{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:19:12Z","timestamp":1773901152727,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"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>Introduction<\/jats:title><jats:p>Gastric inlet patches are often incidental, but can also be a treatable cause of laryngo\u2010esophageal symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed all patients whose gastric inlet patches were diagnosed following assessment for laryngopharyngeal and swallowing symptoms. Improvement following Argon Plasma Coagulation (APC) was assessed using Minimum Clinically\u2010Important Difference methodology combining voice, throat, and swallowing domains. Correlations between APC response and measures of reflux and mucosal barrier integrity, measured during 24\u2010h pH\u2010impedance manometry, were obtained. Proximal and Distal Mean Nocturnal Baseline Impedance (MNBI) values were separately calculated and the novel variable of Mucosal Impedance Gradient was derived as [((Distal MNBI\u2010Proximal MNBI)\/((Distal MNBI\u2009+\u2009Proximal MMBI)\/2))\u2009x\u2009100].<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Inlet patches were detected in 57 of 651 patients who had Transnasal Panendoscopy (8.7\u2009\u00b1\u20092.2%). There were 34 males. Mean age was 58\u2009years. Mean duration of symptoms was 2\u2009years. The commonest symptoms were hoarseness (<jats:italic>n<\/jats:italic>\u2009=\u200933), throat symptoms (<jats:italic>n<\/jats:italic>\u2009=\u200924), and dysphagia (<jats:italic>n<\/jats:italic>\u2009=\u200921), respectively. APC was used to ablate patches in 34 patients. Treatment response was 71% at a mean followup of 5.5\u2009months. MIG\u2009&gt;\u2009\u2212\u200925% predicted response to APC, with area under the receiver operating characteristic curve of 0.875 (Sensitivity\u2009=\u200981%; Specificity\u2009=\u2009100%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gastric inlet patches are common and under\u2010recognized. They can cause protracted pharyngo\u2010esophageal symptoms. Patch ablation is an effective treatment for carefully selected patients. Optimal patient selection requires multidisciplinary teamwork. Mucosal Impedance Gradient could further refine patient selection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14768","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T09:42:27Z","timestamp":1710495747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A multidisciplinary approach to identifying and managing heterotopic gastric inlet patches"],"prefix":"10.1111","volume":"36","author":[{"given":"L.","family":"Ayres","sequence":"first","affiliation":[{"name":"Department of Gastroenterology University Hospitals of Dorset NHS Foundation Trust  Poole UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Perring","sequence":"additional","affiliation":[{"name":"Department of Medical Physics University Hospitals of Dorset NHS Foundation Trust  Poole UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5604-1739","authenticated-orcid":false,"given":"S. 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