Journal of Neurogastroenterology and Motility最新文献

{"title":"Globus: Its True Relationship to Acid Reflux? Opposing Patterns of Location-specific Basal Pressure Compared to Gastroesophageal Reflux Disease.","authors":"Boram Cha","doi":"10.5056/jnm25044","DOIUrl":"https://doi.org/10.5056/jnm25044","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 2","pages":"131-132"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012456","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":"2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome.","authors":"Yonghoon Choi, Young Hoon Youn, Seung Joo Kang, Jeong Eun Shin, Young Sin Cho, Yoon Suk Jung, Seung Yong Shin, Cheal Wung Huh, Yoo Jin Lee, Hoon Sup Koo, Kwangwoo Nam, Hong Sub Lee, Dong Hyun Kim, Ye Hyun Park, Min Cheol Kim, Hyo Yeop Song, Sung-Hoon Yoon, Sang Yeol Lee, Miyoung Choi, Moo-In Park, In-Kyung Sung","doi":"10.5056/jnm25007","DOIUrl":"https://doi.org/10.5056/jnm25007","url":null,"abstract":"<p><p>Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 2","pages":"133-169"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986690","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":"Overlapping Reflux Symptoms in Functional Dyspepsia Are Mostly Unrelated to Gastroesophageal Reflux.","authors":"Songfeng Chen, Xingyu Jia, Qianjun Zhuang, Xun Hou, Kewin T H Siah, Mengyu Zhang, Fangfei Chen, Niandi Tan, Junnan Hu, Yinglian Xiao","doi":"10.5056/jnm24091","DOIUrl":"https://doi.org/10.5056/jnm24091","url":null,"abstract":"<p><strong>Background/aims: </strong>Reflux symptoms frequently present in patients diagnosed with functional dyspepsia (FD). This investigation sought to elucidate the contribution of gastroesophageal reflux in the overlap relationship.</p><p><strong>Methods: </strong>Consecutive patients presenting with reflux symptoms and/or FD symptoms were prospectively included. Comprehensive assessments, including symptoms evaluation, endoscopy, esophageal functional examinations (high-resolution manometry and reflux monitoring), and proton pump inhibitor (PPI) treatment efficacy evaluation, were conducted in these patients.</p><p><strong>Results: </strong>The study enrolled 315 patients, 43.2% of which had concurrent FD symptoms and overlapping reflux symptoms. Notably, a mere 28.7% of patients in the overlap symptoms group had objective gastroesophageal reflux disease evidences (the grade of esophagitis ≥ B or the acid exposure time ≥ 4.2%). Functional heartburn was demonstrated to be the main cause of overlapping reflux symptoms (55.1%). Reflux parameters analysis revealed that the reflux burden in the overlap symptoms group paralleled that of the FD symptoms group, with both registering lower levels than the reflux symptoms group (<i>P</i> < 0.05). Furthermore, PPI response rates were notably diminished in the overlap symptoms group (<i>P</i> < 0.001), even for those with objective gastroesophageal reflux disease evidences.</p><p><strong>Conclusions: </strong>The study illuminated that overlapping reflux symptoms in FD was common. Strikingly, these symptoms primarily diverged from reflux etiology and exhibited suboptimal responses to PPI intervention. These findings challenge prevailing paradigms and accentuate the imperative for nuanced therapeutic approaches tailored to the distinctive characteristics of overlapping reflux symptoms in the context of FD.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 2","pages":"218-226"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968139","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":"Overlap Between Gastroesophageal Reflux Disease and Functional Dyspepsia: Do We Need a New Management Paradigm?","authors":"So Young Byun, Kee Wook Jung","doi":"10.5056/jnm25030","DOIUrl":"https://doi.org/10.5056/jnm25030","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 2","pages":"129-130"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968136","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 for Treatment of Extraesophageal Symptoms and Signs.","authors":"Gwang Ha Kim, Ronnie Fass","doi":"10.5056/jnm24159","DOIUrl":"https://doi.org/10.5056/jnm24159","url":null,"abstract":"<p><p>Extraesophageal symptoms and signs of gastroesophageal reflux disease (GERD), such as throat clearing, globus sensation, hoarseness, cough, asthma, pulmonary fibrosis, otitis, sinusitis, and dental erosions, are common and pose diagnostic and therapeutic challenges. Proton pump inhibitors (PPIs) are the mainstay of treatment for GERD, but have demonstrated a limited effectiveness for extraesophageal symptoms and signs in several meta-analyses. Potassium-competitive acid blockers (P-CABs) offer more rapid and sustained acid inhibition than PPIs; therefore, P-CABs may have the potential to be at least as good or superior to PPIs in relieving extraesophageal symptoms and signs of GERD. To date, there have been 4 prospective randomized trials demonstrating similar efficacy of P-CABs to PPIs in the treatment of extraesophageal symptoms and signs, but more rapid and greater efficacy in patients with severe symptoms. Therefore, P-CABs appear to have a treatment role in extraesophageal symptoms and signs of GERD. However, considering that P-CABs are not superior to PPIs, large-scale, multi-center studies with double dose P-CABs over a prolonged period of time may elucidate a subgroup of patients in whom P-CABs are beneficial in ameliorating extraesophageal symptoms and signs.