{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T04:21:48Z","timestamp":1770524508630,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,26]],"date-time":"2019-08-26T00:00:00Z","timestamp":1566777600000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH 107\u2010P06"],"award-info":[{"award-number":["NTUH 107\u2010P06"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We investigated the prevalence of psychiatric referral, frequency of repeat upper gastrointestinal (<jats:styled-content style=\"fixed-case\">UGI<\/jats:styled-content>) contrast studies, and esophagogastroduodenoscopy (<jats:styled-content style=\"fixed-case\">EGD<\/jats:styled-content>) in children with ineffective esophageal motility (<jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content>) before the confirmation of esophageal dysmotility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 19 children (nine boys, 10 girls; mean age, 13.80\u00a0\u00b1\u00a05.10\u00a0years) with symptoms of refractory gastroesophageal reflux (<jats:styled-content style=\"fixed-case\">GER<\/jats:styled-content>) who underwent high\u2010resolution esophageal impedance manometry (<jats:styled-content style=\"fixed-case\">HRIM<\/jats:styled-content>) were enrolled in this retrospective analysis. Refractory <jats:styled-content style=\"fixed-case\">GER<\/jats:styled-content> symptoms were defined as persistent symptoms even under acid\u2010suppression therapy for 8\u00a0weeks in this study. Clinical data including age, gender, time from symptom onset to diagnosis, and number of <jats:styled-content style=\"fixed-case\">UGI<\/jats:styled-content> contrast studies and <jats:styled-content style=\"fixed-case\">EGD<\/jats:styled-content> before diagnosis were obtained. <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> parameters and the prevalence of psychiatric referral were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There are 14 children (73.68%) diagnosed with IEM by HRIM, and another 5 children (26.32%) diagnosed as GER disease (GERD) by EGD. A significant proportion of <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content> children were misdiagnosed with psychological problems compared with the <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> children (78.57% vs 20.00%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04). Three <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content> children (21.43%) received antipsychotic and antidepressant agents before diagnosis of <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content>, and all of them discontinued these medications after diagnosis. IEM children underwent a greater number of <jats:styled-content style=\"fixed-case\">UGI<\/jats:styled-content> contrast studies (1.07\u00a0\u00b1\u00a00.92 vs 0.20\u00a0\u00b1\u00a00.45; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.02) and <jats:styled-content style=\"fixed-case\">EGD<\/jats:styled-content> (2.36\u00a0\u00b1\u00a02.50 vs 0.60\u00a0\u00b1\u00a00.55; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03) before <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> than <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Esophageal manometry for the diagnosis of <jats:styled-content style=\"fixed-case\">IEM<\/jats:styled-content> should be considered in children with <jats:styled-content style=\"fixed-case\">GER<\/jats:styled-content> symptoms refractory to acid\u2010suppression therapy for 8\u00a0weeks to avoid repeat <jats:styled-content style=\"fixed-case\">UGI<\/jats:styled-content> contrast studies, <jats:styled-content style=\"fixed-case\">EGD<\/jats:styled-content>, and psychological therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13917","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T20:48:11Z","timestamp":1561063691000},"page":"807-811","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Role of esophageal manometry in children with refractory gastroesophageal reflux symptoms"],"prefix":"10.1111","volume":"61","author":[{"given":"Tzu\u2010Yun","family":"Hsing","sequence":"first","affiliation":[{"name":"Department of Pediatrics National Taiwan University Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I\u2010Jung","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Taiwan University 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