{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:10Z","timestamp":1787017090732,"version":"build-2736575974"},"reference-count":25,"publisher":"BMJ","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1994,11]]},"abstract":"<jats:p>Secondary peristalsis was investigated in 30 patients with non-obstructive dysphagia and 20 age matched controls. Oesophageal motility was recorded at 3 cm intervals along the oesophageal body. Primary peristalsis was tested with 5 ml water swallows. Secondary peristalsis was stimulated with 10 ml boluses of air and water injected in the mid-oesophagus and by distensions (5 seconds duration) with a 3 cm balloon at the same level. Primary peristalsis was normal in 19 of the 20 control subjects and in nine of the 30 patients with dysphagia; 11 patients had diffuse spasm and 10 had non-specific abnormalities of primary peristalsis. Secondary peristalsis was triggered significantly less frequently by air and water distension in dysphagia patients (median success rate of 10% for the air boluses and 0% for the water boluses) than in control subjects (50% and 30% respectively, p &lt; 0.005), and was abnormal in six of nine patients with normal primary peristalsis, nine of 11 patients with diffuse spasm and eight of 10 patients with non-specific motor abnormalities. The median frequency of balloon induced secondary peristalsis, however, was not significantly different in the two groups (0% controls, 40% non-obstructive dysphagia, p = 0.22). For each stimulus, there were no significant differences in the response rate in the three subgroups of patients. The major pattern of failure of secondary peristalsis in response to the air and water boluses was the complete absence of any oesophageal response. The amplitude of complete secondary peristalsis triggered by the water boluses and the balloon was greater in the patients with dysphagia (p = 0.03) than in normal subjects, while the amplitude of the secondary peristaltic responses triggered by the air boluses was similar in the two groups. Secondary peristaltic velocity was also similar in normal subjects and patients with non-obstructive dysphagia. Patients with non-obstructive dysphagia show a noticeable defect in the triggering of secondary peristalsis which may make an important contribution to the delayed oesophageal bolus transit and dysphagia seen in this condition.<\/jats:p>","DOI":"10.1136\/gut.35.11.1523","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"1523-1528","source":"Crossref","is-referenced-by-count":56,"title":["Secondary oesophageal peristalsis in patients with non-obstructive dysphagia."],"prefix":"10.1136","volume":"35","author":[{"given":"M N","family":"Schoeman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R H","family":"Holloway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1994,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1007\/BF01537240","article-title":"Peristaltic dysfunction associated with nonobstructive dysphagia in reflux disease","volume":"35","author":"Jacob, P.; Kahrilas, P.; Vanagunas, A.","year":"1990","unstructured":"Jacob P, Kahrilas P, Vanagunas A. Peristaltic dysfunction associated with nonobstructive dysphagia in reflux disease. Dig Dis Sci 1990; 35: 939-42.","journal-title":"Dig Dis Sci"},{"key":"ref_2","first-page":"1292","article-title":"Graded esophageal balloon distension. A new provocative test for noncardiac chest pain","volume":"31","author":"Barish, C.F.; Castell, D.O.; Richter, J.E.","year":"1986","unstructured":"Barish CF, Castell DO, Richter JE. Graded esophageal balloon distension. A new provocative test for noncardiac chest pain. Dig Dis Sci 1986; 31: 1292-8.","journal-title":"Dig Dis Sci"},{"key":"ref_3","first-page":"307","article-title":"Esophageal radiography and manometry: correlation in 172 patients with dysphagia","volume":"149","author":"Ott, D.J.; Richter, J.E.; Chen, Y.M.; Wu, W.C.; Gelfand, D.W.; Castell, D.O.","year":"1987","unstructured":"Ott DJ, Richter JE, Chen YM, Wu WC, Gelfand DW, Castell DO. Esophageal radiography and manometry: correlation in 172 patients with dysphagia. Am _7 Roentgenol 1987; 149: 307-11."},{"key":"ref_4","first-page":"614","article-title":"Nonobstructive dysphagia in reflux esophagitis","volume":"84","author":"Triadafilopoulos, G.","year":"1989","unstructured":"Triadafilopoulos G. Nonobstructive dysphagia in reflux esophagitis. Am _J Gastroenterol 1989; 84: 614-18.","journal-title":"Am _J Gastroenterol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/0016-5085(81)90055-X","article-title":"Radionuclide transit: A sensitive screening test for esophageal dysfunction","volume":"80","author":"Russell, C.; Hill, L.; Holmes, E.; Hull, D.; Gannon, R.; Pope, C.","year":"1981","unstructured":"Russell C, Hill L, Holmes E, Hull D, Gannon R, Pope C. Radionuclide transit: A sensitive screening test for esophageal dysfunction. Gastroenterology 1981; 80: 887-92.","journal-title":"Gastroenterology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF01296854","article-title":"Solid bolus transit by oesophageal scintigraphy in patients with dysphagia and normal manometry and radiography","volume":"29","author":"Kjellen, G.; Svedberg, J.B.; Tibbling, L.","year":"1984","unstructured":"Kjellen G, Svedberg JB, Tibbling L. Solid bolus transit by oesophageal scintigraphy in patients with dysphagia and normal manometry and radiography. Dis Dig Sci 1984; 29: 1-5.","journal-title":"Dis Dig Sci"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/BF01307587","article-title":"Solid swallowing versus water swallowing: manometric study of dysphagia","volume":"37","author":"Keren, S.; Argaman, E.; Golan, M.","year":"1992","unstructured":"Keren S, Argaman E, Golan M. Solid swallowing versus water swallowing: manometric study of dysphagia. 