{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:22:01Z","timestamp":1783470121276,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,2,12]],"date-time":"2017-02-12T00:00:00Z","timestamp":1486857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007872","name":"Bowel and Cancer Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007872","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The joint hypermobility syndrome (<jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>) is a common non\u2010inflammatory connective tissue disorder which frequently co\u2010exists with postural tachycardia syndrome (Po<jats:styled-content style=\"fixed-case\">TS<\/jats:styled-content>), a form of orthostatic intolerance. Gastrointestinal symptoms and dysmotility have been reported in Po<jats:styled-content style=\"fixed-case\">TS<\/jats:styled-content>. Dysphagia and reflux are common symptoms in <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>, yet no studies have examined the physiological mechanism for these, subdivided by Po<jats:styled-content style=\"fixed-case\">TS<\/jats:styled-content> status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty patients (28 female, ages: 18\u201062) with <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content> and symptoms of reflux (n=28)\u00a0\u00b1\u00a0dysphagia (n=25), underwent high\u2010resolution manometry and 24\u00a0hour <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u2010impedance monitoring after questionnaire\u2010based symptom assessment. Esophageal physiology parameters were examined in <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>, subdivided by Po<jats:styled-content style=\"fixed-case\">TS<\/jats:styled-content> status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010three percent of <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content> patients with reflux symptoms had pathological acid reflux, 21% had reflux hypersensitivity, and 25% had functional heartburn. Acid exposure was more likely to be increased in the recumbent than upright position (64% vs 43%). The prevalence of hypotensive lower esophageal sphincter (33%) and hiatus hernia (33%) was low. Forty percent of patients with dysphagia had minor disorders of motility, 60% had functional dysphagia. Eighteen (60%) patients had coexistent Po<jats:styled-content style=\"fixed-case\">TS<\/jats:styled-content>\u2014they had significantly higher dysphagia (21 vs 11.5, <jats:italic>P<\/jats:italic>=.04) and reflux scores (24.5 vs 16.5, <jats:italic>P<\/jats:italic>=.05), and double the prevalence of pathological acid reflux (64% vs 36%, <jats:italic>P<\/jats:italic>=.1) and esophageal dysmotility (50% vs 25%, <jats:italic>P<\/jats:italic>=.2) though this was not significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>A large proportion of <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content> patients with esophageal symptoms have true reflux\u2010related symptoms or mild esophageal hypomotility, and this is more likely if they have Po<jats:styled-content style=\"fixed-case\">TS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13029","type":"journal-article","created":{"date-parts":[[2017,2,13]],"date-time":"2017-02-13T03:56:43Z","timestamp":1486958203000},"source":"Crossref","is-referenced-by-count":27,"title":["Mechanisms underlying reflux symptoms and dysphagia in patients with joint hypermobility syndrome, with and without postural tachycardia syndrome"],"prefix":"10.1111","volume":"29","author":[{"given":"A.","family":"Fikree","sequence":"first","affiliation":[{"name":"Wingate Institute of Neurogastroenterology Centre for Digestive Diseases Blizard Institute of Cell and Molecular Science Barts and the London School of Medicine and Dentistry Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Aziz","sequence":"additional","affiliation":[{"name":"Wingate Institute of Neurogastroenterology Centre for Digestive Diseases Blizard Institute of Cell and 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