{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:09:34Z","timestamp":1760832574856,"version":"build-2065373602"},"reference-count":71,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"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":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hypercontractile esophagus (HE) is rare. Esophageal high\u2010resolution manometry (HRM) with solid test meal (STM) in Chicago Classification (CCv4.0) may improve diagnostic yield, but outcome data are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Evaluate the clinical features and long\u2010term outcome of HE, and determine the clinical significance of hypercontractility detected only using STM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010center analysis of all patients with \u2265\u20092 hypercontractile swallows (HS) (distal contractile integral [DCI]\u2009&gt;\u20098000\u2009mmHg.s.cm) on HRM studies with single water swallows (SWS) and\/or STM between June 2014 and December 2021. A telephone survey was conducted between January and June 2023 using Impaction Dysphagia Questionnaire [IDQ], Eckardt scores, and the Gastro\u2010Esophageal Reflux Disease Questionnaire (GERD\u2010Q) to determine long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010eight patients (29 [60.4%] Female, 63.0 [13.4] years) with HS who presented with dysphagia (60%), reflux (37.5%) and chest pain (29.2%) and 58 controls (28 [48.3%] Female, 49 [13.4] years) with dysphagia (<jats:italic>n<\/jats:italic>\u2009=\u200943.1%), reflux (<jats:italic>n<\/jats:italic>\u2009=\u200941.4%) and chest pain (15.5%) with normal HRM findings were identified from 454 studies performed. More patients had HS with STM versus SWS (<jats:italic>n<\/jats:italic>\u2009=\u200941 [85.4%] vs. <jats:italic>n<\/jats:italic>\u2009=\u20097 [14.6%], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Dysphagia was significantly associated with mean DCI (<jats:italic>B<\/jats:italic>\u2009=\u20090.000, <jats:italic>p<\/jats:italic>\u2009=\u20090.035) and maximal DCI (<jats:italic>B<\/jats:italic>\u2009=\u20090.000, <jats:italic>p<\/jats:italic>\u2009=\u20090.036) during STM. 43% (<jats:italic>n<\/jats:italic>\u2009=\u20093\/7) and 22% (<jats:italic>n<\/jats:italic>\u2009=\u20099\/41) of patients with \u2265\u20092 HS using SWS and STM respectively were on medical therapy at mean (SD) clinic follow\u2010up of 28.7 (29.2) months. At mean (SD) follow\u2010up telephone survey of 61.3 (27.1) months from HRM, symptom scores amongst 36\/48 (75%) patients and 58 controls were: IDQ (3.8 [0\u20134] vs. 1.0 [0\u20131.3], <jats:italic>p<\/jats:italic>\u2009=\u20090.03); Eckardt dysphagia score (0.46 [0.0\u20131.0] vs. 0.14 [0\u20130], <jats:italic>p<\/jats:italic>\u2009=\u20090.007); GerdQ (6.4 [6.0\u20136.0] vs. 7.0 [6.0\u20138.0], pNS) respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>STM enhanced diagnostic yield of HS and identified more patients who benefitted from medical therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.70129","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T10:59:21Z","timestamp":1753268361000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hypercontractile Esophagus: Clinical Presentation, Role of Provocative Tests in High Resolution Manometry and Long Term Outcome\u2010Results From an Asian Cohort"],"prefix":"10.1111","volume":"37","author":[{"given":"Daphne","family":"Ang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seok\u2010Hwee","family":"Koo","sequence":"additional","affiliation":[{"name":"Clinical Trials and Research Unit Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wallace Bok\u2010Thoe","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of General Medicine Tan Tock Seng Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan Zi\u2010Yang","family":"Kuang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Tan Tock Seng Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew Xia\u2010Huang","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12071"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14115"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15658"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12252"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12160"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000496"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox085"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12975"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.10"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640618796752"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13276"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13507"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000001021"},{"key":"e_1_2_9_17_1","article-title":"Hypercontractile Esophagus: From Manometric Diagnosis to Clinical Presentation","volume":"3","author":"Clement M.","year":"2019","journal-title":"Canadian Journal of Gastroenterology and Hepatology"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13918"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000505123"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm20229"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm18042"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-020-00748-3"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-022-00916-7"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm22020"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90016-6"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.02.002"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.01003.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(87)90308-8"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(87)90979-6"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14010"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13594"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198312013092201"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01536159"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01682.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30151-6"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30148-6"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.313"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.02.046"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91428-7"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04142.x"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12902"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.01.024"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(00)70252-6"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2023-330616"},{"key":"e_1_2_9_45_1","first-page":"358","article-title":"The Symptom Index: A Clinically Important Parameter of Ambulatory 24\u2010Hour Esophageal pH Monitoring","volume":"93","author":"Wiener G. J.","year":"1988","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90815-X"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13105"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm15162"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12953"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13870"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-27756-9"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2016.06.030"},{"key":"e_1_2_9_54_1","first-page":"1576","article-title":"Acid\u2010Provoked Esophageal Spasm as a Cause of Noncardiac Chest Pain","volume":"86","author":"Crozier R. E.","year":"1991","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.12.289"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000001472"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2012.11.002"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001061"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2022.2047648"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529509101604"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03350130047033"},{"key":"e_1_2_9_62_1","first-page":"272","article-title":"Diltiazem Therapy for Symptoms Associated With Nutcracker Esophagus","volume":"86","author":"Cattau E. L.","year":"1991","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01347298"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i8.987"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2007.00957.x"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.6.758"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox085"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13587"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.03.021"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.10.011"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4373-1"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.15008"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T04:04:10Z","timestamp":1760760250000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.70129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":71,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/nmo.70129"],"URL":"https:\/\/doi.org\/10.1111\/nmo.70129","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"type":"print","value":"1350-1925"},{"type":"electronic","value":"1365-2982"}],"subject":[],"published":{"date-parts":[[2025,7,23]]},"assertion":[{"value":"2025-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70129"}}