{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:44:22Z","timestamp":1785519862992,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,5,25]],"date-time":"2015-05-25T00:00:00Z","timestamp":1432512000000},"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":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010resolution manometry (<jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content>) provides information on esophagogastric junction (<jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>) morphology, distinguishing three different subtypes. Data on the correlation between <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> subtypes and impedance\u2010pH detected reflux patterns are lacking. We aimed to correlate the <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> subtypes with impedance\u2010pH findings in patients with reflux symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with suspected gastroesophageal reflux disease (<jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>) were enrolled. All patients underwent <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> and impedance\u2010pH testing off\u2010therapy. <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> was classified as: Type I, no separation between the 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>); Type II, minimal separation (&gt;1 and &lt;2\u00a0cm); Type III, \u22652\u00a0cm separation. We measured esophageal acid exposure time (<jats:styled-content style=\"fixed-case\">AET<\/jats:styled-content>), number of total reflux episodes and symptom association analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>We enrolled 130 consecutive patients and identified 46.2% Type I <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>, 38.5% Type II, and 15.4% Type III patients. Type III subjects had a higher number of reflux episodes (61 <jats:italic>vs<\/jats:italic> 45, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.03, <jats:italic>vs<\/jats:italic> 25, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), a greater mean <jats:styled-content style=\"fixed-case\">AET<\/jats:styled-content> (12.4 <jats:italic>vs<\/jats:italic> 4.2, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.02, <jats:italic>vs<\/jats:italic> 1.5, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and a greater positive symptom association (75% <jats:italic>vs<\/jats:italic> 72%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.732 <jats:italic>vs<\/jats:italic> 43.3%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.02) compared with Type II and I patients, respectively. Furthermore, Type II subjects showed statistically significant (overall <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) increased reflux when compared with Type I patients. Type III and II EGJ morphologies had a more frequent probability to show a positive multichannel intraluminal impedance pH monitoring than Type I (95% <jats:italic>vs<\/jats:italic> 84% <jats:italic>vs<\/jats:italic> 50%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Increasing separation between <jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> can cause a gradual and significant increase in reflux. <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> morphology may be useful to estimate an abnormal impedance\u2010pH testing in <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12606","type":"journal-article","created":{"date-parts":[[2015,5,26]],"date-time":"2015-05-26T02:57:54Z","timestamp":1432609074000},"page":"1175-1182","source":"Crossref","is-referenced-by-count":107,"title":["Esophagogastric junction morphology is associated with a positive impedance\u2010<scp>pH<\/scp> monitoring in patients with <scp>GERD<\/scp>"],"prefix":"10.1111","volume":"27","author":[{"given":"S.","family":"Tolone","sequence":"first","affiliation":[{"name":"Division of Surgery Department of Surgery Second University of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"de Cassan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Surgery, Oncology and Gastroenterology University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"de Bortoli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Roman","sequence":"additional","affiliation":[{"name":"Digestive Physiology Hospices Civils de Lyon Lyon I University and Labtau, INSERM 1032 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Galeazzi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Surgery, Oncology and Gastroenterology University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Salvador","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia Generale Department of Surgery, Oncology and Gastroenterology University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Marabotto","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine University of Genoa Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Furnari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine University of Genoa Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Zentilin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine University of Genoa Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Marchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Bardini","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia Generale Department of Surgery, Oncology and Gastroenterology University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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