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 2","pages":"170-177"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996927","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":"Delayed Gastric Emptying Correlates With Decreased Post-prandial Motility in Children: A Single-center Retrospective Review.","authors":"Raul E Sanchez, Elizabeth Reichard, Adam Bobbey, Neetu Bali Puri, Peter L Lu, Desale Yacob, Carlo Di Lorenzo, Kent Williams, Karla K H Vaz","doi":"10.5056/jnm24057","DOIUrl":"10.5056/jnm24057","url":null,"abstract":"<p><strong>Background/aims: </strong>Pediatric patients with suspected gastroparesis often undergo antroduodenal manometry (ADM) and gastric emptying scintigraphy (GES) for diagnostic purposes. However, it is unknown if delayed gastric emptying (DGE) correlates with manometric findings. This study evaluates whether ADM parameters differ between normal and abnormal GES in pediatric patients.</p><p><strong>Methods: </strong>Data from pediatric patients undergoing ADM and GES at Nationwide Children's Hospital from 2011-2020 were retrospectively reviewed. Manometry parameters including motility index (Ln [sum of amplitudes × number of contractions + 1]), number of antral contractions, and direction of the phase III migrating motor complex (MMC) were compared to GES results from age-matched patients with DGE (n = 32) and normal gastric emptying (NGE) (n = 32) of similar sex, body mass index, and weight.</p><p><strong>Results: </strong>Children with DGE had a lower post-prandial antral motility index and antral contraction number than those with NGE (9.4 vs 11.2, <i>P</i> = 0.005; 21.8 vs 49.6, <i>P</i> < 0.001). The gastric emptying percentage at 4 hours was lower in patients with retrograde phase III (59.2% vs 83.9%, <i>P</i> = 0.022) and in those without an antral component in the fasting phase III of the migrating motor complex (70.3% vs 86.5%, <i>P</i> = 0.003). Post-prandial antral hypomotility occurred more frequently in the DGE group than in the NGE group (41% vs 9%, <i>P</i> = 0.008).</p><p><strong>Conclusions: </strong>ADM findings differ between children with DGE and NGE. Children with DGE are more likely to have abnormal fasting phase III patterns and decreased post-prandial antral activity during ADM testing.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"102-109"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950296","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":"Exploring Diagnostic Challenges at the Intersection of Eating Disorders and Functional Dyspepsia: Implications for Rome V.","authors":"Yong Sung Kim, Sung Hoon Yoon, Suck Chei Choi","doi":"10.5056/jnm24172","DOIUrl":"10.5056/jnm24172","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"6-7"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950303","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":"Optimizing Assessment of Contraction Reserve in Ineffective Esophageal Motility: A Study of Upright Multiple Rapid Swallows.","authors":"Tian Li, D Chamil Codipilly, Diana Snyder, Karthik Ravi, Maoyin Pang, Andree H Koop","doi":"10.5056/jnm24097","DOIUrl":"10.5056/jnm24097","url":null,"abstract":"<p><strong>Background/aims: </strong>Multiple rapid swallows (MRS) is a provocative test during high-resolution esophageal manometry (HRM) to evaluate contraction reserve (CR). This study aims to determine the prevalence of CR in patients with ineffective esophageal motility (IEM) and MRS performed in the upright position, and to assess the ideal number of MRS sequences.</p><p><strong>Methods: </strong>We enrolled adult patients diagnosed with IEM according to the Chicago classification version 4.0 who underwent HRM with 3 MRS sequences. Presence of CR was identified as either: the distal contraction integral (DCI) of the post-MRS sequence exceeding the mean DCI of single swallows (ratio > 1) or the mean DCI of the 3 post-MRS sequences surpassing the mean DCI of single swallows. The occurrence of CR was compared following 1, 2, and 3 MRS sequences.</p><p><strong>Results: </strong>When assessing CR in 57 patients referenced to mean single supine swallow DCI, the pooled prevalence of CR following 1, 2, and 3 MRS sequences was 23/57 (40.4%), 31/57 (54.4%), and 33/57 (57.9%), respectively. More patients had CR after 2 MRS sequences compared to 1 (<i>P</i> < 0.001), but there was no significant difference in CR between 2 and 3 MRS sequences (<i>P</i> = 0.160). More patients had CR after 2 (<i>P</i> = 0.013) and 3 MRS sequences (<i>P</i> = 0.034) when CR was referenced to single upright compared to single supine swallows.