Evidence map›Paper›PMID 38009826›Full record

ArticleNeurogastroenterology and motility2024

Esophageal anatomy and physiology vary across spastic and non-spastic phenotypes of disorders of esophagogastric junction outflow.

Farnoosh Vahedi, Eric E Low, Alexander M Kaizer, Syed Abbas Fehmi, Aws Hasan, Michael A Chang, Wilson Kwong, Mary L Krinsky, Gobind Anand, Madeline Greytak and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurogastroenterology and motility, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Farnoosh VahediDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Eric E LowDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.ORCID https://orcid.org/0000-0003-0852-8005
Alexander M KaizerDepartment of Biostatistics and Informatics, University of Colorado, Anschutz Medical Campus, Colorado School of Public Health, Aurora, Colorado, USA.
Syed Abbas FehmiDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Aws HasanDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Michael A ChangDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Wilson KwongDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Mary L KrinskyDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Gobind AnandDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Madeline GreytakDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Rena YadlapatiDivision of Gastroenterology, University of California San Diego, La Jolla, California, USA.ORCID https://orcid.org/0000-0002-7872-2033

Funding

Training Grant in GastroenterologyT32DK007202 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GHOSH, PRADIPTA · 1985 to 2022
$7.7M
The MVP Trial: A Randomized Controlled Trial of Mechanism Guided vs PPI Strategy for Laryngopharyngeal RefluxR01DK139089 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Rena Hiren Yadlapati · 2024 to 2026
$2.0M
Mechanism Guided Therapy for Laryngopharyngeal RefluxK23DK125266 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI YADLAPATI, RENA HIREN · 2021 to 2025
$963k
NIDDK NIH HHS K23 DK125266NIDDK NIH HHS R01 DK139089NIDDK NIH HHS T32 DK007202
6 · The paper itself

Abstract

backgroundPathophysiologic mechanisms of disorders of esophagogastric junction (EGJ) outflow are poorly understood. We aimed to compare anatomic and physiologic characteristics among patients with disorders of EGJ outflow and normal motility.

methodsWe retrospectively evaluated adult patients with achalasia types 1, 2, 3, EGJ outflow obstruction (EGJOO) or normal motility on high-resolution manometry who underwent endoscopic ultrasound (EUS) from January 2019 to August 2022. Thickened circular muscle was defined as ≥1.6 mm. Characteristics from barium esophagram (BE) and functional lumen imaging probe (FLIP) were additionally assessed. KEY

resultsOf 71 patients (mean age 56.2 years; 49% male), there were 8 (11%) normal motility, 58 (82%) had achalasia (5 (7%) type 1, 32 (45%) classic type 2, 21 (30%) type 3 [including 12 type 2 with FEPs]), and 7 (7%) had EGJOO. A significantly greater proportion of type 3 achalasia had thickened distal circular muscle (76.2%) versus normal motility (0%; p < 0.001) or type 2 achalasia (25%; p < 0.001). Type 1 achalasia had significantly wider mean maximum esophageal diameter on BE (57.8 mm) compared to type 2 achalasia (32.8 mm), type 3 achalasia (23.4 mm), EGJOO (15.9 mm), and normal motility (13.5 mm). 100% type 3 achalasia versus 0% type 1 achalasia/normal motility had tertiary contractions on BE. Mean EGJ distensibility index on FLIP was lower for type 3 achalasia (1.2 mmHg/mm

conclusionsOur findings suggest distinct pathologic pathways may exist: type 3 achalasia and EGJOO may represent a spastic outflow phenotype consisting of a thickened, spastic circular muscle, which is distinct from type 1 and 2 achalasia consisting of a thin caliber circular muscle layer with more prominent esophageal dilation.

Indexed as

Esophageal AchalasiaEsophageal Motility DisordersAdultEsophagogastric JunctionFemaleHumansMaleManometryMiddle AgedMuscle SpasticityRetrospective Studiesdysphagiaesophagealmanagementmotilitynon-achalasia disordersoutcomesphysiologytreatment

Identifiers

PMID38009826
PMCPMC10843578

What OpenQuestion holds

Textmetadata
LicenceTDM
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.