{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:50:09Z","timestamp":1773413409571,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Clinical Research Plan of SHDC","award":["SHDC2022CRT004"],"award-info":[{"award-number":["SHDC2022CRT004"]}]},{"name":"Science and Technology Innovation Action Plan of STCSM","award":["22DZ2203900"],"award-info":[{"award-number":["22DZ2203900"]}]},{"name":"Shanghai Municipal Science and Technology Project","award":["21Y11658500"],"award-info":[{"award-number":["21Y11658500"]}]},{"name":"Shanghai Informatization Development Special project","award":["202001003"],"award-info":[{"award-number":["202001003"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81974067"],"award-info":[{"award-number":["81974067"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"DOI":"10.1186\/s12876-026-04676-x","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T05:05:13Z","timestamp":1770613513000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mid-esophageal mucosal impedance reflects mucosal integrity and phenotypes refractory reflux-like symptoms"],"prefix":"10.1186","volume":"26","author":[{"given":"Bo","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenxiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huihui","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuchang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"issue":"8","key":"4676_CR1","doi-asserted-by":"publisher","first-page":"1900","DOI":"10.1111\/j.1572-0241.2006.00630.x","volume":"101","author":"N van Vakil","year":"2006","unstructured":"Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900\u201320. quiz 1943.","journal-title":"Am J Gastroenterol"},{"issue":"3","key":"4676_CR2","doi-asserted-by":"publisher","first-page":"142","DOI":"10.4297\/najms.2011.3142","volume":"3","author":"BM Mahdi","year":"2011","unstructured":"Mahdi BM. The relationship between Helicobacter pylori infection and gastro-esophageal reflux disease. N Am J Med Sci. 2011;3(3):142\u20135.","journal-title":"N Am J Med Sci"},{"issue":"1","key":"4676_CR3","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1590\/s0004-2803.2017v54n1-08","volume":"54","author":"BM Mahdi","year":"2017","unstructured":"Mahdi BM, Hasan RM, Salih WH. Human leukocyte antigen HLADRB1 determinants susceptibility to gastroesophageal reflux disease. Arq Gastroenterol. 2017;54(1):41\u20135.","journal-title":"Arq Gastroenterol"},{"issue":"1","key":"4676_CR4","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1007\/s10157-015-1130-2","volume":"20","author":"T Namikoshi","year":"2016","unstructured":"Namikoshi T, Harada K, Hatta H, Tokura T, Oshiro Y, Nishizaki T, Obata T, Mori M, Fueki T, Fujimoto S, Haruna Y, Kuwabara A, Yorimitsu D, Ihoriya C, Kadoya H, Itano S, Fujimoto Y, Komai N, Sasaki T, Kashihara N. Prevalence of gastroesophageal reflux disease symptoms and effects of Esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance Hemodialysis. Clin Exp Nephrol. 2016;20(1):134\u201342.","journal-title":"Clin Exp Nephrol"},{"issue":"7","key":"4676_CR5","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1080\/00365521.2021.1929448","volume":"56","author":"KM Klausen","year":"2021","unstructured":"Klausen KM, Bomme H\u00f8gh M, David M, de Schaffalitzky OB, Hansen JM. How dyspepsia, gastroesophageal reflux symptoms, and overlapping symptoms affect quality of life, use of health care, and medication - a long-term population based cohort study. Scand J Gastroenterol. 2021;56(7):753\u201360.","journal-title":"Scand J Gastroenterol"},{"issue":"1","key":"4676_CR6","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s12876-018-0832-9","volume":"18","author":"I Martinucci","year":"2018","unstructured":"Martinucci I, Natilli M, Lorenzoni V, Pappalardo L, Monreale A, Turchetti G, Pedreschi D, Marchi S, Barale R, de Bortoli N. Gastroesophageal reflux symptoms among Italian university students: epidemiology and dietary correlates using automatically recorded transactions. BMC Gastroenterol. 