{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:10:19Z","timestamp":1781244619833,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,1,12]],"date-time":"2017-01-12T00:00:00Z","timestamp":1484179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rumination syndrome is characterized by recurrent regurgitation of recently ingested food into the mouth. Differentiation with other diagnoses and gastroesophageal reflux disease (<jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>) in particular, is difficult. Recently, objective <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u2010impedance (<jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MII<\/jats:styled-content>) and manometry criteria were proposed for adults. The aim of this study was to determine diagnostic ambulatory <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MII<\/jats:styled-content> and manometry criteria for rumination syndrome in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data and 24\u2010hour <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MII<\/jats:styled-content> and manometry recordings of children with a clinical suspicion of rumination syndrome were reviewed. Recordings were analyzed for retrograde bolus flow extending into the proximal esophagus. Peak gastric and intraesophageal pressures closely related to these events were recorded and checked for a pattern compatible with rumination. Events were classified into primary, secondary, and supragastric belch\u2013associated rumination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Twenty\u2010five consecutive patients (11 males, median age 13.3\u00a0years [<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 5.9\u201015.8]) were included; recordings of 18 patients were suitable for analysis. Rumination events were identified in 16\/18 patients, with 50% of events occurring &lt;30\u00a0minutes postprandially. Fifteen of 16 patients showed \u22651 gastric pressure peak &gt;30\u00a0mmHg, while only 50% of all events was characterized by peaks &gt;30\u00a0mmHg and an additional 20% by peaks &gt;25\u00a0mmHg. Four patients had evidence of acid <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>, all showing secondary rumination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Combined 24\u2010hour <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MII<\/jats:styled-content> and manometry can be used to diagnose rumination syndrome in children and to distinguish it from <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>. Rumination patterns in children are similar compared with adults, albeit with lower gastric pressure increase. We propose a diagnostic cutoff for gastric pressure increase &gt;25\u00a0mmHg associated with retrograde bolus flow into the proximal esophagus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12996","type":"journal-article","created":{"date-parts":[[2017,1,12]],"date-time":"2017-01-12T09:52:25Z","timestamp":1484214745000},"source":"Crossref","is-referenced-by-count":33,"title":["Objectively diagnosing rumination syndrome in children using esophageal <scp>pH<\/scp>\u2010impedance and manometry"],"prefix":"10.1111","volume":"29","author":[{"given":"M. M. J.","family":"Singendonk","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Oors","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Academic Medical Center Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. J.","family":"Bredenoord","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Academic Medical Center Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. I.","family":"Omari","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Health Network  North Adelaide SA Australia"},{"name":"Translational Research Center for Gastrointestinal Diseases University of Leuven  Leuven Belgium"},{"name":"School of Medicine Flinders University  Bedford Park SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J.","family":"van der Pol","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Smits","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Benninga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8112-8414","authenticated-orcid":false,"given":"M. P.","family":"van Wijk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital AMC  Amsterdam The Netherlands"},{"name":"Department of Pediatric Gastroenterology VU University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.015"},{"issue":"1443","key":"e_1_2_9_3_1","first-page":"e2","article-title":"Childhood functional gastrointestinal disorders: neonate\/toddler","volume":"150","author":"Benninga MA","year":"2016","journal-title":"Gastroenterology"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2006.04617.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-014-0398-9"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.1.158"},{"key":"e_1_2_9_7_1","first-page":"924","article-title":"Rumination: etiology and treatment","volume":"13","author":"Chatoor I","year":"1984","journal-title":"Pediatr Ann"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-12-163"},{"issue":"39","key":"e_1_2_9_9_1","first-page":"e3","article-title":"Prevalence of functional gastrointestinal disorders in children and adolescents","volume":"177","author":"Lewis ML","year":"2016","journal-title":"J Pediatr"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.033"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000142"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181fa06f3"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04584.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.428"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2011.605467"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01431.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-105-4-513"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00065-5"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2003.033290"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.042945"},{"issue":"650","key":"e_1_2_9_22_1","first-page":"e1","article-title":"Detection of gastroesophageal reflux in children using combined multichannel intraluminal impedance and pH measurement: data from the German Pediatric Impedance Group","volume":"158","author":"Pilic D","year":"2011","journal-title":"J Pediatr"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145445505282439"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(00)90018-0"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90199-X"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12148"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12737"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.10.042"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.05.029"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(01)00068-3"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181b7f563"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.12996","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.12996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T21:54:48Z","timestamp":1695506088000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.12996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,12]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1111\/nmo.12996"],"URL":"https:\/\/doi.org\/10.1111\/nmo.12996","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,12]]},"article-number":"e12996"}}