{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:47:03Z","timestamp":1793227623884,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with obesity often report esophageal symptoms, with abnormal reflux and esophageal motility suggested as potential mechanisms. However, prior studies showed varying results, often limited by study design\/size and esophageal function\/symptom measures utilized. We aimed to examine the relationship between obesity and objective esophageal function testing and patient\u2010reported outcomes, utilizing prospective symptom, manometric and reflux monitoring data with impedance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adults referred for high\u2010resolution impedance\u2010manometry (HRiM) and multichannel intraluminal impedance\u2010pH monitoring (MII\u2010pH) to evaluate esophageal symptoms were enrolled. Validated symptom and health\u2010related quality of life (HR\u2010QOL) instruments were prospectively collected: GERDQ, reflux symptoms index (RSI), dominant symptom intensity (DSI, multiplied 5\u2010point Likert scales for symptom frequency\/severity), global symptom severity (GSS, 100\u2010point visual analog scale), and Short Form\u201012 (SF\u201012) for HR\u2010QOL. Esophageal function testing measures were compared across body mass index (BMI) categories and correlated with patient\u2010reported outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Seven hundred and fifty four patients were included (Normal:281\/Overweight:253\/Class I obesity:137\/Class II\/III obesity:83). Reflux burden measures on MII\u2010pH (acid exposure time, total reflux episodes, bolus exposure time), conclusive pathologic reflux (Lyon), and hiatal hernia were increased in higher obesity classes compared to normal BMI. Class II\/III obesity was associated with more normal\/hypercontractile swallows, less ineffective swallows, and better bolus transit on HRiM. BMI correlated positively with GERDQ\/RSI\/DSI\/GSS, and negatively with physical component score (SF\u201012). Esophageal symptom severity and HR\u2010QOL correlated strongly with MII\u2010pH findings, but not HRiM measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions\/Inferences<\/jats:title><jats:p>Obesity is associated with increased esophageal symptom burden and worse physical HR\u2010QOL, which correlate with higher acid\/bolus reflux burden but not altered esophageal motility\/transit\/contractile reserve.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14691","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T06:28:23Z","timestamp":1697610503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Higher obesity class is associated with more severe esophageal symptoms and reflux burden but not altered motor function or contractile reserve"],"prefix":"10.1111","volume":"36","author":[{"given":"Brent","family":"Hiramoto","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walker D.","family":"Redd","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayssan","family":"Muftah","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saikiran","family":"Jonnadula","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noreen C.","family":"Okwara","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliza","family":"Cricco\u2010Lizza","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren J. 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