{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T17:01:57Z","timestamp":1778605317751,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007197","name":"U.S. Public Health Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007197","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of esophageal dysmotility among patients with post\u2010fundoplication esophageal symptoms is not fully understood. This study aimed to investigate secondary peristalsis and esophagogastric junction (EGJ) opening biomechanics using functional lumen imaging probe (FLIP) panometry in symptomatic post\u2010fundoplication patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010seven adult patients post\u2010fundoplication who completed FLIP for symptomatic esophageal evaluation were included. Secondary peristaltic contractile response (CR) patterns and EGJ opening metrics (EGJ distensibility index (EGJ\u2010DI) and maximum EGJ diameter) were evaluated on FLIP panometry and analyzed against high\u2010resolution manometry (HRM), patient\u2010reported outcomes, and fundoplication condition seen on esophagram and\/or endoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>FLIP CR patterns included 14 (16%) normal CR, 30 (34%) borderline CR, 28 (32%) impaired\/disordered CR, 13 (15%) absent CR, and 2 (2%) spastic reactive CR. Compared with normal and borderline CRs (i.e., CR patterns with distinct, antegrade peristalsis), patients with impaired\/disordered and absent CRs demonstrated significantly greater time since fundoplication (2.4 (0.6\u20136.8) vs. 8.9 (2.6\u201314.5) years; <jats:italic>p<\/jats:italic>\u2009=\u20090.002), greater esophageal body width on esophagram (<jats:italic>n<\/jats:italic>\u2009=\u200950; 2.3 (2.0\u20132.8) vs. 2.9 (2.4\u20133.6) cm; <jats:italic>p<\/jats:italic>\u2009=\u20090.013), and lower EGJ\u2010DI (4.3 (2.7\u20135.4) vs. 2.6 (1.7\u20133.7) mm<jats:sup>2<\/jats:sup>\/mmHg; <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Intact fundoplications had significantly higher rates of normal CRs compared to anatomically abnormal (i.e., tight, disrupted, slipped, herniated) fundoplications (9 (28%) vs. 5 (9%); <jats:italic>p<\/jats:italic>\u2009=\u20090.032), but there were no differences in EGJ\u2010DI or EGJ maximum diameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Symptomatic post\u2010fundoplication patients were characterized by frequent abnormal secondary peristalsis after fundoplication, potentially worsening with time after fundoplication or related to EGJ outflow resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14746","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T07:49:41Z","timestamp":1706082581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Secondary peristalsis and esophagogastric junction distensibility in symptomatic post\u2010fundoplication patients"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-0657","authenticated-orcid":false,"given":"Michelle M.","family":"Lu","sequence":"first","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8260-1250","authenticated-orcid":false,"given":"Peter J.","family":"Kahrilas","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezra N.","family":"Teitelbaum","sequence":"additional","affiliation":[{"name":"Department of Surgery, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John E.","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-7758","authenticated-orcid":false,"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.07.045"},{"issue":"3","key":"e_1_2_10_3_1","first-page":"138","article-title":"Laparoscopic Nissen fundoplication: preliminary report","volume":"1","author":"Dallemagne B","year":"1991","journal-title":"Surg Laparosc Endosc"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4574"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.01839.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.10.020"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.10.946"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.07.016"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.09.036"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0115-7"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-017-0582-9"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rgmx.2016.08.005"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.10981"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200012070-00004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.35.11.1523"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.454"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14192"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001532"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.06.040"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.07.042"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04212.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01303214"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14116"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12204"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12889"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14605"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.370"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox038"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2020.02.017"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.07.027"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08966-1"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003394"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/10.4.247"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14638"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-1086-1"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002658"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.03.069"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07941-6"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-017-0592-7"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-011-1785-z"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doab078"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14746","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T04:22:06Z","timestamp":1750652526000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.14746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,23]]},"references-count":41,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/nmo.14746"],"URL":"https:\/\/doi.org\/10.1111\/nmo.14746","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,23]]},"assertion":[{"value":"2023-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14746"}}