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J7ournal of Gastrointestinal Motility 1991; 3: 123-30."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1136\/gut.24.5.421","article-title":"Radionuclide transit studies in the detection of oesophageal dysmotility","volume":"24","author":"Blackwell, J.; Hannan, W.; Adam, R.; Heading, R.","year":"1983","unstructured":"Blackwell J, Hannan W, Adam R, Heading R. Radionuclide transit studies in the detection of oesophageal dysmotility. Gut 1983; 24: 421-6.","journal-title":"Gut"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/0016-5085(89)91688-0","article-title":"Manometric responses to balloon distension in patients with nonobstructive dysphagia","volume":"97","author":"Deschner, W.K.; Maher, K.A.; Cattau, E.L.; Benjamin, S.B.","year":"1989","unstructured":"Deschner WK, Maher KA, Cattau EL, Benjamin SB. Manometric responses to balloon distension in patients with nonobstructive dysphagia. 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Journal of Gastrointestinal Motility 1990; 2:163.","journal-title":"Journal of Gastrointestinal Motility"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0016-5085(19)32264-4","article-title":"Improved infusion system for intraluminal esophageal manometry","volume":"73","author":"Arndorfer, R.C.; Stef, J.J.; Dodds, W.J.; Linehan, J.H.; Hogan, W.J.","year":"1977","unstructured":"Arndorfer RC, Stef JJ, Dodds WJ, Linehan JH, Hogan WJ. Improved infusion system for intraluminal esophageal manometry. Gastroenterology 1977; 73: 23-7.","journal-title":"Gastroenterology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/j.1365-2982.1989.tb00148.x","article-title":"Analysis of spontaneous gastroesophageal reflux and esophageal acid clearance in patients with reflux esophagitis","volume":"1","author":"Dodds, W.J.; Kahrilas, P.J.; Dent, J.; Hogan, W.J.; Kern, M.K.; Armdorfer, R.C.","year":"1989","unstructured":"Dodds WJ, Kahrilas PJ, Dent J, Hogan WJ, Kern MK, Armdorfer RC. Analysis of spontaneous gastroesophageal reflux and esophageal acid clearance in patients with reflux esophagitis. Journal of Gastrointestinal Motility 1989; 1: 105-14.","journal-title":"Journal of Gastrointestinal Motility"},{"issue":"94","key":"ref_15","first-page":"73","article-title":"Effect of peristaltic dysfunction on esophageal volume clearance","volume":"1988","author":"Kahrilas, P.J.; Dodds, W.J.; Hogan, W.J.","unstructured":"Kahrilas PJ, Dodds WJ, Hogan WJ. 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Dig Dis Sci 1987; 32: 583-92.","journal-title":"Dig Dis Sci"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1136\/gut.35.2.152","article-title":"Stimulation and characteristics of secondary oesophageal peristalsis in normal subjects","volume":"35","author":"Schoeman, M.; Holloway, R.","year":"1994","unstructured":"Schoeman M, Holloway R. Stimulation and characteristics of secondary oesophageal peristalsis in normal subjects. Gut 1994; 35: 152-8.","journal-title":"Gut"},{"key":"ref_19","article-title":"Discrete multivariate analysis: theory and practise","author":"Bishop, Y.M.M.; Fienberg, S.E.; Holland, P.W.","year":"1975","unstructured":"Bishop YMM, Fienberg SE, Holland PW. Discrete multivariate analysis: theory and practise. Cambridge, MA: The MIT Press, 1975."},{"key":"ref_20","article-title":"Computational Handbook of Statistics","author":"Brunning, J.L.; Kintz, B.L.","year":"1987","unstructured":"Brunning JL, Kintz BL. Computational Handbook of Statistics 3rd ed. Glenview, Illinois: Harper Collins Publishers, 1987.","edition":"3rd ed"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1002\/bjs.1800761104","article-title":"Primary disorders of oesophageal motility","volume":"76","author":"Stuart, R.C.; Hennessy, T.P.J.","year":"1989","unstructured":"Stuart RC, Hennessy TPJ. Primary disorders of oesophageal motility. BrJ Surg 1989; 76: 1111-20.","journal-title":"BrJ Surg"},{"key":"ref_22","first-page":"284","article-title":"Effect of oesophageal emptying and saliva on clearance of acid from the esophagus","volume":"310","author":"Helm, J.F.; Dodds, W.J.; Pelc, L.R.; Palmer, D.W.; Hogan, W.J.; Teeter, B.C.","year":"1984","unstructured":"Helm JF, Dodds WJ, Pelc LR, Palmer DW, Hogan WJ, Teeter BC. Effect of oesophageal emptying and saliva on clearance of acid from the esophagus. NEngl7Med 1984; 310: 284-8."},{"key":"ref_23","first-page":"256","article-title":"Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects..7 Clin Invest","volume":"65","author":"Dent, J.; Dodds, W.J.; Freidman, R.H.","year":"1980","unstructured":"Dent J, Dodds WJ, Freidman RH, et al. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects..7 Clin Invest 1980; 65: 256-67."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/0016-5085(92)90028-W","article-title":"Identification of an abnormal esophageal clearance response to intraluminal distension in patients with esophagitis","volume":"103","author":"Williams, D.; Thompson, D.G.; Marples, M.","year":"1992","unstructured":"Williams D, Thompson DG, Marples M, et al. Identification of an abnormal esophageal clearance response to intraluminal distension in patients with esophagitis. Gastroenterology 1992; 103: 943-53.","journal-title":"Gastroenterology"},{"key":"ref_25","first-page":"157","article-title":"Integrity and characteristics of secondary peristalsis in patients with gastroesophageal reflux disease","volume":"100","author":"Schoeman, M.N.; Tippett, M.; Dent, J.; Holloway, R.H.","year":"1991","unstructured":"Schoeman MN, Tippett M, Dent J, Holloway RH. Integrity and characteristics of secondary peristalsis in patients with gastroesophageal reflux disease [Abstract]. 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