Evidence map›Paper›PMID 33452552›Full record

ArticleDysphagia2022

Effects of Pyridostigmine on Esophageal and Pharyngeal Motility in Dysphagic Patients Undergoing High-Resolution Manometry.

Shumon I Dhar, Nogah Nativ-Zeltzer, Omid B Mehdizadeh, Apoorva T Ramaswamy, Yuval Nachalon, Peter C Belafsky

Abstract read
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In one paragraph

Article in Dysphagia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Shumon I DharDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA. Sdhar4@jhmi.edu.ORCID http://orcid.org/0000-0001-9873-8641
Nogah Nativ-ZeltzerDepartment of Otolaryngology-Head and Neck Surgery, Davis, Medical Center, University of California, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA.
Omid B MehdizadehPacific Eye, Ear, and Skull Base Center, Pacific Neuroscience Institute, 11645 Wilshire Blvd., 6th Floor, Los Angeles, CA, 90025, USA.
Apoorva T RamaswamyDepartment of Otolaryngology-Head and Neck Surgery, Davis, Medical Center, University of California, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA.
Yuval NachalonDepartment of Otolaryngology-Head and Neck Surgery, Davis, Medical Center, University of California, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA.
Peter C BelafskyDepartment of Otolaryngology-Head and Neck Surgery, Davis, Medical Center, University of California, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA.
University of California Davis Medical Center · USJohns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Weak or absent peristalsis of the esophageal musculature is a common finding in ambulatory patients suffering from dysphagia and frequently associated with gastroesophageal reflux. There is currently no pharmacologic intervention that reliably improves esophageal contractility in patients suffering from various esophageal motility disorders. Our objective was to evaluate the acute effects of pyridostigmine on high-resolution manometry parameters in patients suffering from dysphagia with evidence of esophageal dysmotility. Pyridostigmine is an acetylcholinesterase inhibitor which increases effective concentrations of acetylcholine at the neuromuscular junction of both striated and smooth muscle cells. We conducted a prospective crossover study of five patients with dysphagia and proven esophageal dysmotility. Three patients had baseline ineffective esophageal motility and two had achalasia. Patients underwent pharyngeal and esophageal manometry before and after pyridostigmine administration. The median distal contractile integral (DCI), a marker of esophageal contractile vigor, was significantly higher post pyridostigmine administration 3001 (1950.3-3703.2) mmHg × s × cm compared to pre-pyridostigmine DCI of 1229.9 (956.2-2100) mmHg × s × cm; P < 0.001. Pre-pyridostigmine 18/25 (72%) of the patient's swallows was peristaltic compared to 25/25 (100%) post-pyridostigmine; P < 0.005. No other pharyngeal or esophageal high-resolution manometry parameter differed significantly after pyridostigmine administration. The results of this pilot study demonstrate that pyridostigmine acutely improves esophageal contractile vigor in patients suffering from dysphagia with esophageal dysmotility. Further investigation with larger sample size, longer follow-up, side effect profile, and patient-reported outcome measures is still needed to determine the clinical usefulness of pyridostigmine in specific disorders of esophageal motility.

Indexed as

Esophageal Motility DisordersPyridostigmine BromideAcetylcholinesteraseCross-Over StudiesHumansManometryPeristalsisPilot ProjectsProspective StudiesAcetylcholinesterasePyridostigmine BromideDysphagiaEsophageal dysmotilityHigh-resolution manometryPyridostigmine

Identifiers

PMID33452552
OpenAlexW3118307104

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.