Review
Gastroenterology & Hepatology
Joan W. Chen, Edoardo Savarino, Andre Smout, Yinglian Xiao, Nicola de Bortoli, Rena Yadlapati, Charles Cock
Summary: This article discusses the definition, diagnostic criteria, and subtypes of hypercontractile esophagus (HE), emphasizing the diagnosis of clinically relevant HE and noting the lack of compelling data to formally subdivide HE into different subgroups at present.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Article
Gastroenterology & Hepatology
Yang Won Min, Kee Wook Jung, Kyoungwon Jung, Yu Kyung Cho, Moo In Park
Summary: This study investigates the characteristics and treatment outcomes of hypercontractile esophagus (HE). The results show that 61% of patients diagnosed with HE based on high-resolution manometry meet the criteria for CC v4.0. Chest pain and regurgitation are common symptoms. Medical treatment showed moderate efficacy, with 47.1% showing moderate improvement and 29.4% showing significant improvement.
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Gastroenterology & Hepatology
Sami R. Achem, Genaro Vazquez-Elizondo, Ronnie Fass
Summary: Jackhammer esophagus (JE) is a newly recognized esophageal motility disorder characterized by hypercontractile peristalsis. It predominantly affects women with an average age of 65.2 years, presenting with dysphagia, reflux, and chest pain. The cause and pathogenesis remain unclear, with a variety of associated conditions, and treatment efficacy is largely anecdotal with insufficient study.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Apichet Sirinawasatien, Pallop Sakulthongthawin
Summary: Jackhammer esophagus is a rare esophageal motility disorder that can cause symptoms like dysphagia. High-resolution manometry and upper gastrointestinal endoscopy are key in diagnosis, with treatment options including calcium channel blockers and proton pump inhibitors.
BMC GASTROENTEROLOGY
(2021)
Review
Gastroenterology & Hepatology
Nicola de Bortoli, Prakash Chandra Gyawali, Sabine Roman, Salvatore Tolone, Daniel Sifrim, Radu Tutuian, Roberto Penagini, John Erik Pandolfino, Edoardo Vincenzo Savarino
Summary: Hypercontractile esophagus (HE) is a heterogeneous motility disorder characterized by high-contractile peristaltic sequences on esophageal high-resolution manometry (HRM). The pathophysiology may involve excessive cholinergic drive and asynchronous muscle contractions. Empiric trial of proton pump inhibitor is recommended as first-line therapy, followed by consideration of other medications and endoscopic intervention.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Pierfrancesco Visaggi, Matteo Ghisa, Giulio Del Corso, Federica Baiano Svizzero, Lucia Mariani, Salvatore Tolone, Marzio Frazzoni, Andrea Buda, Massimo Bellini, Vincenzo Savarino, Roberto Penagini, C. Prakash Gyawali, Edoardo V. Savarino, Nicola de Bortoli
Summary: The CCv4.0 criteria significantly decreased the prevalence of EGJOO by 80%, refining the diagnosis and identifying clinically relevant outflow obstruction. Elevated RDC-IRP can predict conclusive EGJOO diagnosis per CCv4.0.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Gastroenterology & Hepatology
Yuyang Shao, Chen Xie, Huang Feng, Donglin Yan, Weichang Chen
Summary: Potassium-competitive acid blockers like vonoprazan offer an alternative therapeutic method for patients with hypercontractile esophagus who are refractory to proton pump inhibitor therapy. Further research is needed to explore the application of potassium-competitive acid blockers in hypercontractile esophagus and to provide evidence for an acid-related etiology.
BMC GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Morgane Sallette, Jamila Lenz, Francois Mion, Sabine Roman
Summary: This study compared the frequency of motility disorders diagnosed with CCv3.0 and CCv4.0 and evaluated the severity of symptoms. The results showed that while the diagnoses remained mainly unchanged with both versions, CCv4.0 had a lower frequency of ineffective esophageal motility (IEM) compared to CCv3.0.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Andrew R. Leopold, Patrick McCarthy, Anupama Nair, Raymond E. Kim, Guofeng Xie
Summary: This study found that patients with hypercontractile esophagus (HE) who had compartmentalized pressurization (CP) had higher initial symptom scores and did not respond to medical therapy, while patients without CP usually responded to medical therapy. Therefore, CP may have prognostic value in determining treatment strategies for HE patients.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Surgery
Dolores T. T. Mueller, Brett Parker, Reid Fletcher, Ahmed Sharata, Daniel Davila Bradley, Steven R. R. DeMeester, Kevin M. M. Reavis, Lee L. L. Swanstrom, Christy M. M. Dunst
Summary: The aim of this study was to provide a complete set of HRM data for patients with a normally functioning fundoplication. The results showed that the addition of a fundoplication significantly increased the values of the lower esophageal sphincter. The previously accepted upper limit defining esophageal outflow obstruction may not be clinically applicable after fundoplication.