2018;18(1):116.","journal-title":"BMC Gastroenterol"},{"issue":"4","key":"4676_CR7","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1590\/S0004-28032012000400012","volume":"49","author":"JP Moraes-Filho","year":"2012","unstructured":"Moraes-Filho JP. Refractory gastroesophageal reflux disease. Arq Gastroenterol. 2012;49(4):296\u2013301.","journal-title":"Arq Gastroenterol"},{"issue":"1","key":"4676_CR8","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.mcna.2018.08.002","volume":"103","author":"R Yadlapati","year":"2019","unstructured":"Yadlapati R, DeLay K. Proton pump Inhibitor-Refractory gastroesophageal reflux disease. Med Clin North Am. 2019;103(1):15\u201327.","journal-title":"Med Clin North Am"},{"issue":"3","key":"4676_CR9","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1038\/ajg.2012.444","volume":"108","author":"P O Katz","year":"2013","unstructured":"O Katz P, B Gerson L, F Vela M. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308\u201328. quiz 329.","journal-title":"Am J Gastroenterol"},{"issue":"12","key":"4676_CR10","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1111\/apt.16930","volume":"55","author":"APS Hungin","year":"2022","unstructured":"Hungin APS, Scarpignato C, Keefer L, Corsetti M, Anastasiou F, Muris JWM, Mendive JM, Kahrilas PJ. Review article: rethinking the ladder approach to reflux-like symptom management in the era of PPI resistance - a multidisciplinary perspective. Aliment Pharmacol Ther. 2022;55(12):1492\u2013500.","journal-title":"Aliment Pharmacol Ther"},{"issue":"4","key":"4676_CR11","doi-asserted-by":"publisher","first-page":"e14075","DOI":"10.1111\/nmo.14075","volume":"33","author":"F Zerbib","year":"2021","unstructured":"Zerbib F, Bredenoord AJ, Fass R, Kahrilas PJ, Roman S, Savarino E, Sifrim D, Vaezi M, Yadlapati R, Gyawali CP. ESNM\/ANMS consensus paper: diagnosis and management of refractory gastro-esophageal reflux disease. Neurogastroenterol Motil. 2021;33(4):e14075.","journal-title":"Neurogastroenterol Motil"},{"issue":"7","key":"4676_CR12","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1136\/gutjnl-2017-314722","volume":"67","author":"CP Gyawali","year":"2018","unstructured":"Gyawali CP, Kahrilas PJ, Savarino E, Zerbib F, Mion F, Smout A, Vaezi M, Sifrim D, Fox MR, Vela MF, Tutuian R, Tack J, Bredenoord AJ, Pandolfino J, Roman S. Modern diagnosis of GERD: the Lyon consensus. Gut. 2018;67(7):1351\u201362.","journal-title":"Gut"},{"issue":"3","key":"4676_CR13","doi-asserted-by":"publisher","first-page":"e13752","DOI":"10.1111\/nmo.13752","volume":"32","author":"M Ribolsi","year":"2020","unstructured":"Ribolsi M, Gyawali CP, Savarino E, Rogers B, Rengarajan A, Della Coletta M, Ghisa M, Cicala M. Correlation between reflux burden, peristaltic function, and mucosal integrity in GERD patients. Neurogastroenterol Motil. 2020;32(3):e13752.","journal-title":"Neurogastroenterol Motil"},{"issue":"1","key":"4676_CR14","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.cgh.2015.06.026","volume":"14","author":"M Frazzoni","year":"2016","unstructured":"Frazzoni M, Savarino E, de Bortoli N, Martinucci I, Furnari M, Frazzoni L, Mirante VG, Bertani H, Marchi S, Conigliaro R, Savarino V. Analyses of the Post-reflux Swallow-induced peristaltic wave index and nocturnal baseline impedance parameters increase the diagnostic yield of impedance-pH monitoring of patients with reflux disease. Clin Gastroenterol Hepatol. 2016;14(1):40\u20136.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"2","key":"4676_CR15","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1136\/gutjnl-2023-330616","volume":"73","author":"CP Gyawali","year":"2024","unstructured":"Gyawali CP, Yadlapati R, Fass R, Katzka D, Pandolfino J, Savarino E, Sifrim D, Spechler S, Zerbib F, Fox MR, Bhatia S, de Bortoli N, Cho YK, Cisternas D, Chen CL, Cock C, Hani A, Remes Troche JM, Xiao Y, Vaezi MF, Roman S. Updates to the modern diagnosis of GERD: Lyon consensus 2.0. Gut. 2024;73(2):361\u201371.","journal-title":"Gut"},{"key":"4676_CR16","doi-asserted-by":"publisher","unstructured":"Zerbib F, Roman S, Bruley Des Varannes S, Gourcerol G, Coffin B, Ropert A, Lepicard P, Mion F. Groupe Fran\u00e7ais de Neuro-Gastroent\u00e9rologie. Normal values of pharyngeal and esophageal 24-hour pH impedance in individuals on and off therapy and interobserver reproducibility. Clin Gastroenterol Hepatol. 