{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:15:23Z","timestamp":1784204123425,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>According to Lyon 2.0, laryngopharyngeal symptoms (LPS) should undergo upfront pathophysiologic tests. The novel Milan score integrates esophagogastric junction (EGJ) morphology, ineffective esophageal motility, EGJ\u2010contractile integral (EGJ\u2010CI), and straight leg raise (SLR) response. It has been demonstrated to predict abnormal AET. The aim of this study was to assess the value of the Milan score in predicting GERD in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled patients with suspected GERD who underwent HRM and MII pH from 12 referral centers. Patients with isolated LPS (reflux symptom index\u2009&gt;\u200913) were compared with typical GERD symptoms (GERD\u2010HRQL\u2009\u2265\u200910). A Milan score\u2009&gt;\u2009137 was considered positive. The effectiveness of the Milan score in the identification of patients with pathologic GERD was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 570 patients (49% females, median age 49\u2009years, BMI\u200924\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), isolated LPS was found in 30 patients and isolated typical symptoms in 154. An AET\u2009&gt;\u20096% was found in 23% of the LPS group and 43% of the typical symptom group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). The Milan score was higher in the typical symptoms group, with higher scores for EGJ\u2010CI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039) and SLR response (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) components. The likelihood of concordance of the Milan score and AET on reflux monitoring was similar (83.3% vs. 84.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.532).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with isolated LPS demonstrated a lower likelihood of EGJ disruption, pathologic GERD, and abnormal Milan score. The Milan score performed similarly well in the identification of GERD in both LPS and typical symptoms and could therefore be used as an upfront test in LPS patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70015","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T14:34:32Z","timestamp":1746196472000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Milan Score is an Effective Manometric Tool to Predict Gastroesophageal Reflux in Patients With Laryngopharyngeal Symptoms"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0532-3135","authenticated-orcid":false,"given":"Stefano","family":"Siboni","sequence":"first","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Sozzi","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6985-5301","authenticated-orcid":false,"given":"Pierfrancesco","family":"Visaggi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7999-1625","authenticated-orcid":false,"given":"Ivan","family":"Kristo","sequence":"additional","affiliation":[{"name":"Upper\u2010GI\u2010Service Medizinische Universit\u00e4t  Wien Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-1060","authenticated-orcid":false,"given":"Nicola","family":"De Bortoli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1653-9903","authenticated-orcid":false,"given":"Salvatore","family":"Tolone","sequence":"additional","affiliation":[{"name":"Division of General, Mini\u2010Invasive and Bariatric Surgery University of Naples  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Marabotto","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit IRCCS Policlinico San Martino  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian F.","family":"Schoppmann","sequence":"additional","affiliation":[{"name":"Upper\u2010GI\u2010Service Medizinische Universit\u00e4t  Wien Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6918-9479","authenticated-orcid":false,"given":"Roberto","family":"Penagini","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Hobson","sequence":"additional","affiliation":[{"name":"The Functional Gut Clinic  London 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Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6562-2666","authenticated-orcid":false,"given":"Vincent","family":"Tee","sequence":"additional","affiliation":[{"name":"School of Medical Sciences and GI Function and Motility Unit Universiti Sains Malaysia  Kota Bharu Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Surgery Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Foregut Surgery Unit University of Athens School of Medicine  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"Foregut Surgery Unit University of Athens School of Medicine  Athens 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Prakash","family":"Gyawali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31134"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2020.11.002"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102023\u2010330616"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001389"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000538399"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30421"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17934"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doy018"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002557"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12565"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04142.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2007.00658.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(02)00097-8"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12267"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12175548"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.10.008"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13067"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i32.4371"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.670"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.06.026"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640616675040"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05482-w"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i32.4363"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15391"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm22049"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2017.1322139"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002839"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.69"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpgasthep0358"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102020\u2010322627"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.01.021"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70015","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.70015","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:43:34Z","timestamp":1777470214000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.70015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,2]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/nmo.70015"],"URL":"https:\/\/doi.org\/10.1111\/nmo.70015","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,2]]},"assertion":[{"value":"2024-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70015"}}