{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T18:06:18Z","timestamp":1780941978544,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T00:00:00Z","timestamp":1422316800000},"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":[[2015,3]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Gastroesophageal reflux plays an important role in chronic cough (CC<\/jats:styled-content>). Whether disturbed esophageal motility contributes to increased esophageal reflux exposure or interferes with swallowed bolus clearance is unclear. This study used high resolution esophageal manometry and impedance (HRIM<\/jats:styled-content>) together with Chicago Classification, and 24\u2010h impedance pH (MII<\/jats:styled-content>\/pH) to address these questions in patients with CC<\/jats:styled-content> compared with heartburn (HB<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>A retrospective review of 32 patients with CC<\/jats:styled-content> (mean age 57 [95% CI<\/jats:styled-content>: 52\u201362] years) and 32 patients with symptoms of HB<\/jats:styled-content> (55 [52\u201362] years) referred for HRIM<\/jats:styled-content> and MII<\/jats:styled-content>\/pH between September 2012 and September 2013 was undertaken.<\/jats:p><\/jats:sec>Key Results<\/jats:title>Weak peristalsis with large breaks (WPLB<\/jats:styled-content>s) was observed in 34% of CC<\/jats:styled-content> patients compared with only 12% of HB<\/jats:styled-content> patients (p<\/jats:italic>\u00a0=\u00a00.027). Pathological acid exposure time (AET<\/jats:styled-content>) was identified in 81% of CC<\/jats:styled-content> patients with WPLB<\/jats:styled-content>s compared with 29% without (p<\/jats:italic>\u00a0=\u00a00.011). Increased AET<\/jats:styled-content> was associated with prolonged clearance time of refluxed events (p<\/jats:italic>\u00a0=\u00a00.006) rather than increased number of events. AET<\/jats:styled-content> correlated with the percentage of peristaltic events with large breaks in CC<\/jats:styled-content> (\u03c1<\/jats:italic>\u00a0=\u00a00.467, p<\/jats:italic>\u00a0=\u00a00.007). Similar data were obtained for total bolus (acid and non\u2010acid) exposure time. Only one of the CC<\/jats:styled-content> patients with WPLB<\/jats:styled-content>s exhibited complete bolus transit (CBT<\/jats:styled-content>) on swallowing compared with 81% without WPLB<\/jats:styled-content>s (p<\/jats:italic>\u00a0<\u00a00.001). Moreover, the percentage of peristaltic events associated with CBT<\/jats:styled-content> negatively correlated with the percentage of peristaltic events with large breaks (r<\/jats:italic>\u00a0=\u00a0\u22120.653, p<\/jats:italic>\u00a0<\u00a00.001) in CC<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>One\u2010third of CC<\/jats:styled-content> patients exhibit WPLB<\/jats:styled-content>s, which directly impacts on clearance of refluxed events and bolus's swallowed. These observations may have important implications for esophageal\u2010bronchial interaction in CC<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12513","type":"journal-article","created":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T02:36:02Z","timestamp":1422412562000},"page":"431-442","source":"Crossref","is-referenced-by-count":45,"title":["Weak peristalsis with large breaks in chronic cough: association with poor esophageal clearance"],"prefix":"10.1111","volume":"27","author":[{"given":"C.","family":"Almansa","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Jacksonville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonology Mayo Clinic Jacksonville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. R.","family":"DeVault","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Jacksonville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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