Journal of Neurogastroenterology and Motility最新文献

{"title":"A Median Arcuate Ligament Syndrome Could Be Re-termed as a Nutcracker Celiac Ganglion Abdominal Pain Syndrome.","authors":"Ji Eun Kim,&nbsp;Mira Kang,&nbsp;Ok Soon Jeong,&nbsp;Poong-Lyul Rhee","doi":"10.5056/jnm22158","DOIUrl":"https://doi.org/10.5056/jnm22158","url":null,"abstract":"<p><strong>Background/aims: </strong>Median arcuate ligament syndrome (MALS) is known as chronic recurrent abdominal pain related to compression of the celiac artery by the median arcuate ligament. We aim to seek the specific mechanism of the pain by evaluating symptoms and radiological characteristics on abdominal CT scans.</p><p><strong>Methods: </strong>We analyzed 35 patients who visited the emergency room for recurrent abdominal pain after cholecystectomy. We classified the characteristics of patients as 4 clinical components and 2 radiological components. We defined the sum of weighted clinical scores and weighted radiological scores as nutcracker ganglion abdominal pain syndrome (NCGAPS) scores. We categorized the patients into 3 groups classified by the degree of NCGAPS scores. The 3 patients with top-3 NCGAPS scores were recommended for CT angiography.</p><p><strong>Results: </strong>When the suspicion was graded by NCGAPS scores, post stenotic dilatation was significantly different among all groups (<i>P</i> < 0.001). The clinical components of pain varied positional or respirational change and continuous pain were significantly different among all the groups (<i>P</i> < 0.01). NCGAPS scores can remarkably differentiate highly suspicious patients in comparison to simply combined scores. Only 1 patient in the highly suspicious group by NCGAPS scores took the CT angiography and was confirmed with NCGAPS.</p><p><strong>Conclusions: </strong>We suggest renaming MALS as NCGAPS, nutcracker celiac ganglion abdominal pain syndrome, to better explain the mechanism of the recurrent abdominal pain. Further studies on the diagnostic cutoff of clinical and radiological scores of NCGAPS are needed not to miss the diagnosis of NCGAPS.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/d6/jnm-29-2-200.PMC10083118.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9721081","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":"Prevalence of Irritable Bowel Syndrome in East Asia: Are There Differences Between Countries?","authors":"Cheol Min Shin","doi":"10.5056/jnm23042","DOIUrl":"https://doi.org/10.5056/jnm23042","url":null,"abstract":"c 2023 The Korean Society of Neurogastroenterology and Motility J Neurogastroenterol Motil, Vol. 29 No. 2 April, 2023 www.jnmjournal.org Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders seen by primary care physicians. The worldwide prevalence of IBS is reported to be over 10%, but there are differences in the prevalence of IBS across countries; its prevalence is reported to be 17.5% in Latin America, 9.6% in Asia, 7.1% in North America and Europe, and 5.8% in the Middle East and Africa. Also, the prevalence of IBS subtypes (ie, constipationpredominant IBS [IBS-C], diarrhea-predominant IBS [IBS-D], mixed IBS [IBS-M], and unclassified IBS [IBS-U]) also differs by country or ethnicity. In this issue, the prevalence of IBS were evaluated using internet-based survey in the 3 East Asian countries, Japan, China, and South Korea. These 3 countries have some similarities in ethnicity, diet, and experiencing rapid socioeconomic change, while they have their own unique cultures. Interestingly, the overall prevalence of IBS was quite different; IBS prevalence in China was statistically lower (6%) than those in Japan and South Korea (15% and 16%, respectively.) In terms of IBS subtypes, IBS-M was the most common subtype, followed by IBS-D, IBS-C, and IBS-U in the overall analysis (6.01%, 2.76%, 2.07% and 1.74%, respectively). IBS-M was the most common subtype in all 3 countries; however, the second most common subtype was IBS-D