{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:20:42Z","timestamp":1789050042387,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T00:00:00Z","timestamp":1516752000000},"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":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Esophageal pressure topography (<jats:styled-content style=\"fixed-case\">EPT<\/jats:styled-content>) diagnosis of ineffective esophageal motility (<jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content>) can be non\u2010specific with unclear clinical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine whether peristaltic vigor or lower esophageal sphincter (<jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content>) integrity is associated with poor clearance and acid reflux in <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Bolus clearance on high\u2010resolution impedance manometry (<jats:styled-content style=\"fixed-case\">HRIM<\/jats:styled-content>) and available reflux studies in patients with <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content> were retrospectively reviewed. Bolus clearance was assessed using both line tracing and colored contour methods on <jats:styled-content style=\"fixed-case\">HRIM<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">EPT<\/jats:styled-content> parameters, bolus clearance, and acid reflux variables were explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Eighty\u2010eight patients with <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content> were included. Bolus clearance occurred in 71% of all swallows, and 55.7% of patients had complete bolus transit (<jats:styled-content style=\"fixed-case\">CBT<\/jats:styled-content>, bolus clearance in \u226580% of swallows). Bolus clearance was impaired in swallows with distal contractile integral (<jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content>) &lt;100\u00a0mmHg\u2022cm\u2022s compared to <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> 100\u2010450 (0.43 vs 0.79, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). A cutoff at <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> 100\u00a0mmHg\u2022cm\u2022s was associated with clearance with an accuracy of 76% compared to 49% at <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> 450 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0001 for both). A median <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> &lt;100 was associated with a higher Eckardt score (9 vs 3, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03), and on reflux testing available in 47 patients, with abnormal acid exposure time (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002). Peristaltic reserve (<jats:styled-content style=\"fixed-case\">PR<\/jats:styled-content>) defined as (<jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> of multiple rapid swallow\/median <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> of wet swallows), integrated relaxation pressure, and resting lower esophageal sphincter pressure were not associated with clearance or acid exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Failed peristalsis, as defined by <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> &lt;100\u00a0mmHg\u2022cm\u2022s, is associated with impaired bolus clearance and more severe dysphagia in <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content>, and likely abnormal acid exposure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13297","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T04:32:42Z","timestamp":1516854762000},"source":"Crossref","is-referenced-by-count":41,"title":["In ineffective esophageal motility, failed swallows are more functionally relevant than weak swallows"],"prefix":"10.1111","volume":"30","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 MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. R.","family":"Baker","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Michigan Health System  Ann Arbor MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. W.","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Michigan Health System  Ann Arbor MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(86)90692-X"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018802908358"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(03)70033-0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00010-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.30035.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01593.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.6030"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07391.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.286"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-015-0472-y"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.02.046"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S111820"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000225542.03880.68"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7573"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001669"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/ctg.2017.4"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12728"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.289"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00104-002-0474-9"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12204"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.313"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2010.16.1.90"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2003.033290"},{"key":"e_1_2_9_26_1","first-page":"2110","article-title":"Prolonged ambulatory pH monitoring in patients with persistent gastroesophageal reflux disease symptoms: testing while on therapy identifies the need for more aggressive anti\u2010reflux therapy","volume":"91","author":"Katzka DA","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2001.00958.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2008.00854.x"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12941"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12300"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13093"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.13297","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.13297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T15:18:25Z","timestamp":1695482305000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.13297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,24]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1111\/nmo.13297"],"URL":"https:\/\/doi.org\/10.1111\/nmo.13297","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,24]]},"article-number":"e13297"}}