Our group was the first to define POSED (Post-Obesity Surgery Esophageal Dysfunction), a newly recognized motility disorder that can develop in a subset of patients after metabolic bariatric surgery. In our latest @NGMJournal Neurogastroenterology & Motility study, we uncover a potential mechanism: 🔹 Low proximal gastric distensibility and elevated post-swallow intragastric pressure increase esophageal afterload 🔹 This leads to secondary peristalsis abnormalities, eventually progressing to primary motor dysfunction (resembling achalasia) 🔹 70% had abnormal FLIP findings despite normal or borderline HRM 📌 Clinical vigilance is key—patients with new-onset dysphagia after bariatric surgery should be evaluated for POSED, even when standard manometry appears normal. Collaborative work with @KarthikRavi @OMGhanemMD @MayoClinicGIHep colleagues. #POSED #EsophagealMotility #BariatricSurgery #Dysphagia #FLIP #GIInnovation #Neurogastroenterology