ArticleNeurogastroenterology and motility2025
Optimizing the Straight Leg Raise Maneuver to Improve Prediction of Conclusive Gastro-Esophageal Reflux Disease.
Article in Neurogastroenterology and motility, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Inter-Observer Variability of Gerd-Related Metrics on High-Resolution Manometry and Calculation of the Milan Score.Neurogastroenterology and motility · 2026Article
- Gatherings in Esophagology: Innovations and Future Directions in the Diagnosis and Management of Reflux Disease.Annals of the New York Academy of Sciences · 2026Article
- Is Mean Basal Esophagogastric Junction Pressure a Simpler and More Reliable Marker for Gastroesophageal Reflux Disease Barrier Function?Journal of neurogastroenterology and motility · 2026Article
- The American Foregut Society endoscopic classification outperforms Hill in phenotyping the esophago-gastric junction to guide gastroesophageal reflux disease management.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
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8 authors.
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Abstract
backgroundGastroesophageal reflux disease (GERD) arises from dysfunction of the anti-reflux barrier. While high-resolution manometry (HRM) is routinely performed in suspected GERD, traditional metrics are poor predictors. The routine adoption of the straight leg raise (SLR) maneuver has unveiled a series of unaddressed challenges. This study aimed to determine the minimum intra-abdominal pressure (IAP) increase for effectively stressing the esophago-gastric junction (EGJ), the optimal intra-esophageal pressure (IEP) increase threshold for GERD prediction, and explore EGJ behavior in GERD and non-GERD patients.
methodsWe performed a retrospective review of HRM tracings and pH-impedance studies of consecutive adult patients with GERD symptoms. Peak and mean IAP and IEP during the reference period and SLR were recorded. The SLR was effective if the EGJ-contractile integral (EGJ-CI) during the maneuver increased by 50% compared to baseline. GERD was diagnosed based on Lyon 2.0. The optimal thresholds for effective and positive SLR were determined using the receiver operator characteristics analysis.
resultsAmong the 298 patients included (53% females, age 52 years, BMI 24 kg/m
conclusionsThe SLR maneuver enhances GERD diagnosis in HRM by dynamically assessing EGJ competence. Our study validated the thresholds to define an effective (mean IAP increase of 15.4 mmHg) and positive (peak IEP increase of 11.4 mmHg) maneuver.
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