2013;11(4):366\u201372. https:\/\/doi.org\/10.1016\/j.cgh.2012.10.041. Epub 2012 Nov 8. PMID: 23142603.","DOI":"10.1016\/j.cgh.2012.10.041"},{"key":"4676_CR17","doi-asserted-by":"publisher","unstructured":"Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: disorders of gut-brain interaction. Gastroenterol. 2016;150(6):1257\u201361.\u00a0https:\/\/doi.org\/10.1053\/j.gastro.2016.03.035. PMID: 27147121.","DOI":"10.1053\/j.gastro.2016.03.035"},{"issue":"3","key":"4676_CR18","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1111\/jgh.13986","volume":"33","author":"WY Lei","year":"2018","unstructured":"Lei WY, Hung JS, Liu TT, Yi CH, Chen CL. Influence of Prucalopride on esophageal secondary peristalsis in reflux patients with ineffective motility. J Gastroenterol Hepatol. 2018;33(3):650\u20135.","journal-title":"J Gastroenterol Hepatol"},{"key":"4676_CR19","doi-asserted-by":"publisher","unstructured":"Ravi K, Geno DM, Vela MF, Crowell MD, Katzka DA. Baseline impedance measured during high-resolution esophageal impedance manometry reliably discriminates GERD patients. Neurogastroenterol Motil. 2017;29(5). https:\/\/doi.org\/10.1111\/nmo.12974.","DOI":"10.1111\/nmo.12974"},{"issue":"1","key":"4676_CR20","doi-asserted-by":"publisher","first-page":"43","DOI":"10.5056\/jnm17032","volume":"24","author":"C Xie","year":"2018","unstructured":"Xie C, Sifrim D, Li Y, Chen M, Xiao Y. Esophageal baseline impedance reflects mucosal integrity and predicts symptomatic outcome with proton pump inhibitor treatment. J Neurogastroenterol Motil. 2018;24(1):43\u201350.","journal-title":"J Neurogastroenterol Motil"},{"issue":"9","key":"4676_CR21","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1111\/nmo.12620","volume":"27","author":"TV Herregods","year":"2015","unstructured":"Herregods TV, Troelstra M, Weijenborg PW, Bredenoord AJ, Smout AJ. Patients with refractory reflux symptoms often do not have GERD. Neurogastroenterol Motil. 2015;27(9):1267\u201373.","journal-title":"Neurogastroenterol Motil"},{"issue":"4","key":"4676_CR22","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/s00535-022-01861-z","volume":"57","author":"K Iwakiri","year":"2022","unstructured":"Iwakiri K, Fujiwara Y, Manabe N, Ihara E, Kuribayashi S, Akiyama J, Kondo T, Yamashita H, Ishimura N, Kitasako Y, Iijima K, Koike T, Omura N, Nomura T, Kawamura O, Ohara S, Ozawa S, Kinoshita Y, Mochida S, Enomoto N, Shimosegawa T, Koike K. Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2021. J Gastroenterol. 2022;57(4):267\u201385.","journal-title":"J Gastroenterol"},{"issue":"5","key":"4676_CR23","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1038\/nrgastro.2016.50","volume":"13","author":"E Scarpellini","year":"2016","unstructured":"Scarpellini E, Ang D, Pauwels A, De Santis A, Vanuytsel T, Tack J. Management of refractory typical GERD symptoms. Nat Rev Gastroenterol Hepatol. 2016;13(5):281\u201394.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"4676_CR24","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/17474124.2022.2163236","volume":"17","author":"M Ribolsi","year":"2023","unstructured":"Ribolsi M, Andrisani G, Di Matteo FM, Cicala M. Achalasia, from diagnosis to treatment. Expert Rev Gastroenterol Hepatol. 2023;17(1):21\u201330.","journal-title":"Expert Rev Gastroenterol Hepatol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-026-04676-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-026-04676-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-026-04676-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:33:26Z","timestamp":1773398006000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12876-026-04676-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4676"],"URL":"https:\/\/doi.org\/10.1186\/s12876-026-04676-x","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]},"assertion":[{"value":"6 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"166"}}