Journal of Neurogastroenterology and Motility最新文献

{"title":"The Effect of Curcumin on the Gut-Brain Axis: Therapeutic Implications.","authors":"Ayesheh Enayati,&nbsp;Aida Soghi,&nbsp;Alexandra E Butler,&nbsp;Manfredi Rizzo,&nbsp;Amirhossein Sahebkar","doi":"10.5056/jnm23065","DOIUrl":"10.5056/jnm23065","url":null,"abstract":"<p><p>The gut-brain axis describes the bidirectional communication between the gut, the enteric nervous system, and the central nervous system. The gut-brain axis has attracted increasing attention owing to its regulatory effect on dysbiosis and a wide range of related diseases. Several types of nutrients, such as curcumin, have been proposed as regulators of the dysbiotic state, and preclinical experiments have suggested that curcumin is not only beneficial but also safe. This review focuses on the interplay between curcumin and the gut microbiota. Moreover, it provides a comprehensive review of the crosstalk between the gut-brain axis and disease, whilst also discussing curcumin-mediated gut-brain axis-dependent and -independent signaling about modulation of gut microbiota dysbiosis. This will help to define the utility of curcumin as a novel therapeutic agent to regulate intestinal microflora dysbiosis.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 4","pages":"409-418"},"PeriodicalIF":3.4,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182871","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":"Extended Wireless pH Monitoring Significantly Increases Gastroesophageal Reflux Disease Diagnoses in Patients With a Normal pH Impedance Study.","authors":"Sebastian S Zeki,&nbsp;Ismail Miah,&nbsp;Pierfrancesco Visaggi,&nbsp;Anna Wolak,&nbsp;Minerva deSilva,&nbsp;Jason M Dunn,&nbsp;Andrew Davies,&nbsp;James Gossage,&nbsp;Abrie Botha,&nbsp;Guiping Sui,&nbsp;Jafar Jafari,&nbsp;Terry Wong","doi":"10.5056/jnm22130","DOIUrl":"https://doi.org/10.5056/jnm22130","url":null,"abstract":"<p><strong>Background/aims: </strong>Extended wireless pH monitoring (WPM) is used to investigate gastroesophageal reflux disease (GERD) as subsequent or alternative investigation to 24-hour catheter-based studies. However, false negative catheter studies may occur in patients with intermittent reflux or due to catheter-induced discomfort or altered behavior. We aim to investigate the diagnostic yield of WPM after a negative 24-hour multichannel intraluminal impedance pH (MII-pH) monitoring study and to determine predictors of GERD on WPM given a negative MII-pH.</p><p><strong>Methods: </strong>Consecutive adult patients (> 18 years) who underwent WPM for further investigation of suspected GERD following a negative 24-hour MII-pH and upper endoscopy between January 2010 and December 2019 were retrospectively included. Clinical data, endoscopy, MII-pH, and WPM results were retrieved. Fisher's exact test, Wilcoxon rank sum test, or Student's t test were used to compare data. Logistic regression analysis was used to investigate predictors of positive WMP.</p><p><strong>Results: </strong>One hundred and eighty-one consecutive patients underwent WPM following a negative MII-pH study. On average and worst day analysis, 33.7% (61/181) and 34.2% (62/181) of the patients negative for GERD on MII-pH were given a diagnosis of GERD following WPM, respectively. On a stepwise multiple logistic regression analysis, the basal respiratory minimum pressure of the lower esophageal sphincter was a significant predictor of GERD with OR = 0.95 (0.90-1.00, <i>P</i> = 0.041).</p><p><strong>Conclusions: </strong>WPM increases GERD diagnostic yield in patients with a negative MII-pH selected for further testing based on clinical suspicion. Further studies are needed to assess the role of WPM as a first line investigation in patients with GERD symptoms.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"335-342"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/16/jnm-29-3-335.PMC10334198.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892343","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":"Gastroesophageal Reflux Characteristics in Supragastric Belching Patients With Positive Versus Negative pH Monitoring: An Evidence of Secondary Gastroesophageal Reflux Disease From Excessive Belching.","authors":"Suriya Keeratichananont,&nbsp;Tanisa Patcharatrakul,&nbsp;Sutep Gonlachanvit","doi":"10.5056/jnm22198","DOIUrl":"https://doi.org/10.5056/jnm22198","url":null,"abstract":"<p><strong>Background/aims: </strong>A high prevalence of GERD has been reported in patients with supragastric belching. We aim to evaluate reflux characteristics and explore the temporal relationship between supragastric belches (SGBs) and reflux episodes in GERD patients with excessive belching.