{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:38:26Z","timestamp":1753879106014,"version":"3.41.2"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T00:00:00Z","timestamp":1493769600000},"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":[[2017,9]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>A manometric diagnosis of esophagogastric junction outflow obstruction (EGJOO<\/jats:styled-content>) without a mechanical cause creates a therapeutic conundrum. The aim of this study was to assess esophageal bolus clearance in EGJOO<\/jats:styled-content> and assess manometric factors associated with clearance in EGJOO<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Bolus clearance was assessed using line\u2010tracing method and contour method to determine Complete Bolus Transit (CBT<\/jats:styled-content>) and Functional Clearance (FC<\/jats:styled-content>), respectively, on combined High\u2010Resolution Impedance Manometry (HRIM<\/jats:styled-content>). HRIM<\/jats:styled-content> studies of EGJOO<\/jats:styled-content> patients, as well as a sample of achalasia types I\u2010III<\/jats:styled-content> and asymptomatic controls, were retrospectively analyzed. In EGJOO<\/jats:styled-content>, associations between Integrated Relaxation Pressure (IRP<\/jats:styled-content>) or Distal Contractile Integral (DCI<\/jats:styled-content>) and clearance were assessed using receiver\u2010operating\u2010characteristic (ROC<\/jats:styled-content>) curves.<\/jats:p><\/jats:sec>Key Results<\/jats:title>Seventy\u2010five EGJOO<\/jats:styled-content>, 28 achalasia, and 11 normal subjects were included. Agreement between CBT<\/jats:styled-content> and FC<\/jats:styled-content> was good (Kappa=0.75). CBT<\/jats:styled-content> across swallows in each group was as follows: type I achalasia: 14%, type II<\/jats:styled-content> achalasia: 8%, type III<\/jats:styled-content> achalasia: 61%, EGJOO<\/jats:styled-content>: 86%, and normal: 98% (p values .023, .006, and <.0001 for EGJOO<\/jats:styled-content> vs normals, type III<\/jats:styled-content> achalasia, and all achalasia, respectively). In idiopathic EGJOO<\/jats:styled-content>, CBT<\/jats:styled-content> \u226560% of swallows was seen in 96.4% of patients when mean DCI<\/jats:styled-content>>610\u00a0mmHg\u2010s\u2010cm (accuracy 87.7%, P<\/jats:italic>=.004). Complete Bolus Transit( CBT<\/jats:styled-content>) across individual swallows was 97.8% when DCI<\/jats:styled-content>>884\u00a0mmHg\u2010s\u2010cm (accuracy 81.9%, P<\/jats:italic><.0001). IRP<\/jats:styled-content> was poorly associated with bolus clearance.<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>Bolus clearance in EGJOO<\/jats:styled-content> is impaired compared to normal, but not as severely as in achalasia. In idiopathic EGJOO<\/jats:styled-content>, weak peristalsis is associated with poor bolus clearance. Bolus transit appears to be unimpaired when DCI<\/jats:styled-content>>900\u00a0mmHg\u2010s\u2010cm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13093","type":"journal-article","created":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T05:42:39Z","timestamp":1493790159000},"source":"Crossref","is-referenced-by-count":14,"title":["Bolus clearance in esophagogastric junction outflow obstruction is associated with strength of peristalsis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2632-8624","authenticated-orcid":false,"given":"A.","family":"Jain","sequence":"first","affiliation":[{"name":"Division of Gastroenterology University of Michigan Health System Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. R.","family":"Baker","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Michigan Health System Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. H.","family":"Rubenstein","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Michigan Health System Ann Arbor Michigan USA"},{"name":"Veterans Affairs Center for Clinical Management Research Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. W.","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Michigan Health System Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0b013e3283530f62"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01829.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12625"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.12.041"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12814"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12708"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(03)70033-0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12642"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2012.6.4.440"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12300"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.61"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2010.16.1.90"},{"key":"e_1_2_9_15_1","first-page":"801","article-title":"Impact of weight loss surgery on esophageal physiology","volume":"11","author":"Naik RD","year":"2015","journal-title":"Gastroenterol Hepatol (NY)"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.154"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.08.005"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.289"},{"issue":"3","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","DOI":"10.1111\/nmo.12941","article-title":"High\u2010resolution impedance manometry parameters enhance the esophageal motility evaluation in non\u2010obstructive dysphagia patients without a major Chicago Classification motility disorder","volume":"29","author":"Carlson DA","year":"2016","journal-title":"Neurogastroenterol Motil"}],"container-title":["Neurogastroenterology & Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.13093","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.13093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T22:39:25Z","timestamp":1695508765000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.13093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,3]]},"references-count":18,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1111\/nmo.13093"],"URL":"https:\/\/doi.org\/10.1111\/nmo.13093","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"type":"print","value":"1350-1925"},{"type":"electronic","value":"1365-2982"}],"subject":[],"published":{"date-parts":[[2017,5,3]]},"article-number":"e13093"}}