{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:35:01Z","timestamp":1792510501854,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"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":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010resolution manometry (HRM) is performed for evaluation of esophageal symptoms, but patient outcome is unclear when no actionable motor disorder is identified. We evaluated long\u2010term symptomatic outcome of patients with nonactionable HRM findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent (HRM) studies in 2006\u20132008 were tracked. Patients with achalasia spectrum disorders, foregut surgery before or after HRM, and incomplete symptom documentation were excluded. Symptom questionnaires assessing dominant symptom intensity (DSI, product of symptom severity and frequency recorded on 5\u2010point Likert scales) and global symptom severity (GSS, from 10\u2009cm visual analog scale) were repeated. Change in symptom burden was compared against HRM motor findings using Chicago Classification 4.0 (CCv4.0), applied retroactively to 2006\u20132008 data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Overall, 134 patients (median age 68\u2009years, 64.5% female) could be contacted. The majority (73.1%) had normal motility; others had ineffective esophageal motility (8.2%), esophagogastric junction outflow obstruction (13.4%), hypercontractile esophagus (3.0%), or absent contractility (2.2%), none managed invasively. Over 15\u2009years of follow\u2010up, DSI decreased from 8.0 (4.0\u201316.0) to 1.0 (0.0\u20136.0) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and GSS improved from 5.5 (3.3\u20137.7) to 2.0 (0.0\u20134.0) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); improvement was consistent across CCv4.0 diagnoses and subgroups. The majority (82.8%) reported improvement over time, and antisecretory medication was the most effective intervention (83.0% improvement). There was no difference in medication efficacy (<jats:italic>p<\/jats:italic>\u2009=\u20090.75) or improvement in symptoms (<jats:italic>p<\/jats:italic>\u2009=\u20090.20) based on CCv4 diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Esophageal symptoms improve with conservative symptomatic management over long\u2010term follow\u2010up when no conclusive obstructive motor disorders or achalasia spectrum disorders are found on HRM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14747","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T04:33:18Z","timestamp":1706589198000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fifteen\u2010year symptomatic outcome of patients with nonactionable motor findings on high\u2010resolution manometry"],"prefix":"10.1111","volume":"36","author":[{"given":"Rahul","family":"Peravali","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  Saint Louis Missouri USA"},{"name":"Division of Gastroenterology, Hepatology, and Nutrition University of Louisville School of Medicine  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3388-0660","authenticated-orcid":false,"given":"C. Prakash","family":"Gyawali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000734"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00356-8"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14119"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001061"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13584"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14134"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14193"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.08.019"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2014.06.003"},{"issue":"139","key":"e_1_2_10_12_1","first-page":"e27","article-title":"Botulinum toxin injection in dysphagia syndromes with preserved esophageal peristalsis and incomplete lower esophageal sphincter relaxation","volume":"23","author":"Porter RF","year":"2011","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01315604"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.08.029"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12838"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13777"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.41775.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4373-1"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-006-9022-y"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.02.046"},{"key":"e_1_2_10_21_1","first-page":"825","article-title":"Long\u2010term clinical and manometric follow\u2010up of patients with nonspecific esophageal motor disorders","volume":"87","author":"Achem SR","year":"1992","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2009.00962.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.13"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2016-000126"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314722"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox012"},{"issue":"1292","key":"e_1_2_10_28_1","first-page":"e336","article-title":"Perception of dysphagia: lack of correlation with objective measurements of esophageal function","volume":"22","author":"Lazarescu A","year":"2010","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.384"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12728"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14747","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T04:22:09Z","timestamp":1750652529000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.14747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,29]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/nmo.14747"],"URL":"https:\/\/doi.org\/10.1111\/nmo.14747","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,29]]},"assertion":[{"value":"2023-10-02","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":"2024-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14747"}}