Article
Gastroenterology & Hepatology
Pamela Milito, Stefano Siboni, Luigi Bonavina
Summary: Diagnosis of esophageal disorders is more advanced than available treatment options. A patient with hiatal hernia, experiencing reflux, dysphagia, and chest pain, was diagnosed with jackhammer esophagus and treated with a hybrid approach of POEM, crural repair, and Dor fundoplication.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Article
Gastroenterology & Hepatology
Anouk Overwater, Sjoerd G. Elias, Erik J. Schoon, Jacques J. G. H. M. Bergman, Roos E. Pouw, Bas L. A. M. Weusten
Summary: This study aimed to describe the course of pain and dysphagia after radiofrequency ablation (RFA) treatment for Barrett's esophagus (BE) neoplasia and identify associated risk factors. The results showed that 95% of patients reported post-RFA pain, with 64% experiencing major pain. Dysphagia was present in 83% of patients.
Article
Multidisciplinary Sciences
Sudarshan R. Jadcherla, Kathryn A. Hasenstab, Erika K. Osborn, Deborah S. Levy, Haluk Ipek, Roseanna Helmick, Zakia Sultana, Nicole Logue, Vedat O. Yildiz, Hailey Blosser, Summit H. Shah, Lai Wei
Summary: This study demonstrates that an integrated approach with parent-preferred therapy based on mechanistic understanding of VFSS and HRM metrics improves oral feeding outcomes, despite evidence of penetration or aspiration. The application of new knowledge of the physiology of swallowing and airway protection may contribute to these findings.
SCIENTIFIC REPORTS
(2021)
Article
Gastroenterology & Hepatology
Chamara Basnayake, Sawangpong Jandee, Annelies Geeraerts, Hannelore Geysen, Ans Pauwels, Lien Timmermans, Tim Vanuytsel, Nathalie Rommel, Jan Tack
Summary: This study aimed to investigate the impact of position, different volumes and consistencies of swallows, and perception of bolus passage on high-resolution esophageal manometry (HRM) metrics. The results showed significant differences in HRM metrics with different positions, volumes, and consistencies of swallows. Interpretation of HRM studies should consider normative values specific to position and bolus type.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Mohd Ridzuan Mohd Said, Zhiqin Wong, Rafiz Abdul Rani, Chai Soon Ngiu, Raja Affendi Raja Ali, Yeong Yeh Lee
Summary: Variations in the Chicago 3.0 normative metrics exist in a healthy Asian population with different postures and provocative swallow materials. Upright posture may lead to more motility disorders.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Allergy
Ahsan R. Khan, Christian Misdary, Nikhil Yegya-Raman, Sinae Kim, Navaneeth Narayanan, Sheraz Siddiqui, Padmini Salgame, Jared Radbel, Frank De Groote, Carl Michel, Janice Mehnert, Caleb Hernandez, Thomas Braciale, Jyoti Malhotra, Michael A. Gentile, Salma K. Jabbour
Summary: A retrospective analysis showed that COVID-19 patients treated with montelukast had fewer events of clinical deterioration, suggesting potential clinical activity. Further prospective studies are needed to validate these findings and explore the efficacy of montelukast in treating COVID-19.
Article
Gastroenterology & Hepatology
Rena Yadlapati, John E. Pandolfino, Madeline Greytak, Jonathon Cahoon, Mary Clarke, Matthew Clary, Daniel Fink, Paul Menard-Katcher, Andrew M. Vahabzadeh-Hagh, Philip Weissbrod, Samir Gupta, Alexander Kaizer, Sachin Wani
Summary: The study found that the external upper esophageal sphincter compression device as an adjunct to proton pump inhibitor therapy in patients with laryngopharyngeal reflux has potential efficacy in significantly improving symptoms.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Article
Gastroenterology & Hepatology
Dustin A. Carlson, Alexandra J. Baumann, Jacqueline E. Prescott, Erica N. Donnan, Rena Yadlapati, Abraham Khan, C. Prakash Gyawali, Wenjun Kou, Peter J. Kahrilas, John E. Pandolfino
Summary: This study systematically evaluated a classification scheme of secondary peristalsis using FLIP panometry by comparing it with primary peristalsis on HRM. The results showed that different contractile response patterns can reflect various pathophysiological states of esophageal peristalsis. The findings suggest that FLIP panometry can facilitate the evaluation of esophageal motility.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
Rena Yadlapati, C. Prakash Gyawali, Melina Masihi, Dustin A. Carlson, Peter J. Kahrilas, Billy Darren Nix, Anand Jain, Joseph R. Triggs, Michael F. Vaezi, Leila Kia, Alexander Kaizer, John E. Pandolfino
Summary: This clinical trial found that a total acid exposure time (AET) of 4.0% is a high-performing prognostic marker for discontinuing PPI therapy. 96 hours of monitoring performed better than 48 hours in predicting the ability to discontinue PPI. These findings have implications for the diagnostic approaches for patients with GERD symptoms who are unresponsive to PPI therapy.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Editorial Material
Gastroenterology & Hepatology
Rena Yadlapati, Andrew J. Gawron, John E. Pandolfino
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Gastroenterology & Hepatology
Steven D. Ma, Vandan G. Patel, Madeline Greytak, Joshua E. Rubin, Alexander M. Kaizer, Rena H. Yadlapati
Summary: This study assessed the diagnostic performance of salivary pepsin thresholds for GERD and determined the optimal collection protocol of saliva. The results showed that a single fasting AM salivary pepsin concentration can accurately diagnose GERD.
