{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:53:18Z","timestamp":1772160798132,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T00:00:00Z","timestamp":1499990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 DK007130\u2010AP"],"award-info":[{"award-number":["T32 DK007130\u2010AP"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH K23DK84413\u20104\u2010GSS"],"award-info":[{"award-number":["NIH K23DK84413\u20104\u2010GSS"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,12]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n The upper esophageal sphincter (\n UES<\/jats:styled-content>\n ) reflexively responds to bolus presence within the esophageal lumen, therefore\n UES<\/jats:styled-content>\n metrics can vary in achalasia.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Within consecutive patients undergoing esophageal high\u2010resolution manometry (\n HRM<\/jats:styled-content>\n ), 302 patients (58.2\u00b11.0\u00a0year, 57% F) with esophageal outflow obstruction were identified, and compared to 16 asymptomatic controls (27.7\u00b10.7\u00a0year, 56% F). Esophageal outflow obstruction was segregated into achalasia subtypes 1, 2, and 3, and esophagogastric junction outflow obstruction (\n EGJOO<\/jats:styled-content>\n with intact peristalsis) using Chicago Classification v3.0.\n UES<\/jats:styled-content>\n and lower esophageal sphincter (\n LES<\/jats:styled-content>\n ) metrics were compared between esophageal outflow obstruction and normal controls using univariate and multivariate analysis. Linear regression excluded multicollinearity of pressure metrics that demonstrated significant differences across individual subtype comparisons.\n <\/jats:p>\n <\/jats:sec>\n \n Key Results<\/jats:title>\n \n LES<\/jats:styled-content>\n integrated relaxation pressure (\n IRP<\/jats:styled-content>\n ) had utility in differentiating achalasia from controls (\n P<\/jats:italic>\n <.0001), but no utility in segregating between subtypes (\n P<\/jats:italic>\n =.27). In comparison to controls, patients collectively demonstrated univariate differences in\n UES<\/jats:styled-content>\n mean basal pressure, relaxation time to nadir, recovery time, and residual pressure (\n UES<\/jats:styled-content>\n \u2010\n RP<\/jats:styled-content>\n ) (\n P<\/jats:italic>\n \u2264.049).\n UES<\/jats:styled-content>\n \u2010\n RP<\/jats:styled-content>\n was highest in type 2 achalasia (\n P<\/jats:italic>\n <.0001 compared to other subtypes and controls). In multivariate analysis, only\n UES<\/jats:styled-content>\n \u2010\n RP<\/jats:styled-content>\n retained significance in comparison between each of the subgroups (\n P<\/jats:italic>\n \u2264.02 for each comparison). Intrabolus pressure was highest in type 3 achalasia; this demonstrated significant differences across some but not all subtype comparisons.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Inferences<\/jats:title>\n \n Nadir\n UES<\/jats:styled-content>\n \u2010\n RP<\/jats:styled-content>\n can differentiate achalasia subtypes within the esophageal outflow obstruction spectrum, with highest values in type 2 achalasia. This metric likely represents a surrogate marker for esophageal pressurization.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nmo.13136","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T04:16:41Z","timestamp":1500005801000},"source":"Crossref","is-referenced-by-count":24,"title":["Upper esophageal sphincter (\n UES<\/scp>\n ) metrics on high\u2010resolution manometry (\n HRM<\/scp>\n ) differentiate achalasia subtypes"],"prefix":"10.1111","volume":"29","author":[{"given":"P.","family":"Blais","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine Saint Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-5901","authenticated-orcid":false,"given":"A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Duke University School of Medicine and the Durham Veterans Affairs Medical Center Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. S.","family":"Sayuk","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine Saint Louis MO USA"},{"name":"John Cochran Veterans Affairs Medical Center St. Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3388-0660","authenticated-orcid":false,"given":"C. P.","family":"Gyawali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine Saint Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.08.038"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12750"},{"key":"e_1_2_9_4_1","first-page":"1712","article-title":"Abnormal upper esophageal sphincter function in achalasia","volume":"87","author":"Dudnick RS","year":"1992","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009530"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900514"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-015-2901-5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12228"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v2.i9.448"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000157"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91180-C"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12494"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00444.2005"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12711"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.12.027"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.02.017"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.01.006"}],"container-title":["Neurogastroenterology & Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.13136","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.13136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T06:13:33Z","timestamp":1696140813000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.13136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,14]]},"references-count":17,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/nmo.13136"],"URL":"https:\/\/doi.org\/10.1111\/nmo.13136","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.727807251.793558542","asserted-by":"object"}]},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,14]]},"article-number":"e13136"}}