Journal of Neurogastroenterology and Motility最新文献

{"title":"Substrate-dependent Differences of Colonic Hydrogen Production in a Patient With Fructose Malabsorption.","authors":"Gernot Kriegshäuser","doi":"10.5056/jnm25163","DOIUrl":"10.5056/jnm25163","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"300-301"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potassium-competitive Acid Blockers Versus Proton Pump Inhibitors for Erosive Esophagitis: A Systematic Review and Network Meta-analysis.","authors":"Jin Won Chang, Da Hyun Jung, Nak-Hoon Son, Sohyeon Gwon, Da Mi Jeong, Cheal Wung Huh","doi":"10.5056/jnm25161","DOIUrl":"10.5056/jnm25161","url":null,"abstract":"<p><strong>Background/aims: </strong>: Potassium-competitive acid blockers (P-CABs) have emerged as promising alternatives to proton pump inhibitors (PPIs) to treat erosive esophagitis (EE). This study aims to compare the efficacy and safety of P-CABs and PPIs in patients with mild to severe EE stratified by treatment phase.</p><p><strong>Methods: </strong>: A systematic literature search was conducted using PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials comparing the efficacy of P-CABs and PPIs for EE were included. The pooled risk ratios (RRs) and risk differences with 95% confidence intervals (CIs) were calculated. A frequentist network meta-analysis was performed, and treatment ranking was assessed using P-scores.</p><p><strong>Results: </strong>: Nineteen studies evaluating 5 P-CABs (vonoprazan, tegoprazan, keverprazan, fexuprazan, and zastaprazan) and 2 PPIs (lansoprazole and esomeprazole) were included. P-CABs demonstrated superior efficacy in healing EE during the initial phase, particularly in patients with severe EE (RR = 1.10; 95% CI, 1.00-1.20) and were also associated with a lower EE recurrence risk during maintenance treatment (RR = 0.59; 95% CI, 0.41-0.85). The efficacy was notably greater in patients with higher EE severity and among cytochrome P450 2C19 extensive metabolizers. The safety profiles of the P-CABs and PPIs were comparable. Vonoprazan consistently ranked the highest for both initial treatment (P-score = 0.68) and maintenance (P-score = 0.94).</p><p><strong>Conclusions: </strong>: P-CABs, especially vonoprazan, showed superior efficacy compared to PPIs in both the initial and maintenance treatment of EE. These findings support the use of P-CABs as a potent and reliable first-line option for EE management, particularly in high-risk populations, with acceptable safety outcomes.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":" ","pages":"172-184"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DA-9701 for Gastrointestinal Symptoms in Postural Orthostatic Tachycardia Syndrome: A Randomized Pilot Study.","authors":"Hee-Jae Jung, Dayoung Seo, Hyunjin Kim, Young-Min Lim, Ji-Sung Lee, Eun-Jae Lee","doi":"10.5056/jnm25140","DOIUrl":"10.5056/jnm25140","url":null,"abstract":"<p><strong>Background/aims: </strong>: Patients with postural tachycardia syndrome (POTS) commonly experience gastrointestinal (GI) symptoms. We aim to assess the feasibility and preliminary efficacy data for DA-9701, a prokinetic agent targeting 5-hydroxytryptamine 1A, 5-hydroxytryptamine 4, and dopamine D₂ receptors, in patients with POTS.</p><p><strong>Methods: </strong>: In a randomized, double-blind, placebo-controlled, single-center crossover trial, patients with POTS were given either 30 mg of DA-9701 or a placebo 3 times daily for eight weeks in a 1:1 ratio. After a 4-week washout, patients received the alternate treatment for another 8 weeks. The primary endpoint focused on assessing the change in GI symptoms (total Nepean Dyspepsia Index-Korean version [NDI-K] symptom score) from baseline over the 8 week-treatment period. Endpoints were assessed in all enrolled and randomized patients (intention-to-treat), and in those who completed the trial (per-protocol analysis).</p><p><strong>Results: </strong>: Between January 2022 and August 2023, 24 patients were randomized (n = 12 per group), with 3 discontinuing after randomization. DA-9701 did not significantly improve primary endpoints for total NDI-K symptom scores in either the intention-to-treat (least-squares means, -13.9 vs. -9.5, <i>P</i> = 0.326) or per-protocol analyses (-17.2 vs -12.0, <i>P</i> = 0.242). Notably, a trend toward improvement in specific GI symptoms, such as upper abdominal pain, was observed in both intention- to-treat (-0.6 vs 0.7; <i>P</i> = 0.066) and per-protocol analyses (-0.9 vs 0.6; <i>P</i> = 0.045). No serious adverse events were observed.