DISEASES OF THE ESOPHAGUS
(2023)
Letter
Gastroenterology & Hepatology
Eric E. E. Low, Rena Yadlapati
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Rena Yadlapati, C. Prakash Gyawali, Dustin A. A. Carlson, John E. E. Pandolfino, Ronnie Fass, Abraham Khan, Haiying Lin, Joel E. E. Richter, Marcelo F. Vela, Michael F. Vaezi, John O. O. Clarke
Summary: This study assessed the reliability of FLIP measurements and found that normative FLIP parameters can be extracted from FLIP videos using both real-time and post hoc analyses. There is high consistency between novice and experienced users.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Editorial Material
Gastroenterology & Hepatology
Rena Yadlapati, Walter W. Chan
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Edoardo Vespa, Domenico A. Farina, Peter J. Kahrilas, Wenjun Kou, Eric E. Low, Rena Yadlapati, John E. Pandolfino, Dustin A. Carlson
Summary: This study found that patients with high PEP values on high-resolution manometry, high FLIP 60 mL pressures, and a spastic-reactive contractile response pattern on FLIP before treatment were more likely to experience post-treatment spasm. Evaluating these features may guide personalized patient management.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Eric E. E. Low, Aws Hasan, Syed Abbas Fehmi, Michael A. A. Chang, Wilson Kwong, Mary L. L. Krinsky, Gobind Anand, Madeline Greytak, Alexander Kaizer, Rena Yadlapati
Summary: This study aimed to assess the agreement between different detection methods for the length of spastic segments in patients with type 3 achalasia. The results showed a good agreement between the lengths obtained from high-resolution manometry (HRM) and barium esophagram (BE), while there was a negative correlation and poor agreement when compared to endoscopic ultrasound (EUS). This suggests that HRM is more commonly used and the role of EUS in determining tailored myotomy length for type 3 achalasia is uncertain.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Medicine, Research & Experimental
Rena Yadlapati, Katherine Cappell, Robert Sedgley, Corey Pelletier, Rinu Jacob, Machaon Bonafede, Shailja C. Shah
Summary: Erosive esophagitis (EE) is a severe form of gastroesophageal reflux disease commonly treated with proton pump inhibitors (PPIs). This retrospective cohort study in the USA found that patients with EE commonly switch between different PPIs, and higher PPI use is associated with increased healthcare costs.
ADVANCES IN THERAPY
(2023)
Review
Gastroenterology & Hepatology
Kelli Liu, Amanda Krause, Rena Yadlapati
Summary: Laryngopharyngeal reflux (LPR) is a syndrome characterized by the reflux of gastric contents into the pharynx or larynx, causing symptoms such as cough, throat clearing, sore throat, globus, and dysphonia. Unlike gastroesophageal reflux disease (GERD), LPR is not well-studied, and there is no gold standard for diagnosis. Further research is needed to explore the relationship between symptom burden, acid reflux, and quality of life, anxiety, and depression in LPR patients and guide treatment strategies.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Letter
Gastroenterology & Hepatology
Eric E. Low, Syed A. Fehmi, Rena Yadlapati
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Economics
Shailja Shah, Katherine Cappell, Robert Sedgley, Corey Pelletier, Rinu Jacob, Machaon Bonafede, Rena Yadlapati
Summary: This study aimed to characterize the cost drivers of patients with Helicobacter pylori (HP) and estimate the cost savings associated with successful eradication compared to failed eradication. The results showed that the healthcare costs of HP patients are influenced by comorbidities and there are significant cost savings for patients with successful HP eradication in specific HP-related conditions.
JOURNAL OF MEDICAL ECONOMICS
(2023)