in Japan, IBS-C in China, and IBS-U in South Korea. Furthermore, the IBS prevalence was significantly higher in men, especially in the case of IBS-D. As females are reportedly more susceptible to IBS, verification of the results of this study is essential. Great caution is needed in interpreting the results of the study. Above all, in this study, nationally representative sampling of each country was not performed. This study could be highly biased as it is based on an internet-based questionnaire of the volunteers. Considering the nature of the internet surveys, it is important to provide the percentage of respondents out of the total number of respondents requesting a survey by country. For example, it is possible that Chinese IBS patients responded less, whereas Korean and Japanese IBS patients responded more actively. For the results of this study to be confirmed, it is necessary to determine what percentage of the response rate was in the 3 countries and whether there was a difference in the response rate. Also, the high prevalence of IBS in men, which is contrary to previous studies, may also be influenced by differences in response rates by sex. Furthermore, as the authors mentioned, as China is a large country and each region has different cultures and dietary habits, selection bias can be noticeable when a JNM J Neurogastroenterol Motil, Vol. 29 No. 2 April, 2023 pISSN: 2093-0879 eISSN: 2093-0887 https://doi.org/10.5056/jnm23042 Editorial Journal of Neurogastroenterology and Motility","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/08/jnm-29-2-127.PMC10083116.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9361273","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":"Prevalence of Non-erosive Esophageal Phenotypes in Children: A European Multicenter Study.","authors":"Elisa Blasi,&nbsp;Ettore Stefanelli,&nbsp;Renato Tambucci,&nbsp;Silvia Salvatore,&nbsp;Paola De Angelis,&nbsp;Paolo Quitadamo,&nbsp;Claudia Pacchiarotti,&nbsp;Giovanni Di Nardo,&nbsp;Fanj Crocco,&nbsp;Enrico Felici,&nbsp;Valentina Giorgio,&nbsp;Nicoletta Staropoli,&nbsp;Simona Sestito,&nbsp;Efstratios Saliakellis,&nbsp;Osvaldo Borrelli,&nbsp;Licia Pensabene","doi":"10.5056/jnm22115","DOIUrl":"https://doi.org/10.5056/jnm22115","url":null,"abstract":"Background/Aims Since available data on pediatric non-erosive esophageal phenotypes (NEEPs) are scant, we investigated their prevalence and the phenotype-dependent treatment response in these children. Methods Over a 5-year period, children with negative upper endoscopy, who underwent esophageal pH-impedance (off-therapy) for persisting symptoms not responsive to proton pump inhibitor (PPI)-treatment, were recruited. Based on the results of acid reflux index (RI) and symptom association probability (SAP), patients were categorized into: (1) abnormal RI (non-erosive reflux disease [NERD]), (2) normal RI and abnormal SAP (reflux hypersensitivity [RH]), (3) normal RI and normal SAP (functional heartburn [FH]), and (4) normal RI and not-reliable SAP (normal-RI-not otherwise-specified [normal-RI-NOS]). For each subgroup, treatment response was evaluated. Results Out of 2333 children who underwent esophageal pH-impedance, 68 cases, including 18 NERD, 14 RH, 26 FH, and 10 normal-RI-NOS were identified as fulfilling the inclusion criteria and were analyzed. Considering symptoms before endoscopy, chest pain was more reported in NERD than in other cases (6/18 vs 5/50, P = 0.031). At long-term follow-up of 23 patients (8 NERD, 8 FH, 2 RH, and 5 normal-RI-NOS): 17 were on PPIs and 2 combined alginate, 1 (FH) was on benzodiazepine + anticholinergic, 1 (normal-RI-NOS) on citalopram, and 3 had no therapy. A complete symptom-resolution was observed in 5/8 NERD, in 2/8 FH, and in 2/5 normal-RI-NOS. Conclusions FH may be the most common pediatric NEEP. At long-term follow-up, there was a trend toward a more frequent complete symptom resolution with PPI-therapy in NERD patients