</p><p><strong>Conclusion: </strong>DA-9701 did not improve GI symptoms in this crossover trial; however, its potential effect on specific GI symptoms merits further investigation.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"228-236"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Guidance and Practical Recommendations for Probiotic Use in Patients With Irritable Bowel Syndrome, Functional Constipation, and <i>Clostridioides difficile</i> Infection Considering Sex-based Differences.","authors":"Yong Sung Kim, Seon-Young Park, Seung Joo Kang, Min Woo Lee, Yonghoon Choi, Byung Yong Kim, Miyoung Choi, Cheol Min Shin, Young Sun Kim, Nayoung Kim, Moo In Park","doi":"10.5056/jnm25221","DOIUrl":"10.5056/jnm25221","url":null,"abstract":"<p><p>Probiotics have gained increasing clinical attention as adjunctive treatment for lower gastrointestinal disorders. However, evidence supporting their therapeutic efficacy remains limited, particularly with regard to sex-related differences. This expert review provides evidence-based insights and practical recommendations for the use of probiotics in patients with irritable bowel syndrome (IBS), functional constipation (FC), and <i>Clostridioides difficile</i> infection (CDI), considering possible sex-related differences. Evidence from randomized controlled trials and meta-analyses indicates that probiotics can modestly improve global symptoms, abdominal pain, and bloating in IBS and enhance bowel movement frequency and stool consistency in FC. However, these effects are strain-specific and heterogeneous. Although clinical studies on probiotics in IBS have not confirmed significant sex-related differences, experimental animal studies using stress-induced IBS models have demonstrated sex-dependent responses to specific probiotic strains, supporting the biological plausibility of such differences. For CDI, the efficacy of probiotics in preventing primary or recurrent infections remains inconsistent across large trials, and current guidelines usually do not recommend their routine use. However, sex and age difference of immunology supports the clinical differences of CDI. Probiotics are generally considered safe for healthy individuals, although caution is advised in patients who are immunocompromised or critically ill. Clinicians should select probiotic products based on strain-specific clinical evidence, adequate viable doses, patient's characteristics, or patient's sex. In conclusion, probiotics might play a role as adjunctive therapy for IBS and FC, with variability in responses influenced by microbial, host, and potential sex-related factors. Further research is needed to establish optimized personalized probiotic strategies.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":" ","pages":"198-216"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Belief to Behavior: Closing the Knowledge-Practice Gap in Irritable Bowel Syndrome Self-management.","authors":"Jung-Wook Kim","doi":"10.5056/jnm26049","DOIUrl":"10.5056/jnm26049","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"145-147"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia is Associated With the Combination of Defective Bolus Transit and Poorly Relaxing Lower Esophageal Sphincter in Patients With Ineffective Esophageal Motility.","authors":"Abdel-Jalil Ala, Thai Hau Koo, Ronnie Fass","doi":"10.5056/jnm25058","DOIUrl":"10.5056/jnm25058","url":null,"abstract":"<p><strong>Background/aims: </strong>: Ineffective esophageal motility (IEM) is the most frequently encountered esophageal manometric abnormality. Nonobstructive dysphagia is frequently associated with severe esophageal peristaltic dysfunction. This study aims to evaluate the presenting symptoms and association between dysphagia and specific manometric findings in patients with IEM.</p><p><strong>Methods: </strong>: We retrospectively reviewed 228 IEM patients diagnosed on high-resolution manometry at an academic institution (2010-2013). We collected data regarding the main presenting symptoms and manometric findings: bolus transit, distal esophageal pressure amplitude, and lower esophageal sphincter (LES) resting and relaxation pressure.