{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:51:08Z","timestamp":1791910268906,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diaphragmatic breathing training (DBT) improves symptoms in patients with gastroesophageal reflux disease; however, the effect of DBT on the anti\u2010reflux barrier and esophageal motility is unclear. This study aimed to evaluate the changes in specific parameters of EGJ function and esophageal motility before and after DBT using high\u2010resolution manometry (HRM) in patients with reflux symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospectively collected data from adult patients with persistent reflux symptoms who underwent initial and follow\u2010up HRM after at least 3\u2009months of DBT were analyzed. Esophagogastric junction (EGJ) function was assessed using basal lower esophageal sphincter (LES) pressure (LESP), the EGJ contractile integral (EGJ\u2010CI), and integrated relaxation pressure (IRP). Esophageal motility was assessed using the distal contractile integral (DCI) and percentage of ineffective esophageal motility (IEM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Data from 53 patients with a median age of 45\u2009years (range 25\u201377) were analyzed. LES pressure increased after DBT (mean LES pressure 25.6 [SE 1.3] vs. 29.1 [SE 1.4] mmHg after DBT;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). This effect was also observed in patients with an initially hypotensive LES, but no effect was found on the size of hiatus hernia. There was a trend to increased EGJ\u2010CI (mean EGJ\u2010CI 52.8 [SE 3.7] vs. 59.9 [SE 4.3] mmHg\u0387cm after DBT,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07). Esophageal contractility improved (mean DCI 1046.6 [SE 112] vs. 1264.1 [SE 137] mmHg\u0387s\u0387cm after DBT;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) with the prevalence of IEM reduced from 38.0% [SE 5] to 29.2% [SE 4] after DBT;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Inferences<\/jats:title>\n                    <jats:p>Diaphragmatic breathing training increased LES pressure and esophageal peristaltic vigor in patients with reflux symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70172","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T06:25:38Z","timestamp":1758608738000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Diaphragmatic Breathing Training on the Esophagogastric Junction and Esophageal Motility in Patients With Reflux Symptoms"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6193-4657","authenticated-orcid":false,"given":"Lucie","family":"Zdrhova","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine, Pilsen University Hospital Charles University in Prague  Pilsen Czech Republic"},{"name":"Pavel Kol\u00e1\u0159 Centre for Movement Medicine  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Bitnar","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Friedl","sequence":"additional","affiliation":[{"name":"Department of Anthropology University of West Bohemia  Pilsen Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Mares","sequence":"additional","affiliation":[{"name":"Department of Data Science Institute for Clinical and Experimental Medicine  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Madle","sequence":"additional","affiliation":[{"name":"Pavel Kol\u00e1\u0159 Centre for Movement Medicine  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel","family":"Balihar","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Pilsen University Hospital Charles 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