while other groups did not benefit from extended acid-suppressive-treatment.","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/28/jnm-29-2-156.PMC10083122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367513","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":"Diagnosis of Ineffective Esophageal Motility According to Chicago Classification Version 4.0: More Stringent Criteria, but Also New Difficulties.","authors":"Luigi Ruggiero,&nbsp;Antonella Santonicola,&nbsp;Paola Iovino","doi":"10.5056/jnm23041","DOIUrl":"https://doi.org/10.5056/jnm23041","url":null,"abstract":"c 2023 The Korean Society of Neurogastroenterology and Motility J Neurogastroenterol Motil, Vol. 29 No. 2 April, 2023 www.jnmjournal.org TO THE EDITOR: We read with great interest the study by Kurin et al about the clinical characteristics of patients with ineffective esophageal motility (IEM) comparing diagnosis according to the Chicago classification version 3.0 (CC v3.0) versus CC v4.0. Kurin et al demonstrated that 41 patients out of the 66 patients selected with IEM at high-resolution manometry (HRM) according to CC v3.0 also met the criteria for IEM according to the new CC v4.0. This subgroup of 41 patients had higher acid exposure time (especially in the supine position), lower adequate peristaltic reserve and higher Demeester score. We agree that CC v4.0, with its more stringent criteria, allows a clearer diagnosis of IEM. However, in our clinical practice, changes in the examination protocol have been brought to light critical issues. Specifically, the new HRM protocol according to CCv 4.0 includes 10 swallows in the supine or upright position followed by 5 swallows in the opposite position. We applied the new protocol to all new HRMs. In 15 patients who complained of dysphagia or were undergoing a pre-bariatric surgery evaluation we obtained a diagnosis of IEM in the supine or upright position but not in the opposite position. Compared with diagnosis of esophagogastric junction outflow obstruction or absent contractility in which CC v4.0 specifies the importance of pathological alterations in both positions, this aspect was not described in IEM diagnosis. Consequently, there is some concern in managing such an ambiguous situation. Our group evaluated the use of additional tests to support the diagnosis of IEM such as multiple rapid swallows’ or rapid drink challenge performed in both positions. Even in these contexts, we found mixed results related to the 2 positions. Another possible auxiliary test described is the use of solid swallowing, although scientific evidence to support this test is still lacking. In these complex situations, we provided an “inconclusive” diagnosis of IEM and recommended a 24-hour pH-impedance testing to assess for the presence of gastroesophageal reflux disease and a further manometric assessment after at least 1 year. We hope CC v5.0 will provide more clarity on this topic and allow us to obtain certainty in the diagnosis of IEM according to the new protocol for performing HRM.","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/bd/jnm-29-2-264.PMC10083105.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737426","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":"RETRACTION NOTICE.","authors":"Hyun Jin Kim","doi":"10.5056/jnm19101R","DOIUrl":"https://doi.org/10.5056/jnm19101R","url":null,"abstract":"The authors retracted this paper (Yu.A. Gladilina, A.N. Shishparenok, D.D. Zhdanov (2023) “Approaches for improving L-asparaginase expression in heterologous systems”, Biomeditsinskaya Khimiya, 2023, 69(1), 19-38. DOI: 10.18097/PBMC20236901019) from the first issue the journal Biomeditsinskaya Khimiya (2023). Their decision is explained by identification of errors and inconsistences in the interpretation and citation of literature data recognized after the publication, which question correctness of important points considered in the review.","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/8e/jnm-29-2-266.PMC10083113.