{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T21:12:55Z","timestamp":1785186775845,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,1,29]],"date-time":"2013-01-29T00:00:00Z","timestamp":1359417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Impedance\u2010pH monitoring allows assessment of retrograde and antegrade intra\u2010esophageal movement of fluids and gas. Reflux is followed by volume clearance and chemical clearance, elicited by secondary and swallow\u2010induced peristalsis, respectively. We aimed to assess whether chemical clearance is impaired in gastro\u2010esophageal reflux disease (<jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Blinded retrospective review of impedance\u2010pH tracings from patients with erosive reflux disease (<jats:styled-content style=\"fixed-case\">ERD<\/jats:styled-content>) and non\u2010erosive reflux disease (<jats:styled-content style=\"fixed-case\">NERD<\/jats:styled-content>), and from proton pump inhibitor (<jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>)\u2010refractory patients before and after laparoscopic fundoplication. The number of refluxes followed within 30\u00a0s by swallow\u2010induced peristaltic waves was divided by the number of total refluxes to obtain a parameter representing chemical clearance namely the postreflux swallow\u2010induced peristaltic wave (<jats:styled-content style=\"fixed-case\">PSPW<\/jats:styled-content>) index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">PSPW<\/jats:styled-content> index was significantly lower in 31 <jats:styled-content style=\"fixed-case\">ERD<\/jats:styled-content> (15%) and in 44 <jats:styled-content style=\"fixed-case\">NERD<\/jats:styled-content> (33%) off\u2010<jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> patients than in 30 controls (75%), as well as in 18 <jats:styled-content style=\"fixed-case\">ERD<\/jats:styled-content> (16%) and in 48 <jats:styled-content style=\"fixed-case\">NERD<\/jats:styled-content> (31%) on\u2010<jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> patients than in 26 on\u2010<jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> functional heartburn (<jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content>) cases (67%) (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05 for all comparisons). In 29 <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>\u2010refractory patients, the median <jats:styled-content style=\"fixed-case\">PSPW<\/jats:styled-content> index was unaltered by otherwise effective antireflux surgery (20% postoperatively, 21% preoperatively). The overall sensitivity, specificity, positive, and negative predictive values of the <jats:styled-content style=\"fixed-case\">PSPW<\/jats:styled-content> index in identifying <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> patients were 97%, 89%, 96%, and 93%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Impairment of chemical clearance is a primary pathophysiological mechanism specific to <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>: it is unaffected by medical\/surgical therapy, is not found in <jats:styled-content style=\"fixed-case\">FH<\/jats:styled-content>, and is more pronounced in <jats:styled-content style=\"fixed-case\">ERD<\/jats:styled-content> than in <jats:styled-content style=\"fixed-case\">NERD<\/jats:styled-content>. Using the <jats:styled-content style=\"fixed-case\">PSPW<\/jats:styled-content> index could improve the diagnostic efficacy of impedance\u2010pH monitoring.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12080","type":"journal-article","created":{"date-parts":[[2013,1,30]],"date-time":"2013-01-30T00:57:05Z","timestamp":1359507425000},"page":"399","source":"Crossref","is-referenced-by-count":143,"title":["Esophageal chemical clearance is impaired in gastro\u2010esophageal reflux disease \u2013 a 24\u2010h impedance\u2010pH monitoring assessment"],"prefix":"10.1111","volume":"25","author":[{"given":"M.","family":"Frazzoni","sequence":"first","affiliation":[{"name":"Fisiopatologia Digestiva Nuovo Ospedale S. Agostino Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Manta","sequence":"additional","affiliation":[{"name":"Endoscopia Digestiva Nuovo Ospedale S. Agostino Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. G.","family":"Mirante","sequence":"additional","affiliation":[{"name":"Endoscopia Digestiva Nuovo Ospedale S. Agostino Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Conigliaro","sequence":"additional","affiliation":[{"name":"Endoscopia Digestiva Nuovo Ospedale S. Agostino Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Frazzoni","sequence":"additional","affiliation":[{"name":"Fisiopatologia Digestiva Nuovo Ospedale S. Agostino Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Melotti","sequence":"additional","affiliation":[{"name":"Chirurgia Generale Nuovo Ospedale S. Agostino Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.08.045"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2012.01977.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301897"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.087668"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.05.016"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2010.16.1.8"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.65"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.568"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01800.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03372.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198402023100503"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2005.04005.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(05)80058-0"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.01998.x"},{"key":"e_1_2_10_16_1","first-page":"1","article-title":"Technology review: esophageal impedance monitoring","volume":"101","author":"Bredenoord AG","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03863.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.10.003"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04550.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1590-8658(02)80237-7"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.45.2.172"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00796.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01593.x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04063.x"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2003.033290"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00711.x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(03)70033-0"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.41084.x"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.52.6.784"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.30035.x"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2012.01949.x"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.25486"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.286"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.08.003"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300798"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.07.009"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.02.022"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-010-1381-4"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-011-2091-5"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.12080","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.12080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T11:11:34Z","timestamp":1698664294000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.12080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,29]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1111\/nmo.12080"],"URL":"https:\/\/doi.org\/10.1111\/nmo.12080","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,29]]}}}