{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:40:01Z","timestamp":1781851201252,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK109376"],"award-info":[{"award-number":["R01DK109376"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK138047"],"award-info":[{"award-number":["R01DK138047"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"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>During swallowing, the bolus passes through the esophagus during the relaxation phase of peristalsis\u2014termed the bolus domain (BD)\u2014before being cleared by sequential contractions. Bolus pressure (BP) in BD results from the compartmentalization of the bolus between the advancing contraction and the lower esophageal sphincter. This study aimed to evaluate the genesis of BP in the BD using high\u2010resolution impedance manometry (HRMZ), distension\u2010contraction plots, and high\u2010frequency ultrasound imaging in healthy subjects and \u201cfunctional dysphagia (FD)\u201d patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed HRMZ recordings from 30 healthy controls and 30 FD patients. Swallows of 5\u2009mL and 10\u2009mL saline were recorded in the supine and Trendelenburg positions. BP was measured in the BD (from upper esophageal sphincter relaxation to the 20\u2010mmHg isocontour onset of contraction). Automated tools extracted BP, luminal cross\u2010sectional area (CSA), and the percentage of BD area with CSA \u2264\u200950\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      (no\u2010bolus area). Ultrasound images evaluated the timing of luminal distension and wall changes during the bolus domain and contraction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Controls showed luminal distension in most of the BD. On the other hand, FD patients exhibited higher BP and a significantly larger percentage of no\u2010bolus areas in the BD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to controls. ROC analysis revealed high diagnostic accuracy in distinguishing patients from controls (AUC\u2009=\u20090.898) for the percentage of no\u2010bolus area in the BD; a 16.5% threshold yielding 86.7% sensitivity and 80.0% specificity. Ultrasound imaging confirmed luminal collapse during the bolus domain in patients with FD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions &amp; Inferences<\/jats:title>\n                    <jats:p>In patients with FD, bolus pressure is partly related to the compression of the manometry catheter by the esophageal wall. The proportion of BP\u2010positive, bolus\u2010negative areas in the BD distinguishes FD patients and controls.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70175","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T07:23:01Z","timestamp":1759216981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Genesis of Bolus Pressure During Primary Peristalsis: Key to Understanding \u201cFunctional Dysphagia\u201d"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2564-7380","authenticated-orcid":false,"given":"Myeongsook","family":"Seo","sequence":"first","affiliation":[{"name":"University of California San Diego  San Diego California USA"},{"name":"Department of Internal Medicine, Gangneung Asan Hospital University of Ulsan College of Medicine  Gangneung Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1681-3845","authenticated-orcid":false,"given":"Segyeong","family":"Joo","sequence":"additional","affiliation":[{"name":"University of California San Diego  San Diego California USA"},{"name":"Department of Biomedical Engineering, Brain Korea 21 Project, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0272-7492","authenticated-orcid":false,"given":"Ali","family":"Zifan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine University of California at San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-9617","authenticated-orcid":false,"given":"Ravinder K.","family":"Mittal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine University of California at San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.10.029"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.012"},{"issue":"4","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.7326\/0003-4819-106-4-593","article-title":"Esophageal Testing of Patients With Noncardiac Chest Pain or Dysphagia. 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