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737427","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":"Transcriptome and Proteome Profiling of Primary Human Gastric Interstitial Cells of Cajal Predicts Pacemaker Networks.","authors":"Daphne Foong,&nbsp;Meena Mikhael,&nbsp;Jerry Zhou,&nbsp;Ali Zarrouk,&nbsp;Xiaodong Liu,&nbsp;Jan Schröder,&nbsp;Jose M Polo,&nbsp;Vincent Ho,&nbsp;Michael D O'Connor","doi":"10.5056/jnm22078","DOIUrl":"https://doi.org/10.5056/jnm22078","url":null,"abstract":"<p><strong>Background/aims: </strong>Interstitial cells of Cajal (ICC) are specialized gastrointestinal (GI) pacemaker cells required for normal GI motility. Dysfunctions in ICC have been reported in patients with GI motility disorders, such as gastroparesis, who exhibit debilitating symptoms and greatly reduced quality of life. While the proteins, calcium-activated chloride channel anoctamin-1 (ANO1) and the receptor tyrosine kinase (KIT), are known to be expressed by human ICC, relatively little is known about the broad molecular circuitry underpinning human ICC functions. The present study therefore investigates the transcriptome and proteome of ANO1-expressing, KIT^low/CD45^-/CD11B^- ICC obtained from primary human gastric tissue.</p><p><strong>Methods: </strong>Excess human gastric tissue resections were obtained from sleeve gastrectomy patients. ICC were purified using fluorescence-activated cell sorting (FACSorting). Then, ICC were characterized by using immunofluorescence, real-time polymerase chain reaction, RNA-sequencing and mass spectrometry.</p><p><strong>Results: </strong>Compared to unsorted cells, real-time polymerase chain reaction showed the KIT^low/CD45^-/CD11B^- ICC had: a 9-fold (<i>P</i> < 0.05) increase in ANO1 expression; unchanged KIT expression; and reduced expression for genes associated with hematopoietic cells (CD68, > 10-fold, <i>P</i> < 0.001) and smooth muscle cells (DES, > 4-fold, <i>P</i> < 0.05). RNA-sequencing and gene ontology analyses of the KIT^low/CD45^-/CD11B^- cells revealed a transcriptional profile consistent with ICC function. Similarly, mass spectrometry analyses of the KIT^low/CD45^-/CD11B^- cells presented a proteomic profile consistent with ICC activities. STRING-based protein interaction analyses using the RNA-sequencing and proteomic datasets predicted protein networks consistent with ICC-associated pacemaker activity and ion transport.</p><p><strong>Conclusion: </strong>These new and complementary datasets provide a valuable molecular framework for further understanding how ICC pacemaker activity regulates smooth muscle contraction in both normal GI tissue and GI motility disorders.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/f3/jnm-29-2-238.PMC10083119.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367507","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":"Pyloric Functional Lumen Imaging Probe Measurements Are Dependent on Balloon Position.","authors":"Brandon Yim,&nbsp;Lennon Gregor,&nbsp;Robert M Siwiec,&nbsp;Mohammad Al-Haddad,&nbsp;Thomas V Nowak,&nbsp;John M Wo","doi":"10.5056/jnm22053","DOIUrl":"https://doi.org/10.5056/jnm22053","url":null,"abstract":"<p><strong>Background/aims: </strong>The functional lumen imaging probe (FLIP) device has been used to assess pyloric dysfunction in patients with gastroparesis. We aim to investigate whether varying FLIP catheter positions affect pyloric FLIP measurements.</p><p><strong>Methods: </strong>Patients undergoing endoscopy for chronic unexplained nausea and vomiting (CUNV) or gastroparesis were prospectively enrolled. FLIP balloon was adjusted for 3 positions within the pylorus: (1) proximal position, 75% of FLIP balloon in the duodenum and 25% in the antrum; (2) middle position, 50% in the duodenum and 50% in the antrum; and (3) distal position, 25% in the duodenum and 75% in the antrum. Pylorus cross-sectional area (CSA), intra-bag pressure (P), and distensibility indices (DI) were measured for 30, 40, and 50-mL balloon volumes. Fluoroscopic images were obtained to confirm FLIP balloon geometry. Data was analyzed separately using FLIP Analytic and customized MATLAB software.