ArticleAmerican journal of physiology. Gastrointestinal and liver physiology2014
The four phases of esophageal bolus transit defined by high-resolution impedance manometry and fluoroscopy.
Article in American journal of physiology. Gastrointestinal and liver physiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06883175 (Evolution of the Chicago Classification), which is not on this map. Cited by 36 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evolution of the Chicago Classification: Bridging Physiology and Mechanics
Who cites it
36 citing papers in PubMed.
- Biomechanical Assessment During High-Resolution Impedance Manometry Enhances Characterization of Inconclusive Esophagogastric Junction Outflow Obstruction.Neurogastroenterology and motility · 2026Article
- Future perspectives in esophageal manometry.World journal of gastrointestinal surgery · 2025Review
- Upper Esophageal Sphincter Abnormalities and Esophageal Motility Recovery After Peroral Endoscopic Myotomy for Achalasia.Dysphagia · 2025Article
- Assessing Treatment Outcomes in Achalasia Using 4-Dimensional High-resolution Impedance Manometry.Journal of neurogastroenterology and motility · 2025Article
- Phrenic Ampulla Emptying Dysfunction: Unveiling the Role of Lower Esophageal Sphincter After-contraction.Journal of neurogastroenterology and motility · 2024Article
- A Mechanics-Based Perspective on the Function of Human Sphincters During Functional Luminal Imaging Probe Manometry.Journal of biomechanical engineering · 2024Article
- Why so Many Patients With Dysphagia Have Normal Esophageal Function Testing.Gastro hep advances · 2024Article
- Utility of Functional Lumen Imaging Probe in the Evaluation of Esophageal Conditions.The American journal of gastroenterology · 2024Article
- Impaired sliding between the lower esophageal sphincter and crural diaphragm (esophageal hiatus) in patients with achalasia esophagus.American journal of physiology. Gastrointestinal and liver physiology · 2023Article
- Esophageal wall compliance/stiffness during peristalsis in patients with functional dysphagia and high-amplitude esophageal contractions.American journal of physiology. Gastrointestinal and liver physiology · 2022Article
- Normative values of intra-bolus pressure and esophageal compliance based on 4D high-resolution impedance manometry.Neurogastroenterology and motility · 2022Article
- Distension contraction plots of pharyngeal/esophageal peristalsis: next frontier in the assessment of esophageal motor function.American journal of physiology. Gastrointestinal and liver physiology · 2022Review
- Bolus flow and biomechanical properties of the esophageal wall during primary esophageal peristalsis: Effects of bolus viscosity and posture.Neurogastroenterology and motility · 2022Article
- Esophageal Bolus Domain Pressure and Peristalsis Associated With Experimental Induction of Esophagogastric Junction Outflow Obstruction.Journal of neurogastroenterology and motility · 2022Article
- Measurement of outflow resistance imposed by magnetic sphincter augmentation: defining normal values and clinical implication.Surgical endoscopy · 2021Article
- Four-dimensional impedance manometry derived from esophageal high-resolution impedance-manometry studies: a novel analysis paradigm.Therapeutic advances in gastroenterology · 2020Article
- Characterization and mechanism of the esophago-esophageal contractile reflex of the striated muscle esophagus.American journal of physiology. Gastrointestinal and liver physiology · 2019Article
- New Developments in Esophageal Motility Testing.Current treatment options in gastroenterology · 2019Review
- Advances in Management of Esophageal Motility Disorders.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2018Review
- Studies of abnormalities of the lower esophageal sphincter during esophageal emptying based on a fully coupled bolus-esophageal-gastric model.Biomechanics and modeling in mechanobiology · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
We aimed to model esophageal bolus transit based on esophageal pressure topography (EPT) landmarks, concurrent intrabolus pressure (IBP), and esophageal diameter as defined with fluoroscopy. Ten healthy subjects were studied with high-resolution impedance manometry and videofluoroscopy. Data from four 5-ml barium swallows (2 upright, 2 supine) in each subject were analyzed. EPT landmarks were utilized to divide bolus transit into four phases: phase I, upper esophageal sphincter (UES) opening; phase II, UES closure to the transition zone (TZ); phase III, TZ to contractile deceleration point (CDP); and phase IV, CDP to completion of bolus emptying. IBP and esophageal diameter were analyzed to define functional differences among phases. IBP exhibited distinct changes during the four phases of bolus transit. Phase I was associated with filling via passive dilatation of the esophagus and IBP reflective of intrathoracic pressure. Phase II was associated with auxotonic relaxation and compartmentalization of the bolus distal to the TZ. During phase III, IBP exhibited a slow increase with loss of volume related to peristalsis (auxotonic contraction) and passive dilatation in the distal esophagus. Phase IV was associated with the highest IBP and exhibited isometric contraction during periods of nonemptying and auxotonic contraction during emptying. IBP may be used as a marker of esophageal wall state during the four phases of esophageal bolus transit. Thus abnormalities in IBP may identify subtypes of esophageal disease attributable to abnormal distensibility or neuromuscular dysfunction.
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Registered trials
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