ArticleNeurogastroenterology and motility2012
Multiple rapid swallow responses segregate achalasia subtypes on high-resolution manometry.
Article in Neurogastroenterology and motility, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical Practice Update: The Use of Per-Oral Endoscopic Myotomy in Achalasia: Expert Review and Best Practice Advice From the AGA Institute.Gastroenterology · 2017Guideline
- MULTICHANNEL INTRALUMINAL IMPEDANCE MAY BE USEFUL TO IDENTIFY CLINICALLY RELEVANT ESOPHAGOGASTRIC JUNCTION OUTFLOW OBSTRUCTION.Arquivos de gastroenterologia · 2026Article
- Integrated Relaxation Pressure and Its Diagnostic Ability May Vary According to the Conditions Used for HREM Recording.Dysphagia · 2024Article
- Advancing high-resolution manometry: evaluating the use of multiple rapid swallows versus apple viscous swallows in clinical practice.Esophagus : official journal of the Japan Esophageal Society · 2022Article
- Achalasia.Nature reviews. Disease primers · 2022Review
- A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans.Frontiers in veterinary science · 2022Review
- Normal Values of High-resolution Manometry Parameters With Provocative Maneuvers.Journal of neurogastroenterology and motility · 2021Article
- Chicago classification version 4.0Neurogastroenterology and motility · 2021Review
- Role of the Rapid Drink Challenge Test in Esophageal Motility Disorder Diagnosis.Journal of neurogastroenterology and motility · 2020Article
- Esophageal Motor Dysfunctions in Gastroesophageal Reflux Disease and Therapeutic Perspectives.Journal of neurogastroenterology and motility · 2019Review
- Mechanisms of repetitive retrograde contractions in response to sustained esophageal distension: a study evaluating patients with postfundoplication dysphagia.American journal of physiology. Gastrointestinal and liver physiology · 2018Article
- Maturation Modulates Pharyngeal-Stimulus Provoked Pharyngeal and Respiratory Rhythms in Human Infants.Dysphagia · 2018Article
- Achalasia: It Is Not All Black and White.Current gastroenterology reports · 2017Review
- Esophageal motility after peroral endoscopic myotomy for achalasia.Journal of gastroenterology · 2016Article
- Identification of Quality Measures for Performance of and Interpretation of Data From Esophageal Manometry.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2016Article
- Achalasia symptom response after Heller myotomy segregated by high-resolution manometry subtypes.Journal of gastroenterology · 2016Observational
- Histopathologic patterns among achalasia subtypes.Neurogastroenterology and motility · 2016Article
- Article
- Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology.Neurogastroenterology and motility · 2014Article
- Treatment implications of high-resolution manometry findings: options for patients with esophageal dysmotility.Current treatment options in gastroenterology · 2014Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundMultiple rapid swallows (MRS) inhibit esophageal peristalsis and lower esophageal sphincter (LES) tone; a rebound excitatory response then results in an exaggerated peristaltic sequence. Multiple rapid swallows responses are dependent on intact inhibitory and excitatory neural function and could vary by subtype in achalasia spectrum disorders.
methodsConsecutive subjects with incomplete LES relaxation on high-resolution manometry (HRM) (Sierra Scientific, Los Angeles, CA, USA) in the absence of mechanical obstruction were prospectively identified. Achalasia spectrum disorders were classified and HRM plots reviewed according to Chicago criteria. Esophageal peristaltic performance and LES function were assessed after 10 wet swallows and MRS (five 2 mL water swallows 2-3 s apart). Findings were compared with 18 healthy controls (28.5 ± 0.6 years, 44% women). KEY
resultsA total of 46 subjects (57.1 ± 2.1 years, 52.2% women) met inclusion criteria. There was complete failure of peristalsis with MRS in all subjects with achalasia subtypes 1 and 2. In contrast, 80% of achalasia subtype 3 and incomplete LES relaxation (EGJ outflow obstruction) with preserved esophageal body peristalsis had a contractile response to MRS (P < 0.001 compared with subtypes 1 and 2); controls demonstrated 94.4% peristalsis. Percent decrease in LES residual pressure during MRS (compared to wet swallows) segregated achalasia subtypes; those with aperistalsis (subtypes 1 and 2) had a lesser decline (22.6%) compared to those with retained esophageal body peristalsis (40.5%) and controls (51.3%, P < 0.001 across groups). CONCLUSIONS & INFERENCES: Multiple rapid swallow responses segregate achalasia spectrum disorders into two patterns differentiated by presence or absence of esophageal body contraction response to wet swallows. These findings support subtyping of achalasia, with pathophysiologic implications.
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