{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:29:30Z","timestamp":1761514170230,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T00:00:00Z","timestamp":1521072000000},"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":[[2018,8]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Esophageal dysmotility may predispose to Barrett's esophagus (BE<\/jats:styled-content>). We hypothesized that high\u2010resolution manometry (HRM<\/jats:styled-content>) performed with additional physiologic challenge would better delineate dysmotility in BE<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Included patients had typical reflux symptoms and underwent endoscopy, HRM<\/jats:styled-content> with single water swallows and adjunctive testing with solids and rapid drink challenge (RDC<\/jats:styled-content>) before ambulatory pH<\/jats:styled-content>\u2010impedance monitoring. BE<\/jats:styled-content> and endoscopy\u2010negative reflux disease (ENRD<\/jats:styled-content>) subjects were compared against functional heartburn patient\u2010controls (FHC<\/jats:styled-content>). Primary outcome was incidence of HRM<\/jats:styled-content> contractile abnormalities with standard and adjunctive swallows. Secondary outcomes included clearance measures and symptom association on pH<\/jats:styled-content>\u2010impedance.<\/jats:p><\/jats:sec>Key Results<\/jats:title>Seventy\u2010eight patients (BE<\/jats:styled-content> 25, ENRD<\/jats:styled-content> 27, FHC<\/jats:styled-content> 26) were included. Water swallow contractility was reduced in both BE<\/jats:styled-content> (median DCI<\/jats:styled-content> 87\u00a0mm\u00a0Hg\/cm\/s) and ENRD<\/jats:styled-content> (442\u00a0mm\u00a0Hg\/cm\/s) compared to FHC<\/jats:styled-content> (602\u00a0mm\u00a0Hg\/cm\/s; P<\/jats:italic>\u00a0<\u00a0.001 and .04, respectively). With the challenge of solid swallows and RDC<\/jats:styled-content>, these parameters improved in ENRD<\/jats:styled-content> (solids\u00a0=\u00a01732\u00a0mm\u00a0Hg\/cm\/s), becoming similar to FHC<\/jats:styled-content> (1242\u00a0mm\u00a0Hg\/cm\/s; P<\/jats:italic>\u00a0=\u00a0.93), whereas abnormalities persisted in BE<\/jats:styled-content> (818\u00a0mm\u00a0Hg\/cm\/s; P<\/jats:italic>\u00a0<\u00a0.01 c.f. FHC<\/jats:styled-content>). In BE<\/jats:styled-content> and ENRD<\/jats:styled-content>, reflux events (67 vs 57 events\/24\u00a0hour) and symptom frequency were similar; yet symptom correlation was significantly better in ENRD<\/jats:styled-content> compared to BE<\/jats:styled-content>, which was comparable to FHC<\/jats:styled-content> (symptom index 30% vs 4% vs 0%, respectively). Furthermore, bolus clearance and exposure times were more pronounced in BE<\/jats:styled-content> (P<\/jats:italic>\u00a0<\u00a0.01).<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>Reduced contractile effectiveness persisted in BE<\/jats:styled-content> with the more representative esophageal challenge of swallowing solids and free drinking; while in ENRD<\/jats:styled-content> and FHC<\/jats:styled-content> peristalsis usually improved, demonstrating peristaltic reserve. Furthermore, symptom association and refluxate clearance were reduced in BE<\/jats:styled-content>. These factors may underlie BE<\/jats:styled-content> pathogenesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13330","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T13:52:08Z","timestamp":1521121928000},"source":"Crossref","is-referenced-by-count":19,"title":["Impaired motility in Barrett's esophagus: A study using high\u2010resolution manometry with physiologic challenge"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3145-1050","authenticated-orcid":false,"given":"S.","family":"Sanagapalli","sequence":"first","affiliation":[{"name":"GI Physiology Unit University College London Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Emmanuel","sequence":"additional","affiliation":[{"name":"GI Physiology Unit University College London Hospital London 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