{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T03:42:49Z","timestamp":1781322169649,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Some achalasia patients exhibit esophageal contractile activity on follow\u2010up after treatment, yet its importance remains unclear. We aimed to identify factors associated with presence of contractility after treatment and to assess its impact on timed barium esophagram (TBE) and clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with type I or II achalasia on baseline high\u2010resolution manometry (HRM) who completed HRM, TBE, and functional lumen imaging probe (FLIP) after treatment were retrospectively identified. Contractility was defined on post\u2010treatment HRM as presence of at least 1 supine swallow with DCI \u2265100\u2009mmHg\u2009s\u2009cm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>One hundred twenty\u2010two patients were included (mean age 48\u2009\u00b1\u200917\u2009years, 50% female). At follow\u2010up evaluation after treatment (54% peroral endoscopic myotomy, 24% pneumatic dilation, 22% laparoscopic Heller myotomy), 61 (50%) patients had contractility on HRM. Patients with contractility (compared to those without) more frequently had type II achalasia (84% vs 57%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and a post\u2010treatment normal EGJ opening classification on FLIP (69% vs 49%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the subgroup of patients with post\u2010treatment integrated relaxation pressure &lt;15\u2009mmHg and normal EGJ opening on FLIP (<jats:italic>n<\/jats:italic>\u2009=\u200953), those with contractility had a lower median column height on TBE at 1\u2009min (4 vs 7\u2009cm, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and 5\u2009min (0 vs 5\u2009cm, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). In patients with \u201cabnormal\u201d EGJ metrics, patients with contractility showed lower symptom scores (median Eckardt score 2 vs 3, <jats:italic>p<\/jats:italic>\u2009=\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Occurring more frequently in type II achalasia, and if adequate EGJ opening is achieved after treatment, esophageal contractility may contribute to improved esophageal emptying and improved symptoms in non\u2010spastic achalasia. Preservation of esophageal body muscle could improve outcomes in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14732","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T05:23:46Z","timestamp":1703827426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Presence of esophageal contractility after achalasia treatment is associated with improved esophageal emptying"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5573-447X","authenticated-orcid":false,"given":"Edoardo","family":"Vespa","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico A.","family":"Farina","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8260-1250","authenticated-orcid":false,"given":"Peter J.","family":"Kahrilas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-7085","authenticated-orcid":false,"given":"Andree H.","family":"Koop","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic  Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-7758","authenticated-orcid":false,"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00356-8"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.2996"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.07.022"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000731"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640620903213"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(99)70200-X"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.08.005"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamasurg.38"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178414"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5377-9"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm20126"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.318"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000137"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14552"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001532"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14192"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.06.040"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.03.069"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91428-7"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm21136"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00010-2"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.286"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.07.041"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00281.2021"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm20022"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-325579"}],"container-title":["Neurogastroenterology &amp; 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