Journal of Neurogastroenterology and Motility最新文献

{"title":"Spatiotemporal Remodeling of Enteric Neural Pathways Underlies Colonic Dysmotility Following Spinal Cord Injury in Rats.","authors":"Min Seob Kim, Sei Kim, Se Eun Ha, Hyun Seok Choi, Myeong Hwan Yu, Jisong You, Dahyun Seon, Do Hee Lee, Min Cheol Joo, Yong Sung Kim, Suck Chei Choi, Joong Goo Kwon, Kyung Sik Park, Hyun Jin Kim, Seungil Ro, Moon Young Lee","doi":"10.5056/jnm25093","DOIUrl":"10.5056/jnm25093","url":null,"abstract":"<p><strong>Background/aims: </strong>: Spinal cord injury (SCI) frequently impairs defecation, severely affecting the quality of life. This study examines compensatory neural remodeling after SCI, focusing on basal colonic contractility, neural responses to electrical field stimulation, and alterations in excitatory cholinergic and inhibitory nitrergic pathways.</p><p><strong>Methods: </strong>: Female Sprague-Dawley rats underwent either sham surgery or T10 spinal cord transection and were categorized into 3 groups: sham, 1-week post-SCI (acute), and 4-week post-SCI (chronic). Colonic contractility was assessed in an organ bath using electrical field stimulation in the presence of a nitric oxide synthase inhibitor. Neural protein expression was analyzed by immunofluorescence and Western blotting.</p><p><strong>Results: </strong>: SCI produced region- and time-dependent impairments in colonic contractility, with distinct alterations in the proximal circular and longitudinal muscles across acute and chronic phases. Neural excitability shifted dynamically, showing enhanced excitatory activity in the proximal longitudinal muscle at 1-week and the distal circular muscle at 4-week post-SCI. Protein analysis revealed increased neuronal nitric oxide synthase in the proximal colon, decreased soluble guanylyl cyclase in the distal colon, upregulated muscarinic M₃ receptor in the proximal colon, and reduced vasoactive intestinal peptide receptor 1 in both proximal and distal regions.</p><p><strong>Conclusion: </strong>: SCI induces spatiotemporal remodeling of excitatory and inhibitory neural pathways, contributing to colonic dysmotility and revealing potential targets for therapeutic intervention.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"86-98"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906167","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":"Comparison of Fexuprazan and Esomeprazole for the Control of Nocturnal Gastroesophageal Reflux Symptoms: A Randomized, Crossover Study.","authors":"Dong Jun Oh, Dong Hwan Park, Jiyun Jung, Yun Jeong Lim","doi":"10.5056/jnm25119","DOIUrl":"10.5056/jnm25119","url":null,"abstract":"<p><strong>Background/aims: </strong>: Nocturnal acid reflux disrupts sleep and impairs quality of life. Proton pump inhibitors provide insufficient suppression of nocturnal acid secretion, whereas fexuprazan offers prolonged acid suppression. We compared the efficacy of fexuprazan and esomeprazole in controlling nocturnal reflux.</p><p><strong>Methods: </strong>: In a randomized and crossover study, patients received fexuprazan or esomeprazole daily for 4 weeks, followed by a washout and crossover to the alternate medication for another 4 weeks, with a final washout completing the sequence. Severity (scores 0-10), frequency, sleep disturbance, and medication preferences were evaluated.</p><p><strong>Results: </strong>: Thirty-nine patients were enrolled and randomized to receive either fexuprazan (n = 20) or esomeprazole (n = 19) first. After the first treatment, fexuprazan reduced severity from 7.5 ± 1.7 to 1.4 ± 1.7 (81.3% decrease), versus 7.8 ± 1.5 to 2.8 ± 1.9 (64.1% decrease) with esomeprazole (<i>P</i> = 0.012). In patients with severe symptoms (scores ≥ 7), fexuprazan led to significantly greater improvement than esomeprazole (<i>P</i> = 0.008). Following the first washout, the second crossover treatment resulted in greater improvement in symptom severity with fexuprazan (<i>P</i> = 0.001). During the second washout, nocturnal symptoms severity and frequencies were better controlled with fexuprazan than with esomeprazole (<i>P</i> = 0.005 and 0.019). Patients who switched from esomeprazole to fexuprazan preferred fexuprazan (<i>P</i> = 0.018).</p><p><strong>Conclusions: </strong>: Fexuprazan was more effective than esomeprazole in controlling nocturnal reflux symptom, particularly in patients with severe symptoms. Fexuprazan may offer a therapeutic advantage for patients with severe and persistent nocturnal reflux despite proton pump inhibitor therapy.