</p><p><strong>Methods: </strong>Twenty-four hour esophageal pH-impedance monitoring was analyzed. Reflux episodes were classified into: refluxes preceded by SGBs, followed by SGBs, and lone refluxes. Reflux characteristics were compared between patients with pH-positive (pH+) and pH-negative(pH-).</p><p><strong>Results: </strong>Forty-six patients (34 Female, age 47 ± 13 years) were included. Fifteen patients (32.6%) had pH+. Almost half (48.1 ± 21.0%) of refluxes were preceded by SGBs. The number of SGBs significantly correlated with the number of reflux episodes preceded by SGBs (<i>r</i> = 0.43, <i>P</i> < 0.05) and % time pH < 4 at the distal esophagus (<i>r</i> = 0.41, <i>P</i> < 0.05). Patients with pH+ had significantly more SGBs and reflux episodes preceded by SGBs/day than pH- patients (<i>P</i> < 0.05). The difference in the number of refluxes between pH+ and pH- patients was caused by reflux episodes preceded by SGBs, but not lone refluxes and refluxes followed by SGBs. The proportion of SGBs followed by reflux/total SGBs was similar between patients with pH+ and pH- (<i>P</i> > 0.05). Reflux episodes preceded by SGBs and followed by SGBs extended more proximal and had longer bolus and acid contact time than lone refluxes (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>In patients with GERD and SGB, the number of SGBs positively correlates with the number of reflux episodes preceded by SGBs. Identifying and managing SGB may be beneficial and more likely to improve GERD.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"343-351"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/63/jnm-29-3-343.PMC10334197.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892347","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 <i>Helicobacter pylori</i> Eradication on Body Weight: A Multicenter Propensity Score-matched Analysis in Korea.","authors":"Jong Wook Kim,&nbsp;Myong Ki Baeg,&nbsp;Chang Seok Bang,&nbsp;Jong-Kyu Park,&nbsp;Jung-Hwan Oh,&nbsp;The Diet","doi":"10.5056/jnm22179","DOIUrl":"https://doi.org/10.5056/jnm22179","url":null,"abstract":"<p><strong>Background/aims: </strong>There is growing interest in whether <i>Helicobacter pylori</i> eradication (HPE) can affect body weight.</p><p><strong>Methods: </strong>Data from 5 universities between January 2013 and December 2019 were analyzed retrospectively. <i>H. pylori</i>-positive subjects who had body weight measurements taken at least twice at intervals of 3 months or longer were included. Using propensity score (PS)-matched data, changes in body mass index (BMI) and the lipid profile after HPE were compared with the non-HPE group.</p><p><strong>Results: </strong>Among 363 eligible patients, 131 HPE patients were PS-matched to 131 non-HPE patients. The median intervals between the measurements were 610 (range, 154-1250) days and 606 (range, 154-1648) days in the HPE and non-HPE groups, respectively. In both groups, the mean BMI increased (from 24.5 kg/m² to 24.7 kg/m² in the HPE group, and from 24.4 kg/m² to 24.5 kg/m² in the non-HPE group). The 2 groups did not show significantly different changes (<i>P</i> = 0.921). In the lowest baseline BMI quartile, the BMI increased after HPE by 1.23 (standard deviation [SD], 3.72) kg/m² (<i>P</i> = 0.060), and the non-HPE group showed a decreased BMI at the time of follow-up (by -0.24 [SD, 5.25] kg/m²; <i>P</i> = 0.937) (between-group <i>P</i> = 0.214). Triglyceride levels increased after HPE (mean: 135 [SD, 78] to 153 [SD, 100] mg/dL; between-group <i>P</i> = 0.053).</p><p><strong>Conclusion: </strong>The overall BMI change was not significantly different between the HPE and non-HPE groups, but patients with low BMI showed a tendency to gain weight after HPE. Triglyceride levels increased after HPE with marginal significance.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"352-359"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/fc/jnm-29-3-352.PMC10334196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892349","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":"The Use of Intraoperative Esophageal Functional Luminal Imaging Probe for Prediction of Therapeutic Outcomes in Achalasia Patients.","authors":"Meng Xia,&nbsp;Yu-Lin Chen,&nbsp;Jianlin Lv","doi":"10.5056/jnm23007","DOIUrl":"https://doi.org/10.5056/jnm23007","url":null,"abstract":"c 2023 The Korean Society of Neurogastroenterology and Motility J Neurogastroenterol Motil, Vol. 29 No. 3 July, 2023 www.jnmjournal.org TO THE EDITOR: With great interest, we read the article