</p><p><strong>Results: </strong>: Dysphagia was the main presenting symptom (25%) in IEM patients. Bolus transit was incomplete in either liquid or viscous swallows (30%) and incomplete in both liquid and viscous swallows (59%) in IEM patients. The LES resting pressure and LES relaxation pressure were elevated (9% and 36%, respectively) in IEM patients. There was no significant difference between dysphagia and either poorly relaxing LES (<i>P</i> = 0.725) or defective bolus transit (DBT) to liquid and viscous swallows (<i>P</i> = 0.372) compared to the rest of the IEM patients. However, there was a significant association between dysphagia and the combination of poorly relaxing LES and DBT in liquid and viscous swallows (<i>P</i> = 0.006). Subgroup analysis comparing dysphagia with heartburn/regurgitation demonstrated a similar significant association between dysphagia and the combination of poorly relaxing LES and DBT during viscous and liquid swallows (<i>P</i> = 0.016).</p><p><strong>Conclusions: </strong>: Dysphagia is a variable symptom associated with complex esophageal motility abnormalities. IEM patients with a combination of poorly relaxing LES and DBT are more likely to have dysphagia.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"217-227"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real‑world Application of the International Anorectal Physiology Working Group Standardized Protocol and London Classification: A Multi‑country Cross‑sectional Survey of Anorectal Manometry Practice in Asia.","authors":"Seon-Young Park, Kee Wook Jung, Myeongsook Seo, Han Hee Lee, Ju Yup Lee, Soo In Choi, Jong Wook Kim, Chong Il Sohn, Suck Chei Choi","doi":"10.5056/jnm25157","DOIUrl":"10.5056/jnm25157","url":null,"abstract":"<p><strong>Background/aims: </strong>: The International Anorectal Physiology Working Group (IAPWG) has proposed a standardized protocol and the London classification to enhance the consistency and diagnostic accuracy of anorectal manometry (ARM). However, real-world adoption in Asian countries has not been systematically assessed. This study aims to evaluate current ARM practices and adherence to the IAPWG protocol across Asian centers.</p><p><strong>Methods: </strong>: A cross-sectional, 50-item web-based survey was distributed to gastroenterologists and motility specialists practicing in Asian countries.</p><p><strong>Results: </strong>: Thirty-one centers from 8 countries responded (20 in Korea, 3 in Japan, 2 in Taiwan, 1 in China, and 7 in other countries). High-resolution ARM was used in 80.6% of centers, primarily with solid-state catheters. While all centers performed rest and short squeeze maneuvers, only 58.1% conducted all maneuvers recommended by the IAPWG protocol. Considerable variation was observed in test methodology and interpretation, including definitions of resting pressure, squeeze duration, push maneuver repetition, and rectal balloon volume for rectoanal inhibitory reflex. For balloon expulsion and rectal sensory testing, centers differed in patient positioning, balloon type, inflation methods, and threshold definitions. Only 38.7% of centers reported having institutional normative values for test interpretation, and 64.5% applied the London classification.</p><p><strong>Conclusions: </strong>: Across Asian centers, ARM practice shows marked regional variation and incomplete implementation of the IAPWG standardized protocol and London classification, highlighting persistent gaps in standardization. Strengthening procedural guidance, regionally appropriate normative data, and interpretation criteria through coordinated education and international collaboration is needed to support more consistent and clinically meaningful use of ARM in routine practice.