(A) Antroduodenal manometric tracing showing "R" waves with simultaneous pressurization associated with pH events in the esophagus.
(B) High resolution esophageal manometry showing two gastric pressure events associated with return of gastric content into the proximal esophagus as shown in the impedance tracing.
(C) Diaphragmatic EMG recording associated with a rumination episode. There is an increase in EMG activity of intercostals, anterior abdominal muscles but reduction in diaphragmatic tracing.
The asterisks in panels A and B represent the R-wave, whereas the arrow denotes this in panel C.
From: Absah I, Rishi A, Talley NJ, et al. Rumination syndrome: pathophysiology, diagnosis, and treatment. Neurogastroenterol Motil 2017; 29:e12954.
http://onlinelibrary.wiley.com/wol1/doi/10.1111/nmo.12954/abstract. Copyright © 2017. Reproduced with permission of John Wiley & Sons Inc. This image has been provided by or is owned by Wiley. Further permission is needed before it can be downloaded to PowerPoint, printed, shared or emailed. Please contact Wiley's permissions department either via email:
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