{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:33:00Z","timestamp":1776893580732,"version":"3.51.2"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rumination is defined as the repetitive, effortless regurgitation of recently ingested food into the mouth. These episodes are preceded by a rise in intragastric pressure (IGP) and mainly occur postprandially. IGP peaks &gt;30\u00a0mmHg have been proposed as a cutoff to differentiate rumination from reflux events. In clinical practice, we observed that this cutoff, which does not consider esophagogastric junction (EGJ) resistance, is not always reached.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied 27 patients with rumination syndrome [age: 43.6, 59% female] and 28 gastro\u2010esophageal reflux disease patients [age: 45.9, 54% female]. For each rumination episode, reflux event, transient lower esophageal sphincter relaxation (TLESR), or straining without regurgitation, the following parameters were registered: maximal IGP, IGP, and EGJ pressure preceding the respective episodes. We also quantified the gastro\u2010sphincteric pressure gradient (GSPG) prior to the respective episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Five reflux episodes were characterized by a maximal IGP &gt;30\u00a0mmHg. In 28% of the rumination episodes, the IGP peak did not exceed 30\u00a0mmHg. Median GSPG was positive for rumination episodes and significantly higher compared with TLESRs, reflux episodes, and straining without regurgitation (7 [3\u201313] vs. 0 [\u22121\u20130] vs. 0 [\u22121\u20130] vs. \u22129 [\u221213\u2013\u22122]; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Interferences<\/jats:title><jats:p>Applying the proposed cutoff of 30\u00a0mmHg, 28% of the rumination episodes were missed. We found that the GSPG differentiates between rumination (positive GSPG), TLESRs and reflux events (GSPG around 0), and straining without regurgitation (negative GSPG). We propose a GSPG value \u22652\u00a0mmHg to distinguish rumination from reflux episodes, TLESRs, and straining without regurgitation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14068","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T00:43:50Z","timestamp":1608684230000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The gastro\u2010sphincteric pressure gradient: A new parameter to diagnose a rumination episode"],"prefix":"10.1111","volume":"33","author":[{"given":"Hannelore","family":"Geysen","sequence":"first","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disease KU Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siebe","family":"Michielsen","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disease KU Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"Rommel","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disease KU Leuven Leuven Belgium"},{"name":"ExpORL Department of Neurosciences, Deglutology KU Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-0903","authenticated-orcid":false,"given":"Tim","family":"Vanuytsel","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disease KU Leuven Leuven Belgium"},{"name":"Department of Gastroenterology, Neurogastroenterology and Motility University Hospitals Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3206-6704","authenticated-orcid":false,"given":"Jan","family":"Tack","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disease KU Leuven Leuven Belgium"},{"name":"Department of Gastroenterology, Neurogastroenterology and Motility University Hospitals Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ans","family":"Pauwels","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disease KU Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.011"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.1.158"},{"issue":"22","key":"e_1_2_8_4_1","first-page":"97","article-title":"Rumination or belching \u2013 regurgitation? Differential diagnosis using oesophageal impedance \u2013 manometry","volume":"2010","author":"Rommel N","year":"2009","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00630.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70025-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.012"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520510011579"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01606.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.09.011"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(11)60927-X"},{"issue":"1","key":"e_1_2_8_12_1","first-page":"52","article-title":"Objective manometric criteria for the rumination syndrome","volume":"109","author":"Kessing BF","year":"2014","journal-title":"Gastroenterology"},{"issue":"4","key":"e_1_2_8_13_1","first-page":"A594","article-title":"Improved diagnosis of rumination using impedance\u2010manometry","volume":"132","author":"Rommel N","year":"2007","journal-title":"Gastroenterology"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(19)33219-6"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13067"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04584.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00117.2009"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.14068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T16:37:46Z","timestamp":1693413466000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.14068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,22]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1111\/nmo.14068"],"URL":"https:\/\/doi.org\/10.1111\/nmo.14068","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,22]]},"assertion":[{"value":"2020-07-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14068"}}