{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:59:32Z","timestamp":1778507972892,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Diagnosis of rumination syndrome (RS) relies on Rome IV criteria. Oesophageal high\u2010resolution impedance manometry (HRIM) can objectively demonstrate the episodes of rumination, but its role in the diagnostic pathway is not yet established. We aimed to demonstrate the clinical contribution of this tool for the timely diagnosis of RS and diagnostic work\u2010up of children with unexplained foregut symptoms deemed to be due to other conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HRIMs performed between 2012 and 2021 were searched to retrieve all diagnoses of RS. Medical records were reviewed for clinical data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 461 HRIMs performed, 76 children had manometric diagnosis of RS (35 male, median age: 13 years). Of them, 47% were not clinically suspected as the symptoms did not fulfil clinical criteria for RS. The indications for HRIM in these cases were investigation of unexplained foregut symptoms (37%), suspected refractory gastroesophageal reflux disease (8%) and dysphagia (2%). Among all HRIMs performed for investigations of unexplained foregut symptoms (<jats:italic>n<\/jats:italic>\u2009=\u200980), 35% demonstrated rumination episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Identification of characteristic patterns of rumination on HRIM in children with unexplained foregut symptoms enables the immediate diagnosis of RS. Thus, in situations of diagnostic uncertainty, the use of HRIM at early stages of the diagnostic pathway would reduce unnecessary investigations and treatments.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12164","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T13:56:32Z","timestamp":1708610192000},"page":"1082-1090","source":"Crossref","is-referenced-by-count":4,"title":["The role of high\u2010resolution impedance manometry to identify rumination syndrome in children with unexplained foregut symptoms"],"prefix":"10.1002","volume":"78","author":[{"given":"Maria Giovanna","family":"Puoti","sequence":"first","affiliation":[{"name":"Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility Great Ormond Street Hospital London UK"},{"name":"Department of Paediatric Gastroenterology and Hepatology Santobono\u2010Pausilipon Children's Hospital Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Safe","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology The Royal Children's Hospital Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Thapar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Liver Transplant Queensland Children's Hospital Brisbane Australia"},{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"},{"name":"Woolworths Centre for Child Nutrition Research Quuensland University of Technology Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Di Chio","sequence":"additional","affiliation":[{"name":"Paediatric Unit Paediatric Institute of Southern Switzerland Bellinzona Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena Sofia","family":"Pieri","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Perugia Perugia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kornilia","family":"Nikaki","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility Great Ormond Street Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Lindley","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility Great Ormond Street Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Rybak","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility Great Ormond Street Hospital London 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UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.015"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12954"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.12.237"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-12-163"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2011.06.011"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.709326"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.11.008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16682"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90199-X"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640613518774"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(00)90018-0"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.1.158"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.428"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13239"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000295"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12998"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12996"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.428"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12148"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.02.009"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002569"}],"container-title":["Journal 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