Kessing Boudewijn F, Govaert Frank, Masclee Ad A M, Conchillo José M
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center Maastricht, Maastricht, The Netherlands.
Scand J Gastroenterol. 2011 Nov;46(11):1310-5. doi: 10.3109/00365521.2011.605467. Epub 2011 Aug 5.
Rumination syndrome is a disorder of unknown etiology characterized by regurgitation of recently ingested food. We aimed to improve the diagnosis of rumination syndrome by classification of separate rumination symptoms using (1) an ambulatory manometry/impedance (AMIM) measurement and (2) a single-catheter high-resolution manometry/impedance (HRIM) measurement.
A total of 96 symptoms during AMIM and 37 symptoms during HRIM were analyzed in five patients with clinically diagnosed rumination syndrome.
AMIM identified rumination events in 85 out of 96 reported symptoms (symptom index (SI): 89%). Of these events, 63% were non-acidic and would have been missed by pH-metry. HRIM identified 32 out of 37 reported symptoms (SI: 86%). Upper esophageal sphincter (UES) relaxation was observed during all rumination events identified by HRIM and could be an additional criterion in the definition of rumination events.
Impedance measurement and high-resolution manometry contribute to a more detailed description of rumination events. Rumination events defined as gastric strain, common cavity phenomenon, retrograde esophageal fluid flow, and UES relaxation show a high SI when measured with AMIM or single-catheter HRIM.
反刍综合征是一种病因不明的疾病，其特征为近期摄入食物的反流。我们旨在通过使用（1）动态测压/阻抗（AMIM）测量和（2）单导管高分辨率测压/阻抗（HRIM）测量对单独的反刍症状进行分类，以改善反刍综合征的诊断。
对5例临床诊断为反刍综合征的患者在AMIM期间的96个症状和HRIM期间的37个症状进行了分析。
AMIM在报告的96个症状中的85个中识别出反刍事件（症状指数（SI）：89%）。在这些事件中，63%为非酸性，pH测量会遗漏这些情况。HRIM在报告的37个症状中的32个中识别出反刍事件（SI：86%）。在HRIM识别出的所有反刍事件中均观察到食管上括约肌（UES）松弛，这可能是反刍事件定义中的一个额外标准。
阻抗测量和高分辨率测压有助于更详细地描述反刍事件。当用AMIM或单导管HRIM测量时，定义为胃内压力、共同腔现象、食管内液体逆流和UES松弛的反刍事件显示出高SI。
