Evidence map›Paper›PMID 40317611›Full record

ArticleNeurogastroenterology and motility2026

The Milan Score is an Effective Manometric Tool to Predict Gastroesophageal Reflux in Patients With Laryngopharyngeal Symptoms.

Stefano Siboni, Marco Sozzi, Pierfrancesco Visaggi, Ivan Kristo, Nicola De Bortoli, Salvatore Tolone, Elisa Marabotto, Daniele Bernardi, Sebastian F Schoppmann, Roberto Penagini and 17 more

Abstract readMulticenter Study
In one paragraph

Article in Neurogastroenterology and motility, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

27 authors.

Stefano SiboniDivision of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Italy.ORCID https://orcid.org/0000-0003-0532-3135
Marco SozziDivision of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Italy.
Pierfrancesco VisaggiDivision of Gastroenterology, University of Pisa, Pisa, Italy.ORCID https://orcid.org/0000-0002-6985-5301
Ivan KristoUpper-GI-Service, Medizinische Universität, Wien, Austria.ORCID https://orcid.org/0000-0001-7999-1625
Nicola De BortoliDivision of Gastroenterology, University of Pisa, Pisa, Italy.ORCID https://orcid.org/0000-0003-1995-1060
Salvatore ToloneDivision of General, Mini-Invasive and Bariatric Surgery, University of Naples, Naples, Italy.ORCID https://orcid.org/0000-0002-1653-9903
Elisa MarabottoGastroenterology Unit, IRCCS Policlinico San Martino, Genoa, Italy.
Daniele BernardiDivision of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Italy.
Sebastian F SchoppmannUpper-GI-Service, Medizinische Universität, Wien, Austria.
Roberto PenaginiGastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.ORCID https://orcid.org/0000-0001-6918-9479
Benjamin RogersDivision of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.
Anthony HobsonThe Functional Gut Clinic, London, UK.
Jordan HaworthThe Functional Gut Clinic, London, UK.ORCID https://orcid.org/0000-0002-5325-0789
Brian LouieDivision of Thoracic Surgery, Swedish Medical Center, Digestive Health Institute, Seattle, WA, USA.
Yeong Yeh LeeSchool of Medical Sciences and GI Function and Motility Unit, Universiti Sains Malaysia, Kota Bharu, Malaysia.ORCID https://orcid.org/0000-0002-6486-7717
Vincent TeeSchool of Medical Sciences and GI Function and Motility Unit, Universiti Sains Malaysia, Kota Bharu, Malaysia.ORCID https://orcid.org/0000-0002-6562-2666
Takahiro MasudaDepartment of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Dimitrios TheodorouForegut Surgery Unit, University of Athens School of Medicine, Athens, Greece.
Tania TriantafyllouForegut Surgery Unit, University of Athens School of Medicine, Athens, Greece.
Benedetta BarcellaDivision of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Italy.
Lorenzo CusmaiDivision of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Italy.
Michele PuricelliDivision of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Italy.
Marina ColettaGastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Vito AnneseDivision of Gastroenterology, IRCCS Policlinico San Donato, University Vita-Salute S. Rafael, Milan, Italy.
Edoardo Vincenzo SavarinoDivision of Gastroenterology, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.ORCID https://orcid.org/0000-0002-3187-2894
Emanuele Luigi Giuseppe AstiDivision of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Italy.
C Prakash GyawaliDivision of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.ORCID https://orcid.org/0000-0002-3388-0660

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAccording to Lyon 2.0, laryngopharyngeal symptoms (LPS) should undergo upfront pathophysiologic tests. The novel Milan score integrates esophagogastric junction (EGJ) morphology, ineffective esophageal motility, EGJ-contractile integral (EGJ-CI), and straight leg raise (SLR) response. It has been demonstrated to predict abnormal AET. The aim of this study was to assess the value of the Milan score in predicting GERD in these patients.

methodsWe prospectively enrolled patients with suspected GERD who underwent HRM and MII pH from 12 referral centers. Patients with isolated LPS (reflux symptom index > 13) were compared with typical GERD symptoms (GERD-HRQL ≥ 10). A Milan score > 137 was considered positive. The effectiveness of the Milan score in the identification of patients with pathologic GERD was assessed.

resultsOf 570 patients (49% females, median age 49 years, BMI 24 kg/m

conclusionsPatients with isolated LPS demonstrated a lower likelihood of EGJ disruption, pathologic GERD, and abnormal Milan score. The Milan score performed similarly well in the identification of GERD in both LPS and typical symptoms and could therefore be used as an upfront test in LPS patients.

Indexed as

Gastroesophageal RefluxLaryngopharyngeal RefluxManometryAdultAgedEsophageal pH MonitoringEsophagogastric JunctionFemaleHumansMaleMiddle AgedPredictive Value of TestsProspective Studiesgastroesophageal reflux diseasehigh‐resolution manometrylaryngopharyngeal symptoms

Identifiers

PMID40317611
PMCPMC13121873

What Socratic holds

Textmetadata
LicenceCC BY
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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 Socratic graph.