{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:36:13Z","timestamp":1760783773812},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,1,26]],"date-time":"2014-01-26T00:00:00Z","timestamp":1390694400000},"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":[[2014,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Esophageal acid retention in a hiatal hernia (<jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content>) may play a role in gastro\u2010esophageal reflux. The aims of this study were to determine the prevalence of bolus retention (<jats:styled-content style=\"fixed-case\">BR<\/jats:styled-content>) in <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> and to compare pressure profiles in patients with <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">BR<\/jats:styled-content> in the hernia to those with bolus clearance (<jats:styled-content style=\"fixed-case\">BC<\/jats:styled-content>) through the hernia using high\u2010resolution esophageal manometry with impedance (<jats:styled-content style=\"fixed-case\">HREMI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical <jats:styled-content style=\"fixed-case\">HREMI<\/jats:styled-content> studies with <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> \u22651.5\u00a0cm were analyzed for lower esophageal sphincter (<jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content>) and crural diaphragm (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) pressures and pressure profiles during 12 saline swallows. Impedance was analyzed for swallow retention in the <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Bolus retention in a <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> was present in 35 of 53 (66%) patients with a <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content>. Patients with <jats:styled-content style=\"fixed-case\">BR<\/jats:styled-content> had overall lower pressure profiles including a lower basal <jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content> pressure (14.8\u00a0\u00b1\u00a010.6 <jats:italic>vs<\/jats:italic> 28.9\u00a0\u00b1\u00a016.8\u00a0mmHg; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0001), <jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> gradient (6.8\u00a0\u00b1\u00a017.9 <jats:italic>vs<\/jats:italic> 20.6\u00a0\u00b1\u00a012.2\u00a0mmHg; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002), residual <jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content> pressure (2.5\u00a0\u00b1\u00a04.6 <jats:italic>vs<\/jats:italic> 6.1\u00a0\u00b1\u00a012.2\u00a0mmHg; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.017), amplitude of distal esophageal contractions (83.2\u00a0\u00b1\u00a038.8 <jats:italic>vs<\/jats:italic> 111.2\u00a0\u00b1\u00a042.8\u00a0mmHg; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.020), and distal contractile integral (1487\u00a0\u00b1\u00a01016 <jats:italic>vs<\/jats:italic> 2608\u00a0\u00b1\u00a01221\u00a0mmHg\u2010cm\u2010sec; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) compared to the <jats:styled-content style=\"fixed-case\">BC<\/jats:styled-content> group. Patients with <jats:styled-content style=\"fixed-case\">BR<\/jats:styled-content> were more likely to have a larger sized <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> compared to the <jats:styled-content style=\"fixed-case\">BC<\/jats:styled-content> group (3.1\u00a0\u00b1\u00a01.6 <jats:italic>vs<\/jats:italic> 2.1\u00a0\u00b1\u00a00.6\u00a0cm; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.016); similar pressure changes were found when the groups were divided up by <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> sizes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Bolus retention was seen in 66% of patients with <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content>. Bolus retention in the <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> was associated with larger <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> size, lower <jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content> pressure, and lower esophageal contractile pressures compared to those with <jats:styled-content style=\"fixed-case\">BC<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12312","type":"journal-article","created":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T01:20:47Z","timestamp":1390785647000},"page":"679-684","source":"Crossref","is-referenced-by-count":5,"title":["Bolus retention in hiatal hernia identified by high\u2010resolution esophageal manometry with impedance"],"prefix":"10.1111","volume":"26","author":[{"given":"G. 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