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Editorial: post‐reflux swallow‐induced peristaltic wave in eosinophilic oesophagitis—more questions than answers?

EDITORS, Remnant mucosal acidification following volume reflux clearance is believed to be neutralised via a primary swallow that delivers salivary bicarbonate and epidermal growth factor to the distal oesophagus (Figure 1).1 This process, termed postreflux swallowinduced peristaltic wave (PSPW), is reported to follow 60% of reflux episodes in health,1 with lower proportions in erosive and nonerosive reflux disease,1 and Barrett's oesophagus.2 The proportion of reflux episodes followed by PSPW, termed PSPW index, is recognised as an adjunctive metric in the diagnosis of gastrooesophageal reflux disease (GORD) by the Lyon consensus.3 Proton pump inhibitor (PPI) response in eosinophilic oesophagitis (EoE) remains a matter of debate. Frazzoni et al, who introduced oesophageal chemical clearance concepts, evaluated PSPW in 80