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While the functional luminal imaging probe (FLIP) has been used to assess EGJ distensibility in achalasia, its clinical utility in pediatrics is limited due to absence of normative values and correlations with clinical outcomes in children. Thus, we sought to evaluate FLIP's use in a pediatric achalasia cohort undergoing dilations and non\u2010achalasia controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study of pediatric patients with achalasia who underwent FLIP before and immediately after balloon dilations and compared to a non\u2010achalasia cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Thirty patients with achalasia (mean age, 15.2\u00a0years; 40% female), including fourteen treatment\u2010na\u00efve and thirteen controls (mean age, 7.9\u00a0years; 61% female) were identified. Median EGJ distensibility index (EGJ\u2010DI) 2.07\u00a0mm<jats:sup>2<\/jats:sup>\u00a0mmHg<jats:sup>\u22121<\/jats:sup> and diameter (9.23\u00a0mm) in treatment\u2010na\u00efve patients were significantly lower compared to controls (EGJ\u2010DI 6.8\u00a0mm<jats:sup>2<\/jats:sup>\u00a0mmHg<jats:sup>\u22121<\/jats:sup>; diameter 18.61\u00a0mm; (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Balloon dilations resulted in a significant increase in EGJ\u2010DI immediately after the dilation, particularly in treatment\u2010na\u00efve patients (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and a significant improvement in Eckardt scores (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Functional luminal imaging probe measurements of EGJ\u2010DI in pediatric patients with achalasia are mostly consistent with adult findings. However, normal EGJ\u2010DI is seen in symptomatic patients, including treatment\u2010naive, highlighting the need for pediatric reference data. Balloon dilations achieve a significant increase in EGJ\u2010DI with improvement in Eckardt scores, confirming the therapeutic value of dilations in achalasia management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14133","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T18:32:14Z","timestamp":1618857134000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Use of the functional luminal imaging probe in pediatrics: A comparison study of patients with achalasia before and after endoscopic dilation and non\u2010achalasia controls"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0940-4381","authenticated-orcid":false,"given":"Alain J.","family":"Benitez","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition Children's Hospital of Philadelphia Philadelphia PA USA"},{"name":"Department of Pediatrics 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