{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T18:30:58Z","timestamp":1774117858517,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Esophageal chemical clearance has been evaluated with the post\u2010reflux swallow\u2010induced peristaltic wave (PSPW) index. The factors triggering PSPW in Gastro\u2010esophageal reflux disease (GERD) have not yet been investigated. This multicenter study was aimed at evaluating the characteristics of reflux episodes associated with PSPW occurrence in patients with typical GERD symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Impedance\u2010pH tracings from patients with typical reflux symptoms were analyzed. Sixteen healthy subjects were included for comparison. Multivariate analysis was performed to determine predictors of PSPW events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key results<\/jats:title><jats:p>Impedance\u2010pH tracings from 60 patients and 16 healthy subjects were evaluated. A total of 3454 refluxes were recorded. In patients, comparing reflux episodes followed with those not followed by a PSPW, significantly higher proportions of acid (79% vs. 74%,<jats:italic>p<\/jats:italic>: 0.02), mixed (47% vs. 32%,<jats:italic>p<\/jats:italic>: 0.0001) and proximal refluxes (34% vs. 20%,<jats:italic>p<\/jats:italic>: 0.0001) were observed. A multivariate analysis, acid (OR: 1.3, 95% CI: 1.05\u20131.6), mixed (OR: 2, 95% CI: 1.6\u20132.3), and proximal (OR: 2.1, 95% CI: 1.7\u20132.5) refluxes were independently associated with PSPWs. Reflux episodes followed by a PSPW were characterized by a significantly higher bolus clearing time [(mean\u00a0\u00b1\u00a0SD) 41\u00a0s\u00a0\u00b1\u00a06\u00a0s vs. 30\u00a0s\u00a0\u00b1\u00a05\u00a0s,<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05] whereas nadir pH value of reflux events preceding PSPWs was tangentially but not significantly lower [(mean\u00a0\u00b1\u00a0SD) 2.61\u00a0\u00b1\u00a01.22 vs. 2.74\u00a0\u00b1\u00a01.26,<jats:italic>p<\/jats:italic>: 0.057].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and inferences<\/jats:title><jats:p>Acid, mixed and proximal refluxes, and their duration are key factors in eliciting PSPWs. PSPW represents a response to reflux directly related to the potential harmfulness of reflux contents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14183","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T11:55:44Z","timestamp":1622807744000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Reflux characteristics triggering post\u2010reflux swallow\u2010induced peristaltic wave (PSPW) in patients with GERD symptoms"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5102-1758","authenticated-orcid":false,"given":"Mentore","family":"Ribolsi","sequence":"first","affiliation":[{"name":"Department of Digestive Diseases Campus Bio Medico University of Rome Roma 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