ArticleNeurogastroenterology and motility2017
Upper esophageal sphincter (UES) metrics on high-resolution manometry (HRM) differentiate achalasia subtypes.
Article in Neurogastroenterology and motility, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Clinical characteristics and manometric findings of esophageal achalasia-a systematic review regarding differences among three subtypes.Journal of smooth muscle research = Nihon Heikatsukin Gakkai kikanshi · 2023Pooled it
- Risk factors for dysphagia after stroke and efficacy evaluation of swallowing function training.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Association Between Psychological Burden and Unexplained High Upper Esophageal Sphincter Basal Pressure.Journal of neurogastroenterology and motility · 2025Article
- Optimizing achalasia diagnosis in the era of high-resolution manometry: A Pakistani perspective.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- The Relationship between Upper Esophageal Sphincter Manometry Function and Esophageal Motility Disorders.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025Article
- Upper Esophageal Sphincter Metrics across Eosinophilic Esophagitis, Gastroesophageal Reflux Disease and Functional Dysphagia: A Pilot Study.Journal of clinical medicine · 2023Article
- Esophagogastric Junction Outflow Obstruction Is Likely to Be a Local Manifestation of Other Primary Diseases: Analysis of Single-Center 4-Year Follow-Up Data.Diagnostics (Basel, Switzerland) · 2023Article
- Correlation between Lower Esophageal Sphincter Metrics on High-Resolution Manometry and the Clinical Presentation of Patients with Newly Diagnosed Achalasia.Diagnostics (Basel, Switzerland) · 2023Article
- The Upper Esophageal Sphincter Distensibility Index Measured Using Functional Lumen Imaging Probe Identifies Defective Barrier Function of the Upper Esophageal Sphincter.Journal of neurogastroenterology and motility · 2022Article
- Esophageal Motility Disorders: Current Approach to Diagnostics and Therapeutics.Gastroenterology · 2022Review
- Differences in upper esophageal sphincter function and clinical characteristics among the three subtypes of Japanese patients with esophageal achalasia.Esophagus : official journal of the Japan Esophageal Society · 2022Article
- The upper esophageal sphincter in the high-resolution manometry era.Langenbeck's archives of surgery · 2021Review
- Article
- Upper Esophageal Sphincter Motility and Thoracic Pressure are Determinants of Pressurized Waves in Achalasia Subtypes According to the Chicago Classification.World journal of surgery · 2020Article
- Oropharyngeal swallowing functions are impaired in patients with naive-achalasia.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2020Article
- Upper esophageal sphincter abnormalities on high-resolution esophageal manometry and treatment response of type II achalasia.World journal of clinical cases · 2020Article
- Proximal esophageal contraction after induction of ineffective distal contraction by sildenafil in healthy volunteers.Annals of gastroenterologyArticle
- Can the upper esophageal sphincter contractile integral help classify achalasia?Annals of gastroenterologyArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe upper esophageal sphincter (UES) reflexively responds to bolus presence within the esophageal lumen, therefore UES metrics can vary in achalasia.
methodsWithin consecutive patients undergoing esophageal high-resolution manometry (HRM), 302 patients (58.2±1.0 year, 57% F) with esophageal outflow obstruction were identified, and compared to 16 asymptomatic controls (27.7±0.7 year, 56% F). Esophageal outflow obstruction was segregated into achalasia subtypes 1, 2, and 3, and esophagogastric junction outflow obstruction (EGJOO with intact peristalsis) using Chicago Classification v3.0. UES and lower esophageal sphincter (LES) metrics were compared between esophageal outflow obstruction and normal controls using univariate and multivariate analysis. Linear regression excluded multicollinearity of pressure metrics that demonstrated significant differences across individual subtype comparisons. KEY
resultsLES integrated relaxation pressure (IRP) had utility in differentiating achalasia from controls (P<.0001), but no utility in segregating between subtypes (P=.27). In comparison to controls, patients collectively demonstrated univariate differences in UES mean basal pressure, relaxation time to nadir, recovery time, and residual pressure (UES-RP) (P≤.049). UES-RP was highest in type 2 achalasia (P<.0001 compared to other subtypes and controls). In multivariate analysis, only UES-RP retained significance in comparison between each of the subgroups (P≤.02 for each comparison). Intrabolus pressure was highest in type 3 achalasia; this demonstrated significant differences across some but not all subtype comparisons. CONCLUSIONS AND INFERENCES: Nadir UES-RP can differentiate achalasia subtypes within the esophageal outflow obstruction spectrum, with highest values in type 2 achalasia. This metric likely represents a surrogate marker for esophageal pressurization.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.