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. Author manuscript; available in PMC: 2022 Oct 1.
Published in final edited form as: Neurogastroenterol Motil. 2021 Mar 9;33(10):e14106. doi: 10.1111/nmo.14106

Figure 2. Differences in Rumination Identified on MII-pH Compared to PPHRIM.

Figure 2.

(a) A 50% decrease in baseline impedance with or without a drop in pH on MII-pH could lead to rumination mistakenly identified as a reflux episode and result in the misdiagnosis of GERD. (b) PPHRIM, however, can identify rumination using both impedance and pressure characteristics unique to rumination and not GERD: gastric pressure increased > 30 mmHg with a retrograde pressure gradient and flow of gastric refluxate identified by a 50% decrease in impedance.