of Hsing et al The authors assessed correlation of the diagnostic parameters of functional luminal imaging probe (FLIP) panometry and high-resolution manometry and Eckardt scores. Those parameters were compared before and after peroral endoscopic myotomy (POEM), and those changes were differentially revealed that the patients who showed repetitive antegrade contraction (RAC) and/or diagnosed as achalasia II before POEM were most likely resulted in presence of contractility (POC), a normal contractile response to sustained esophageal distension. A total of 68 achalasia patients underwent POEM were monitored upon measurements as shown in Table 1. Pre-POEM, those patients had similarities in Eckardt score and FLIP motility esophagogastric junction–distensibility index (EGJ-DI) compared in 3 subtypes of achalasia; post-POEM in follow-up 36 patients, Eckardt score was overall achieved < 3 (P < 0.01), integrated relaxation pressure was decreased to < 15 mmHg (P < 0.01) and EGJ-DI > 8 (P < 0.01). Authors obtained a good efficacy of POEM in consistent to other studies. However, all of those cannot be for prediction in correlative to POEM efficacy. Thus, Hsing et al suggested that the POC is one of critical indexes reflecting a good restoration of motility function of lower esophagus sphincter, which was seen in 8%, 67%, and 25% respectively from type-I, -II, and -III achalasia after POEM, ie, there is a better expectation from POEM in achalasia subtype II than I or III. Furthermore, the POC was absolutely not seen when RAC(–), and all other important parameters indicating improvement changes do not correlate to POC as shown in Table","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"400-402"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/1e/jnm-29-3-400.PMC10334195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10269008","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":"Do Proton Pump Inhibitor-refractory Laryngeal Symptoms Represent a True Acid-related Disease?","authors":"Kwon-Eui Hong,&nbsp;Cheal Wung Huh","doi":"10.5056/jnm23074","DOIUrl":"https://doi.org/10.5056/jnm23074","url":null,"abstract":"c 2023 The Korean Society of Neurogastroenterology and Motility J Neurogastroenterol Motil, Vol. 29 No. 3 July, 2023 www.jnmjournal.org Gastroesophageal reflux disease (GERD) is a condition characterized by regurgitation of stomach contents into the esophagus or mouth, leading to troublesome symptoms or complications. Globally, the overall burden of GERD has continued to worsen. The number of prevalent cases increased by 77.53% from 441.57 million in 1990 to 783.95 million in 2019. A systematic review conducted in Asia in 2011 revealed an increasing prevalence of symptom-based GERD in Eastern Asia: 2.5-4.8% before 2005 and 5.2-8.5% between 2005 and 2010. Moreover, this study found that extraesophageal symptoms were more common in patients with GERD than in healthy individuals. Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of GERD. It refers to the reflux of gastric contents into the larynx, causing symptoms such as throat clearing, hoarseness, pain, globus sensation, coughing, excessive mucus in the throat, and dysphonia. However, no gold standard currently exists for the diagnosis and treatment of LPR, which presents a challenge to health-care systems. In a study published in this issue, Tseng et al focused on examining the physiological and clinical characteristics of patients who experienced laryngeal symptoms despite receiving empirical proton pump inhibitor (PPI) therapy for an adequate duration. The authors not only investigated typical reflux symptoms but also considered comorbidities such as sleep disturbances and other psychological problems. According to several studies about the correlation between LPR and anxiety, depressive disorders, or insomnia, PPI-unresponsive laryngeal symptoms may be associated with psychological factors and sleep disturbances. In a study conducted in South Korea in 2022, the association between LPR and insomnia was investigated using multiple intraluminal impedance-pH (MIIpH) monitoring and a questionnaire survey (Insomnia Severity Index questionnaire). The results of that study are consistent with the findings of the current study. Tseng et al used various multidisciplinary assessment tools, including the 5-item Brief Symptom Rating Scale and the Pittsburgh Sleep Quality Index, to obtain objective information from patients and healthy asymptomatic individuals. However, it is difficult to generalize the study results because of the single-center design and lack of a cause-effect relationship. Moreover, a concern exists that endoscopy and MII-pH monitoring may not be adequate for evaluating patients with extraesophageal symptoms suggestive of LPR, as indicated in a previous study. LPR remains a challenging issue in clinical practice because JNM J Neurogastroenterol Motil, Vol. 29 No. 3 July, 2023 pISSN: 2093-0879 eISSN: 2093-0887 https://doi.org/10.5056/jnm23074 Editorial Journal of Neurogastroenterology and Motility","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"267-268"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/0e/jnm-29-3-267.PMC10334205.