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":" ","pages":"52-60"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957834","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":"Reply: Mean Nocturnal Baseline Impedance in Gastroesophageal Reflux Disease: Considerations on the Study by Lee et al.","authors":"Boram Cha, Kee Wook Jung","doi":"10.5056/jnm25231","DOIUrl":"10.5056/jnm25231","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"138"},"PeriodicalIF":3.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906134","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":"Loss of Inspiratory Augmentation as a Predictive Factor for the Development of Gastroesophageal Reflux Disease After Peroral Endoscopic Myotomy in Patients With Achalasia.","authors":"Min-Jae Kim, Se Yeon Jeon, Jun Chul Park, Young Hoon Youn, Hyojin Park","doi":"10.5056/jnm25120","DOIUrl":"10.5056/jnm25120","url":null,"abstract":"<p><strong>Background/aims: </strong>: Gastroesophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM) is a significant challenge. Disruption of the lower esophageal sphincter during POEM and dysfunction of the crural diaphragm, which contributes to esophagogastric junction pressure, may lead to GERD after POEM. We aim to identify predictors of GERD after POEM and focus on physiological parameters of esophagogastric junction pressure in patients with achalasia before POEM.</p><p><strong>Methods: </strong>: We retrospectively analyzed a prospectively collected database of patients who underwent POEM between July 2016 and August 2023. Ninety-two patients with achalasia who underwent high-resolution manometry and endoscopy before and after POEM were included.</p><p><strong>Results: </strong>: Forty-nine (53.3%) patients were diagnosed with GERD. Patient demographics, achalasia subtypes, prior treatments, myotomy length, and myotomy orientation were not associated with GERD after POEM. Loss of inspiratory augmentation before POEM was associated with GERD after POEM (<i>P</i> < 0.05). GERD occurred more frequently in patients with a shorter intra-abdominal lower esophageal sphincter length before POEM. Type III esophagogastric junction morphology in the GERD group (37.1%) was more common than that in the non-GERD group (15.8%). Loss of inspiratory augmentation occurred more frequently in patients with type III esophagogastric junction pressure morphology.</p><p><strong>Conclusion: </strong>: Loss of inspiratory augmentation may predict GERD after POEM.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"129-135"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906106","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":"Interstitial Cells of Cajal Remodeling as a Mechanistic Insight Into the Natural History of Achalasia: Lessons From 3 Clinical Cases.","authors":"Ziwei Li, Youhong Hu, Bibo Zhong, Jiguang Kou, Anlong Yuan","doi":"10.5056/jnm25182","DOIUrl":"10.5056/jnm25182","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"139-140"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906111","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":"Corrigendum: Implementing a Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet in Asia: Addressing Cultural, Clinical and Practical Challenges.","authors":"Jane E Varney, Jagmeet Madan, Emma P Halmos, Shanthi Krishnasamy, Yeong Yeh Lee, Uzma Mustafa, Kewin T H Siah, Po-Shan Wu, Chu K Yao, Uday C Ghoshal","doi":"10.5056/jnm25090C","DOIUrl":"10.5056/jnm25090C","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"144"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906103","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":"Bali Chronic Constipation Roundtable Report: Chronic Constipation Management in Asia.","authors":"Yi Ping Ren, Wah Loong Chan, Kee Huat Chuah, Yong Sung Kim, Atsushi Nakajima, Sanjiv Mahadeva, Yeong Yeh Lee, Andrew S B Chua, Tao Bai, Ari Fahrial Syam, Chien-Lin Chen, Ching-Liang Lu, M Masudur Rahman, Tanisa Patcharatrakul, Victoria Ping Y Tan, Dao Viet Hang, Xiaohua Hou, Yinglian Xiao, Justin Wu, Uday C Ghoshal, Hidekazu Suzuki, Sutep Gonlachanvit, Kewin T H Siah","doi":"10.5056/jnm25076","DOIUrl":"10.5056/jnm25076","url":null,"abstract":"<p><strong>Background/aims: </strong>: Chronic constipation is prevalent yet under-diagnosed across Asia, compromising quality of life and burdening healthcare systems. Cultural stigma, varied diets, and limited access to standardized diagnostic tools delay timely care.</p><p><strong>Methods: </strong>: The Bali Chronic Constipation Roundtable in November 2024, brought together experts from 11 Asian countries. The group reviewed epidemiological data, analyzed multinational questionnaire on clinical practice pattern, and conducted structured discussions to identify key barriers and propose region-specific recommendations.