{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:58:51Z","timestamp":1760785131189,"version":"3.41.2"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Chicago classification primarily utilizes ten 5\u2009mL liquid swallows in a supine position as the standard high\u2010resolution esophageal manometry (HRM) protocol. HRM can be performed with varying volumes and consistencies and in an upright position. We aimed to determine the impact on HRM results by (1) position, (2) swallows of differing volume and consistency, and (3) perception of bolus passage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HRM was performed in healthy volunteers (HV) with the following protocol of swallows: liquids 10\u2009\u00d7\u20095\u2009mL, 5\u2009\u00d7\u200910\u2009mL, and 3\u2009\u00d7\u200910\u2009mL multiple rapid swallows; applesauce 5\u2009\u00d7\u20095\u2009mL and 5\u2009\u00d7\u200910\u2009mL; and bread 5\u2009\u00d7\u20092\u2009\u00d7\u20092\u2009cm and 5\u2009\u00d7\u20094\u2009\u00d7\u20094cm. HV rated difficulty of each swallow on a 5\u2010point Likert scale. All HVs performed the protocol in supine position first and then in \u201csemi\u2010upright\u201d (sitting 70 degrees in a bed) and \u201cupright\u201d (sitting in a chair) in a randomized order.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Thirty\u2010seven HVs, median age 27\u2009years, 64% female completed this study. Median distal contractile integral (DCI) and integrated relaxation pressure 4\u2009s (IRP4) of 5\u2009mL liquid swallows significantly differed (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) between position performed. Large volume swallows resulted in higher DCI and lower IRP4. IRP4 results were significantly increased for 2\u2009\u00d7\u20092\u2009cm pieces of bread compared to 5\u2009mL water swallows. DCI results were higher for 2\u2009\u00d7\u20092\u2009cm pieces of bread compared to 5\u2009mL water swallows. Distal latency was shorter in more upright positions. Among this cohort of HV, perceived difficulty of bolus passage was more likely to occur with solid boluses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>The volume and consistency of a swallow and the position it is performed in, significantly alter HRM metrics. Interpretation of HRM studies should incorporate different normative values which are specific to the position and bolus type.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14593","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T14:16:27Z","timestamp":1681136187000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating the impact of position, volume, and consistency on high\u2010resolution esophageal manometry outcomes"],"prefix":"10.1111","volume":"35","author":[{"given":"Chamara","family":"Basnayake","sequence":"first","affiliation":[{"name":"Translational research center for gastrointestinal disorders (TARGID) Katholieke Universiteit Leuven  Leuven Belgium"},{"name":"University of Melbourne  Melbourne Victoria 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