</p><p><strong>Results: </strong>Twenty-two patients with CUNV (n = 4) and gastroparesis (n = 18) were enrolled. Pressures were significantly higher in the proximal position compared to the middle and distal positions. CSA measurements were significantly higher at the proximal and middle positions for 30-mL and 40-mL volume compared to the distal position values. DI values were significantly lower at the proximal positions for 40-mL and 50-mL distensions when compared to the middle and distal positions. Fluoroscopic images confirmed increased balloon bending when placed mostly in the duodenum.</p><p><strong>Conclusions: </strong>FLIP balloon position within the pylorus directly affects balloon geometry which significantly affects P, CSA, and DI measurements. Standardized pyloric FLIP protocols and balloon design adjustments are needed for the continued application of this technology to the pylorus.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/fc/jnm-29-2-192.PMC10083104.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367511","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":"Small Intestinal Bacterial Overgrowth Complicating Gastrointestinal Manifestations of Systemic Sclerosis: A Systematic Review and Meta-analysis.","authors":"Ayesha Shah,&nbsp;Veenaa Pakeerathan,&nbsp;Michael P Jones,&nbsp;Purna C Kashyap,&nbsp;Kate Virgo,&nbsp;Thomas Fairlie,&nbsp;Mark Morrison,&nbsp;Uday C Ghoshal,&nbsp;Gerald J Holtmann","doi":"10.5056/jnm22168","DOIUrl":"https://doi.org/10.5056/jnm22168","url":null,"abstract":"<p><strong>Background/aims: </strong>Systemic sclerosis (SSc) often is complicated by small intestinal bacterial overgrowth (SIBO). A systematic review and meta-analysis thus examined the prevalence of SIBO in SSc (SSc-subtypes), identify risk factors for SIBO in SSc and the effects of concomitant SIBO on gastrointestinal symptoms in SSc.</p><p><strong>Methods: </strong>We searched electronic databases until January-2022 for studies providing prevalence rates of SIBO in SSc. The prevalence rates, odds ratio (OR) and 95% confidence intervals (CI) of SIBO in SSc and controls were calculated.</p><p><strong>Results: </strong>The final dataset comprised 28 studies with 1112 SSc-patients and 335 controls. SIBO prevalence in SSc-patients was 39.9% (95% CI, 33.1-47.1; <i>P</i> = 0.006), with considerable heterogeneity, (I² = 76.00%, <i>P</i> < 0.001). As compared to controls, there was a 10-fold increased SIBO prevalence in SSc-patients (OR, 9.6; 95% CI, 5.6-16.5; <i>P</i> < 0.001). The prevalence of SIBO was not different in limited cutaneous SSc as compared to diffuse cutaneous SSc (OR, 1.01; 95% CI, 0.46-2.20; <i>P</i> = 0.978). Diarrhea (OR, 5.9; 95% CI, 2.9-16.0; <i>P</i> = 0.001) and the association between SIBO in SSc and proton pump inhibitor use (OR, 2.3; 95% CI, 0.8-6.4; <i>P</i> = 0.105) failed statistical significance. Rifaximin was significantly more effective as compared to rotating antibiotic in eradicating SIBO in SSc-patients (77.8% [95% CI, 64.4-87.9]) vs 44.8% [95% CI, 31.7-58.4]; <i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>There is a 10-fold increased prevalence of SIBO in SSc, with similar SIBO prevalence rates in SSc-subtypes. Antimicrobial therapy of SIBO-positive SSc-patients with diarrhea should be considered. However, the results must be interpreted with caution due to substantial unexplained heterogeneity in the prevalence studies, and the low sensitivity and specificity of the diagnostic tests suggesting that the reliability of the evidence may be low.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/09/jnm-29-2-132.PMC10083111.