</p><p><strong>Conclusion: </strong>Among patients with IEM, 58.0% had CR after 3 upright MRS sequences and 2 were adequate to assess CR.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"38-44"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950318","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":"Association Between Functional Dyspepsia and Binge Eating Disorder: A Frequent, Often Overlooked Overlap Clinical Presentation.","authors":"Francisco A Félix-Téllez, Alejandra X Cruz-Salgado, José M Remes-Troche, Ángel R Flores-Rendon, Héctor R Ordaz-Álvarez, José A Velarde-Ruiz Velasco, Marco A O Flores-Lizárraga, José I Soto-González, Nadia S Abizaid-Herrera","doi":"10.5056/jnm24070","DOIUrl":"10.5056/jnm24070","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aims to investigate the association between Binge Eating Disorder and functional dyspepsia in a Mexican population, focusing on symptomatology and demographic characteristics.</p><p><strong>Methods: </strong>We conducted a cross-sectional study on 1016 subjects, evaluating binge eating disorder (BED) and functional dyspepsia based on the Rome IV criteria. Data collection included sociodemographic information, gastrointestinal symptom severity, and anxiety/depression screening using validated tools. A multivariate logistic regression analysis with the χ2 test was conducted for comparison analysis.</p><p><strong>Results: </strong>The prevalence of dyspepsia in BED was 53.6% (95% CI, 46-56). Postprandial fullness (OR, 1.52; 95% CI, 1.06-2.17; <i>P</i> = 0.021) and overlap syndrome (OR, 1.80; 95% CI, 1.25-2.60; <i>P</i> = 0.002) were significantly associated with BED. Patients with BED also presented more severe postprandial distress syndrome (<i>P</i> = 0.027). Anxiety was prevalent in BED patients, while depression was more prominent in patients with BED and dyspepsia overlap.</p><p><strong>Conclusions: </strong>BED patients have a high prevalence of dyspepsia with an association between postprandial fullness and this eating disorder. BED appears to be more prevalent in younger individuals and males. These findings underscore the importance of considering dyspepsia in the management of BED and highlight the need for further research on this association.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"95-101"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950293","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":"Effect of Anti-reflux Mucosal Ablation on Esophageal Motility in Patients With Gastroesophageal Reflux Disease: A Study Based on High-resolution Impedance Manometry.","authors":"Chien-Chuan Chen, Chu-Kuang Chou, Ming-Ching Yuan, Kun-Feng Tsai, Jia-Feng Wu, Wei-Chi Liao, Han-Mo Chiu, Hsiu-Po Wang, Ming-Shiang Wu, Ping-Huei Tseng","doi":"10.5056/jnm24055","DOIUrl":"10.5056/jnm24055","url":null,"abstract":"<p><strong>Background/aims: </strong>Anti-reflux mucosal ablation (ARMA) is a promising endoscopic intervention for proton pump inhibitor (PPI)-dependent gastroesophageal reflux disease (GERD). However, the effect of ARMA on esophageal motility remains unclear.</p><p><strong>Methods: </strong>Twenty patients with PPI-dependent GERD receiving ARMA were prospectively enrolled. Comprehensive self-report symptom questionnaires, endoscopy, 24-hour impedance-pH monitoring, and high-resolution impedance manometry were performed and analyzed before and 3 months after ARMA.</p><p><strong>Results: </strong>All ARMA procedures were performed successfully. Symptom scores, including GerdQ (11.16 ± 2.67 to 9.11 ± 2.64, <i>P</i> = 0.026) and reflux symptom index (11.63 ± 5.62 to 6.11 ± 3.86, <i>P</i> = 0.001), improved significantly, while 13 patients (65%) reported discontinuation of PPI. Total acid exposure time (5.84 ± 4.63% to 2.83 ± 3.41%, <i>P</i> = 0.024) and number of reflux episodes (73.05 ± 19.34 to 37.55 ± 22.71, <i>P</i> < 0.001) decreased significantly after ARMA. Improved esophagogastric junction (EGJ) barrier function, including increased lower esophageal sphincter resting pressure (13.89 ± 10.78 mmHg to 21.68 ± 11.5 mmHg, <i>P</i> = 0.034), 4-second integrated relaxation pressure (5.75 ± 6.42 mmHg to 9.99 ± 5.89 mmHg, <i>P</i> = 0.020), and EGJ-contractile integral (16.42 ± 16.93 mmHg·cm to 31.95 ± 21.25 mmHg·cm, <i>P</i> = 0.016), were observed. Esophageal body contractility also increased significantly (distal contractile integral, 966.85 ± 845.84 mmHg·s·cm to 1198.8 ± 811.74 mmHg·s·cm, <i>P</i> = 0.023). Patients with symptom improvement had better pre-AMRA esophageal body contractility.</p><p><strong>Conclusions: </strong>ARMA effectively improves symptoms and reflux burden, EGJ barrier function, and esophageal body contractility in patients with PPIdependent GERD during short-term evaluation. Longer follow-up to clarify the sustainability of ARMA is needed.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"75-85"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950297","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}