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"267-275"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a Standard Protocol for Fecal Microbiota Transplantation in Irritable Bowel Syndrome.","authors":"Magdy El-Salhy, Maura Corsetti, Odd Helge Gilja, Sutep Gonlachanvit, Jan Gunnar Hatlebakk, Dag Arne Lihaug Hoff, Perttu Lahtinen, Johan Axel Lunding, Tarek Mazzawi, Tanya M Monaghan, Bodil Ohlsson, Tanisa Patcharatrakul, Yong Sung Kim, Cheol Min Shin","doi":"10.5056/jnm26011","DOIUrl":"10.5056/jnm26011","url":null,"abstract":"<p><p>Randomized controlled trials (RCTs) of fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome (IBS) have produced outcomes varying from no effect at all to high efficacy and durable effects over time. This review analyzed differences in the protocols used in FMT RCTs for IBS in the recently published literature with the aim of identifying the factors responsible for the success or failure of these RCTs. The results of this analysis might be useful in formulating an effective standard protocol for FMT in IBS. A systematic search was conducted in the PubMed database of the literature published in English from January 2015 to December 2023 using several search phrases comprising MeSH expressions. Those RCTs that carefully selected donors based on environmental factors that are known to affect the gut microbiota positively and ensured bacterial diversity before and during FMT produced successful outcomes. Furthermore, direct freezing of the donor's fecal transplant, storing it at -80°C until the FMT is performed, and then thawing it at 4°C and mixing it manually appear to be factors associated with the success of FMT in IBS. Administering the donor's fecal transplant into the small intestine results in durable effects of FMT and long-term colonization of beneficial bacteria. A standard protocol for FMT with large and durable effects should include (1) careful donor selection, (2) handling the donor's fecal transplant in a way that preserves its microbiota contents, and (3) administering the transplant into the small intestine.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"185-197"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Therapeutic Gap: Clinical Efficacy of Endoscopic Radiofrequency Stretta Therapy for Gastroesophageal Reflux Disease in Korea.","authors":"Yang Won Min","doi":"10.5056/jnm26042","DOIUrl":"10.5056/jnm26042","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"148-149"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Endoscopic Radiofrequency Stretta Therapy for Gastroesophageal Reflux Disease Treatment: A Retrospective Analysis From 2 Tertiary Centers in Korea.","authors":"Hyun Lim, Yuri Kim, Jin Hee Noh, Jung In Lee, Eun Jeong Gong, Boram Cha, Chan Hyuk Park, Da Hyun Jung, Ju Yup Lee, Sun Hyung Kang, In Kyung Yoo, Joo Young Cho, Do Hoon Kim","doi":"10.5056/jnm25243","DOIUrl":"10.5056/jnm25243","url":null,"abstract":"<p><strong>Background/aims: </strong>: Endoscopic anti-reflux therapy is a therapeutic option for gastroesophageal reflux disease (GERD), providing durable effects. However, clinical data from Korea remain limited. This study evaluates the clinical outcomes of endoscopic radiofrequency Stretta therapy in Korean patients.</p><p><strong>Methods: </strong>: A retrospective analysis was conducted on 71 patients with GERD who underwent Stretta therapy at 2 tertiary hospitals in Korea between November 2015 and July 2021. Clinical outcomes, including patient satisfaction, medication cessation or reduction, and complications, were evaluated. Pre- and post-procedural esophageal manometry and 24-hour pH monitoring test results were also analyzed.</p><p><strong>Results: </strong>: Patient satisfaction rates at 1, 6, and 12 months post-procedure were 54.7% (35/64), 70.0% (28/40), and 75.0% (21/28), respectively. Medication cessation or reduction was achieved in 31.2% (20/64) at 1 month, 70.0% (28/40) at 6 months, and 67.9% (19/28) at 12 months. Esophageal manometry (n = 21) showed no significant changes in mean lower esophageal sphincter pressure (18.7 mmHg [2.5-52.9] vs 17.4 mmHg [0.0-43.0], <i>P</i> = 0.702) or mean integrated relaxation pressure (8.2 mmHg [0.0-28.0] vs 10.1 mmHg [0.0-31.0], <i>P</i> = 0.840). The 24-hour pH monitoring (n = 18) demonstrated a nonsignificant decrease in acid exposure time (pH < 4) from 2.3% (0.0-8.4) to 1.6% (0.0-7.3) (<i>P</i> = 0.182). Similarly, the DeMeester score decreased non-significantly from 8.4 (0.8-27.7) to 6.6 (0.8-21.8) (<i>P</i> = 0.352). No procedure-related complications occurred.</p><p><strong>Conclusion: </strong>Endoscopic radiofrequency Stretta therapy appears to be a safe treatment option for GERD and may provide favorable patient satisfaction and medication reduction.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 2","pages":"290-297"},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}