{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:43:37Z","timestamp":1778561017009,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T00:00:00Z","timestamp":1449792000000},"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":[[2016,2]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Multiple rapid swallowing (MRS<\/jats:styled-content>) during high\u2010resolution manometry (HRM<\/jats:styled-content>) is increasingly utilized as provocative test to assess esophageal peristaltic reserve. The aim of this study was to evaluate the correlation between MRS<\/jats:styled-content> response and impedance and pH (MII<\/jats:styled-content>\u2010pH) parameters in endoscopy negative heartburn (ENH<\/jats:styled-content>) patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>We enrolled consecutive ENH<\/jats:styled-content> patients, who underwent HRM<\/jats:styled-content> and MII<\/jats:styled-content>\u2010pH study, with a selected MII<\/jats:styled-content>\u2010pH profile: abnormal MII<\/jats:styled-content>\u2010pH (pH+\/MII<\/jats:styled-content>+); normal MII<\/jats:styled-content>\u2010pH (pH\u2212\/MII<\/jats:styled-content>\u2212). HRM<\/jats:styled-content> was performed with 10 wet swallows (WS<\/jats:styled-content>) and one MRS<\/jats:styled-content>. Mean distal contractile integral (DCI<\/jats:styled-content>) during WS<\/jats:styled-content> and MRS<\/jats:styled-content> were calculated. MII<\/jats:styled-content>\u2010pH parameters including acid exposure time (AET<\/jats:styled-content>), reflux events, baseline impedance levels (BI<\/jats:styled-content>) and the efficacy of chemical clearance evaluated with the postreflux swallow\u2010induced peristaltic wave (PSPW<\/jats:styled-content>) index were measured.<\/jats:p><\/jats:sec>Key Results<\/jats:title>We analyzed 103 patients: 49 MII<\/jats:styled-content>+\/pH+ (27 male), and 54 MII<\/jats:styled-content>\u2212\/pH\u2212 (19 male). Mean age was similar between the two groups. As expected, mean AET<\/jats:styled-content> and number of refluxes were higher in pH+\/MII<\/jats:styled-content>+ (p<\/jats:italic> < 0.05). HRM<\/jats:styled-content> was normal in all selected patients. Mean DCI<\/jats:styled-content>\u2010WS<\/jats:styled-content> was similar between two groups (p<\/jats:italic> = n.s.). Mean DCI<\/jats:styled-content>\u2010MRS<\/jats:styled-content>\u2010 was higher in MII<\/jats:styled-content>\u2212\/pH\u2212 vs <\/jats:italic>MII<\/jats:styled-content>+\/pH+ (p<\/jats:italic> < 0.05). The increase in DCI<\/jats:styled-content>\u2010MRS<\/jats:styled-content> was inversely correlated with AET<\/jats:styled-content> (\u22120.699; p<\/jats:italic> < 0.001) and directly correlated with BI<\/jats:styled-content> values (0.631; p<\/jats:italic> < 0.001) and PSPW<\/jats:styled-content> index (0.626; p<\/jats:italic> < 0.001).<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>Following MRS<\/jats:styled-content>, patients with abnormal impedance\u2010pH test showed suboptimal contraction response as compared with those with normal impedance\u2010pH test. Moreover, MRS<\/jats:styled-content> response was inversely correlated with AET<\/jats:styled-content> and directly correlated with BI<\/jats:styled-content> values and PSPW<\/jats:styled-content> index.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12719","type":"journal-article","created":{"date-parts":[[2015,12,13]],"date-time":"2015-12-13T08:25:37Z","timestamp":1449995137000},"page":"243-250","source":"Crossref","is-referenced-by-count":71,"title":["Vigor of peristalsis during multiple rapid swallows is inversely correlated with acid exposure time in patients with NERD<\/scp>"],"prefix":"10.1111","volume":"28","author":[{"given":"I.","family":"Martinucci","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. V.","family":"Savarino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Surgery, Oncology and Gastroenterology University of Padua Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. E.","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department of Internal Medicine Northwest University Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Russo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Bellini","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Tolone","sequence":"additional","affiliation":[{"name":"Division of Surgery Department of Surgery Second University of Naples Naples 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