{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T08:44:31Z","timestamp":1697445871695},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,19]],"date-time":"2012-12-19T00:00:00Z","timestamp":1355875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>There are heterogeneous subgroups among those with heartburn, and data on these individuals are relatively scant. We aimed to evaluate the effect of acid challenge on the segmental contractions of esophageal smooth muscle in endoscopy\u2010negative patients with normal esophageal acid exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>High\u2010resolution esophageal manometry (<jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content>) was performed on 30 endoscopy\u2010negative patients with heartburn accompanied by normal esophageal acid exposure using 10 water swallows followed by 10 acidic pomegranate juice swallows. Patients were classified into functional heartburn (<jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content>) and hypersensitive esophagus (<jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>) groups based on the results of 24\u2010hr impedance <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> testing. <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> topographic plots were analyzed and maximal wave amplitude and pressure volumes were measured for proximal and distal smooth muscle segments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pressure volume of the distal smooth muscle segment in the <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> group measured during acidic swallows was higher than during water swallows (2224.1\u2009\u00b1\u200968.2\u2009<jats:styled-content style=\"fixed-case\">mmHg<\/jats:styled-content>\/cm per s versus 2105.6\u2009\u00b1\u200966.4\u2009<jats:styled-content style=\"fixed-case\">mmHg<\/jats:styled-content>\/cm per s, <jats:italic>P<\/jats:italic>\u2009=\u20090.027). A prominent shift in the pressure volume to the distal smooth muscle segment was observed in the <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> group compared with the <jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content> group (segmental ratio: 2.72\u2009\u00b1\u20090.08 versus 2.39\u2009\u00b1\u20090.07, <jats:italic>P<\/jats:italic>\u2009=\u20090.005). Manometric measurements during acidic swallows revealed that this shift was augmented in the <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> group. The optimal ratio of pomegranate juice swallowing for discrimination of <jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> was 2.82, with a sensitivity of 88.9% and a specificity of 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hypercontractile response of distal smooth muscle segment to acid swallowing was more prominent in the <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> group than the <jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content> group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1440-1746.2012.07258.x","type":"journal-article","created":{"date-parts":[[2012,9,18]],"date-time":"2012-09-18T13:01:24Z","timestamp":1347973284000},"page":"84-89","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effect of acid swallowing on esophageal contraction in patients with heartburn related to hypersensitivity"],"prefix":"10.1111","volume":"28","author":[{"given":"Hyuk","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Kil","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Chul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Kwan","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Chan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,12,19]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03901.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2004.03591.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.670"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02119.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000103879"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.02.016"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.6.885"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.08.060"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2011.01.016"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01834.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01787.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2012.07110.x"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01532.x"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.2001.281.3.G743"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01672.x"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2005.12.011"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90815-X"},{"key":"e_1_2_5_19_1","first-page":"358","article-title":"The symptom index: a clinically important parameter of ambulatory 24\u2010hour esophageal pH monitoring","volume":"83","author":"Wiener GJ","year":"1988","journal-title":"Am. 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