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892346","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":"Ethnic Differences in Anorectal Manometry Findings in Patients With Fecal Incontinence: Results From a Multiethnic Cohort According to the London Classification.","authors":"Daniel L Cohen,&nbsp;Amir Mari,&nbsp;Anton Bermont,&nbsp;Dana Zelnik Yovel,&nbsp;Vered Richter,&nbsp;Haim Shirin","doi":"10.5056/jnm21233","DOIUrl":"https://doi.org/10.5056/jnm21233","url":null,"abstract":"<p><strong>Background/aims: </strong>Clinical rates of fecal incontinence (FI) are known to vary based on race and ethnicity. It is unclear if anorectal manometry (ARM) findings in patients with FI differ based on ethnicity.</p><p><strong>Methods: </strong>High-resolution ARM studies performed between 2014-2021 due to FI at 2 hospitals with multiethnic populations were retrospectively reviewed.</p><p><strong>Results: </strong>Four hundred and seventy-nine subjects were included--87 (18.2%) Arab Israelis, 76 (15.9%) immigrants from the former Soviet Union, and 316 (66.0%) Jewish Israelis. Median age was 67 years old (76.0% women: 90.4% were parous). The Arab Israeli group had higher rates of smoking, diabetes, and obesity. Over 95% of ARM's were abnormal per the London classification including 23% with \"combined anal hypotension and hypocontractility,\" 36% with \"anal normotension with anal hypocontractility,\" 67% with \"dyssynergia,\" and 65% with either \"rectal hyposensation\" or \"borderline rectal hyposensation.\" On univariate analyses, significant differences between the ethnic groups were noted in the rates of \"anal hypotension with normal contractility,\" \"combined anal hypotension with anal hypocontractility,\" and \"dyssynergia.\" In multivariate logistic regression analyses controlling for age, gender, parity, smoking, diabetes, and obesity, the Arab Israeli group remained several times more likely to have \"combined anal hypotension and hypocontractibility\" compared to the other groups.</p><p><strong>Conclusions: </strong>Ethnicity impacts ARM findings in patients with FI. The reason for this is unclear and future studies on ethnically diverse populations evaluating the clinical relevance of these findings are warranted.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"370-377"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/6b/jnm-29-3-370.PMC10334202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892352","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":"Natural History of Chronic Intestinal Pseudo-obstruction and Need for Palliative Care.","authors":"Kosuke Tanaka,&nbsp;Hidenori Ohkubo,&nbsp;Atsushi Yamamoto,&nbsp;Kota Takahashi,&nbsp;Yuki Kasai,&nbsp;Anna Ozaki,&nbsp;Michihiro Iwaki,&nbsp;Takashi Kobayashi,&nbsp;Tsutomu Yoshihara,&nbsp;Noboru Misawa,&nbsp;Akiko Fuyuki,&nbsp;Shingo Kato,&nbsp;Takuma Higurashi,&nbsp;Kunihiro Hosono,&nbsp;Masato Yoneda,&nbsp;Takeo Kurihashi,&nbsp;Masataka Taguri,&nbsp;Atsushi Nakajima,&nbsp;Kok-Ann Gwee,&nbsp;Takaomi Kessoku","doi":"10.5056/jnm22152","DOIUrl":"https://doi.org/10.5056/jnm22152","url":null,"abstract":"<p><strong>Background/aims: </strong>Natural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients.</p><p><strong>Methods: </strong>From October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course.</p><p><strong>Results: </strong>Forty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m², 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care.</p><p><strong>Conclusion: </strong>CIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"378-387"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/56/jnm-29-3-378.PMC10334206.