</p><p><strong>Results: </strong>: Chronic constipation prevalence varies across Asia, ranging from 1.8% in India to 16.6% in Japan, with women and the elderly disproportionately affected. Under-reporting persists owing to cultural taboos and widespread self treatment with laxatives and traditional medications. Although the Rome IV criteria remains the global standard, they may not fully reflect Asian symptom profiles, and diagnosis is limited by scarce motility laboratories. First line therapies such as dietary-fiber optimization and osmotic laxatives are widely available, but newer pharmacotherapies (prucalopride, linaclotide, lubiprostone, and elobixibat) remain costly and unevenly accessible. Biofeedback for dyssynergic defecation is underutilized due to limited availability. Experts recommend expanded regional research on to refine diagnostic criteria, coupled with enhanced physician education and public awareness. They advocate accessibility to second-line and novel therapies that incorporate culturally attuned regional guidelines, and improved access to gastrointestinal motility testing.</p><p><strong>Conclusions: </strong>: The Bali Chronic Constipation Roundtable highlighted Asia's need for region specific diagnostics and management. Addressing diagnostic and treatment gaps will improve outcomes, while ongoing researcher clinician policy collaboration must standardize guidelines, advance research, and ensure equitable care across Asia.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":" ","pages":"109-128"},"PeriodicalIF":3.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557052","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":"Mast Cell Activation Affecting Gastrointestinal Motility.","authors":"Bipneet Singh, Palak Grover, Gurleen Kaur","doi":"10.5056/jnm25087","DOIUrl":"10.5056/jnm25087","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"141-143"},"PeriodicalIF":3.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906155","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":"Changes in Esophageal Transit Scintigraphy After Peroral Endoscopic Myotomy in Patients With Achalasia.","authors":"Young Hoon Youn, Kyung Soo Kim, Yeon Jin Je, Jae-Hoon Lee, Young Hoon Ryu, Hyojin Park","doi":"10.5056/jnm24150","DOIUrl":"10.5056/jnm24150","url":null,"abstract":"<p><strong>Background/aims: </strong>: Esophageal transit scintigraphy is a non-invasive nuclear medicine imaging modality for people with esophageal transit problems. In particular, changes in esophageal motor function can be evaluated non-invasively before and after the treatment in patients undergoing peroral endoscopic myotomy (POEM) for achalasia. This study compared the changes in several parameters of esophageal transit and manometry in patients with achalasia who underwent POEM.</p><p><strong>Methods: </strong>: This study retrospectively analyzed prospectively collected data from POEM participants. We included 38 patients with achalasia who underwent high-resolution manometry and esophageal transit scintigraphy before POEM and after POEM from 2016 to 2023.</p><p><strong>Results: </strong>: All patients had clinical treatment successfully (Eckardt score < 3). Lower esophageal sphincter (LES) pressures were significantly reduced after POEM, including basal resting LES pressure and integrated relaxation pressure (<i>P</i> < 0.001). Esophageal emptying, as assessed by the residual fraction of retained radioactivity at 10 seconds after isotope ingestion, improved from 54.3% to 27.3% (<i>P</i> < 0.001). Analysis of the change in time-to-peak on the time-radioactivity curve showed that it shortened significantly in the upper and middle portions of the esophagus (<i>P</i> < 0.05) but not in the lower portion. The Eckardt symptom score significantly correlated with pre-POEM integrated relaxation pressure (<i>P</i> < 0.05). Post-POEM, the symptom score significantly correlated with time-to-peak of the upper portion of the esophagus (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>: Patients with achalasia who received POEM showed improved not only manometric LES parameters but also esophageal transit. Analysis of the radiation curve's time-to-peak showed that improved retention in the upper portion is an indicator of symptoms improvement in patients who underwent POEM.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"30-34"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906129","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":"Is Mean Basal Esophagogastric Junction Pressure a Simpler and More Reliable Marker for Gastroesophageal Reflux Disease Barrier Function?","authors":"Yu Kyung Cho","doi":"10.5056/jnm25232","DOIUrl":"10.5056/jnm25232","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"1-3"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906144","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}