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9452275","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":"Usefulness of EndoFLIP in Diverticular Peroral Endoscopic Myotomy for Symptomatic Epiphrenic Diverticulum.","authors":"Jin Hee Noh,&nbsp;Do Hoon Kim,&nbsp;Kee Wook Jung,&nbsp;Hee Kyong Na,&nbsp;Ji Yong Ahn,&nbsp;Jeong Hoon Lee,&nbsp;Kee Don Choi,&nbsp;Ho June Song,&nbsp;Gin Hyug Lee,&nbsp;Hwoon-Yong Jung","doi":"10.5056/jnm22016","DOIUrl":"https://doi.org/10.5056/jnm22016","url":null,"abstract":"<p><strong>Background/aims: </strong>Diverticular peroral endoscopic myotomy (D-POEM) is known to be a safe and feasible technique for managing diverticular diseases of the esophagus. In this study, we aim to report our experience with D-POEM and to investigate the usefulness of endoscopic functional luminal imaging probe (EndoFLIP) in determining the need for cardiomyotomy with septotomy for symptomatic epiphrenic diverticulum.</p><p><strong>Methods: </strong>Consecutive patients who underwent D-POEM for symptomatic epiphrenic diverticulum between September 2019 and September 2021 were eligible for this study. EndoFLIP and high-resolution manometry results and endoscopic treatment outcomes were retrospectively investigated.</p><p><strong>Results: </strong>A total of 9 patients with symptomatic epiphrenic diverticulum were included. The median size of the diverticulum and septum was 50 (interquartile range [IQR], 48-80) mm and 20 (IQR, 20-30) mm, respectively. The overall technical success rate was 100%, with a median procedure time of 60 (IQR, 46-100) minutes. The 5 patients (high-resolution manometry results; 3 normal, 1 ineffective esophageal motility, and 1 Jackhammer esophagus) who had decreased esophagogastric junction distensibility index on pre-procedure EndoFLIP underwent cardiomyotomy with septotomy regardless of the presence of esophageal motility disorders, and the distensibility index increased and normalized after procedure. The mean dysphagia score decreased from 2.0 ± 1.0 pre-procedure to 0.4 ± 0.7 during a median follow-up of 11 (IQR, 4-21) months post-procedure. No serious adverse events that required surgical intervention or delayed discharge were noted.</p><p><strong>Conclusions: </strong>EndoFLIP may help decide whether to perform combined cardiomyotomy and septotomy for the treatment of an epiphrenic diverticulum. Further large-scale studies are needed to confirm these results.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/72/jnm-29-2-183.PMC10083120.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9366024","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":"Achalasia: The Current Clinical Dilemma and Possible Pathogenesis.","authors":"Xingyu Jia,&nbsp;Songfeng Chen,&nbsp;Qianjun Zhuang,&nbsp;Niandi Tan,&nbsp;Mengyu Zhang,&nbsp;Yi Cui,&nbsp;Jinhui Wang,&nbsp;Xiangbin Xing,&nbsp;Yinglian Xiao","doi":"10.5056/jnm22176","DOIUrl":"https://doi.org/10.5056/jnm22176","url":null,"abstract":"<p><p>Achalasia is a primary esophageal motility disorder manifested by dysphagia and chest pain that impair patients' quality of life, and it also leads to chronic esophageal inflammation by food retention and increases the risk of esophageal cancer. Although achalasia has long been reported, the epidemiology, diagnosis and treatment of achalasia are not fully understood. The current clinical dilemma of achalasia is mainly due to its unclear pathogenesis. In this paper, epidemiology, diagnosis treatment, as well as possible pathogenesis of achalasia will be reviewed and summarized. The proposed hypothesis on the pathogenesis of achalasia is that genetically susceptible populations potentially have a higher risk of infection with viruses, triggering autoimmune and inflammation responses to inhibitory neurons in lower esophageal sphincter.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/f0/jnm-29-2-145.PMC10083112.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367506","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}