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10269011","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":"2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation.","authors":"Young Sin Cho,&nbsp;Yoo Jin Lee,&nbsp;Jeong Eun Shin,&nbsp;Hye-Kyung Jung,&nbsp;Seon-Young Park,&nbsp;Seung Joo Kang,&nbsp;Kyung Ho Song,&nbsp;Jung-Wook Kim,&nbsp;Hyun Chul Lim,&nbsp;Hee Sun Park,&nbsp;Seong-Jung Kim,&nbsp;Ra Ri Cha,&nbsp;Ki Bae Bang,&nbsp;Chang Seok Bang,&nbsp;Sung Kyun Yim,&nbsp;Seung-Bum Ryoo,&nbsp;Bong Hyeon Kye,&nbsp;Woong Bae Ji,&nbsp;Miyoung Choi,&nbsp;In-Kyung Sung,&nbsp;Suck Chei Choi","doi":"10.5056/jnm23066","DOIUrl":"https://doi.org/10.5056/jnm23066","url":null,"abstract":"<p><p>Chronic constipation is one of the most common digestive diseases encountered in clinical practice. Constipation manifests as a variety of symptoms, such as infrequent bowel movements, hard stools, feeling of incomplete evacuation, straining at defecation, a sense of anorectal blockage during defecation, and use of digital maneuvers to assist defecation. During the diagnosis of chronic constipation, the Bristol Stool Form Scale, colonoscopy, and a digital rectal examination are useful for objective symptom evaluation and differential diagnosis of secondary constipation. Physiological tests for functional constipation have complementary roles and are recommended for patients who have failed to respond to treatment with available laxatives and those who are strongly suspected of having a defecatory disorder. As new evidence on the diagnosis and management of functional constipation emerged, the need to revise the previous guideline was suggested. Therefore, these evidence-based guidelines have proposed recommendations developed using a systematic review and meta-analysis of the treatment options available for functional constipation. The benefits and cautions of new pharmacological agents (such as lubiprostone and linaclotide) and conventional laxatives have been described through a meta-analysis. The guidelines consist of 34 recommendations, including 3 concerning the definition and epidemiology of functional constipation, 9 regarding diagnoses, and 22 regarding managements. Clinicians (including primary physicians, general health professionals, medical students, residents, and other healthcare professionals) and patients can refer to these guidelines to make informed decisions regarding the management of functional constipation.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"271-305"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/2d/jnm-29-3-271.PMC10334201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10269014","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":"Randomized Controlled Trial of Anti-reflux Mucosectomy Versus Radiofrequency Energy Delivery for Proton Pump Inhibitor-refractory Gastroesophageal Reflux Disease.","authors":"Yan Wang,&nbsp;Meihui Lv,&nbsp;Lin Lin,&nbsp;Liuqin Jiang","doi":"10.5056/jnm21240","DOIUrl":"https://doi.org/10.5056/jnm21240","url":null,"abstract":"<p><strong>Background/aims: </strong>The efficacy and safety of anti-reflux mucosectomy (ARMS) or radiofrequency energy delivery in the treatment of gastroesophageal reflux disease (GERD) have been reported, but the difference between the 2 remains unclear.</p><p><strong>Methods: </strong>This was a single center, randomized, comparative clinical study. Patients with symptoms of heartburn and/or regurgitation despite proton pump inhibitor treatment were randomly assigned to either ARMS group (n = 20) or radiofrequency group (n = 20). Primary outcome was the standardized GERD questionnaire (GERDQ) at 2 years after the procedures. Secondary outcomes were the proportions of patients with complete proton pump inhibitor (PPI) cessation and patients satisfied with the treatment.</p><p><strong>Results: </strong>A total of 18 patients randomized to ARMS and 16 to radiofrequency were analyzed in this study. The operation success rate of the 2 groups was 100%. In both ARMS and radiofrequency groups, GERDQ scores at 2 years after the procedures were significantly lower than that before operation (<i>P</i> = 0.044 and <i>P</i> = 0.046). At 2 years postoperatively, the scores of GERDQ did not differ between the 2 groups (<i>P</i> = 0.755). There was no significant difference in the rate of discontinuation of PPIs and patient satisfaction in the ARMS and radiofrequency groups (<i>P</i> = 0.642 and <i>P</i> = 0.934).</p><p><strong>Conclusions: </strong>The clinical efficacy of ARMS and radiofrequency for the PPI-refractory GERD is equivalent. ARMS, the efficacy of which could be maintained for at least 2 years, is promising endoscopic management for the treatment of refractory GERD.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"29 3","pages":"306-313"},"PeriodicalIF":3.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/82/jnm-29-3-306.PMC10334194.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156497","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}