Breakdown of manometric diagnoses. EGJOO, esophagogastric junction outflow obstruction; DES, distal esophageal spasm; FP, fragmented peristalsis; IEM, ineffective esophageal motility.
Examples of representative artifacts, swallows, and pharyngeal acid reflux (PAR) episodes based on visual analyses of 1-hour window screening (step 1) and adequate zooming in (step 2) of the dual pH tracings. Final diagnosis was made based on the magnified hypopharyngeal multichannel intraluminal impedance-pH (HMII-pH) tracings (step 3). (A) Synchronous pH drops were characterized as onset of pH drops occurring simultaneously in both pharyngeal and esophageal channels during adequate zooming in (solid vertical line in step 2), which were most likely due to equipment errors. Moreover, abrupt pH return to baseline (arrowhead) also simultaneously occurred in both channels. (B) Antegrade pH drops were characterized as pharyngeal pH drops followed by esophageal pH drops, in which an acidic liquid swallowing episode outside of meals was diagnosed by HMII-pH tracings (step 3). (C) Retrograde pH drops characterized as pharyngeal pH drops (vertical line), preceded by esophageal pH drops. However, simultaneous abrupt pH return to baseline (arrowhead) in both channels (step 2) suggests artifacts, which were subsequently proved by HMII-pH tracings in step 3. (D) Retrograde pH drops typically occur in a PAR episode when an esophageal pH drop is followed by a pharyngeal pH drop. (E) Retrograde pH drops could also exist in a PAR episode during a prolonged or pre-existing esophageal acidification. (F) Retrograde pH drops due to acidic liquid swallows (arrowhead) may occur immediately after a PAR episode, suggesting a possibility of re-swallowing hypopharyngeal acidic refluxate.
Box and whisker plot demonstrating significant increase in total aggregate symptom score among cyclic vomiting syndrome (CVS) patients compared to controls.
Relationship between diarrhea-predominant irritable bowel syndrome (IBS-D)-like symptoms and the Crohn’s disease activity index (CDAI) or irritable bowel syndrome (IBS) severity index in patients with quiescent Crohn’s disease. Results are expressed as mean ± SD.
Schematic representation of the mechanical tension recordings and representative changes in segmental motility. (A) Bowel contractions were recorded at 3 sites with stainless steel clips and silk strings connected to a force transducer. Ballooning of a Foley catheter in the middle of an isolated segment induced radial stretch. Tension recordings before and after radial stretch at the proximal site of the ascending (B) and the sigmoid colons (D) and at the distal site of the ascending (C) and the sigmoid colons (E). CM, circular muscle; prox, proximal, mid, middle, dist, distal.
J Neurogastroenterol Motil 2023; 29(1): 1~125 
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