","timestamp":1581665493000},"page":"706-718","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Prospective serial diagnostic study: the effects of position and provocative tests on the diagnosis of oesophageal motility disorders by high\u2010resolution manometry"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8719-5175","authenticated-orcid":false,"given":"Benjamin","family":"Misselwitz","sequence":"first","affiliation":[{"name":"Clinic of Visceral Surgery and Medicine Inselspital Bern and Bern University Bern 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