Neurogastroenterology & Motility最新文献

{"title":"Four‐dimensional impedance manometry volume metrics for predicting abnormal bolus retention","authors":"Panyavee Pitisuttithum, Eric Goudie, Isis K. Araujo, Sourav Halder, Dustin A. Carlson, John E. Pandolfino, Wenjun Kou","doi":"10.1111/nmo.14803","DOIUrl":"https://doi.org/10.1111/nmo.14803","url":null,"abstract":"BackgroundThe objective measurement for esophageal bolus volume and bolus clearance could classify abnormal high‐resolution manometry (HRM) beyond the current Chicago classification. We aimed to compare the novel four‐dimensional impedance manometry (4D HRM) volume metrics with timed barium esophagram (TBE).MethodsAdults with esophageal symptoms undergoing HRM and TBE were included. A custom‐built program for 4D HRM analysis measured esophageal luminal cross‐sectional area (CSA) from impedance and subsequently derived esophageal bolus volume and clearance. 4D HRM volume metrics included pre‐swallow residual volume, maximal volume, retention volume, and clearance ratio defined as 1.0—retention volume divided by the maximal volume. An abnormal TBE was defined as a column height &gt;5 cm at 1 min or 5 min.Key ResultsA total of 95 patients (normal motility: 33%; ineffective esophageal motility: 12%; absent contractility: 10%; esophagogastric junction outflow obstruction: 30%; type I achalasia: 5%; type II achalasia: 12%) were categorized into normal TBE (58%), abnormal TBE at 1 min (17%), and abnormal TBE at 5 min (25%). The AUROC demonstrated that, among all 4D HRM volume metrics, the clearance ratio had the best performance in predicting abnormal TBE at 5 min (AUROC, 95% confidence interval: 0.89, 0.82–0.96), and exhibited a strong negative correlation with TBE at 5 min (<jats:italic>r</jats:italic> = −0.65; <jats:italic>p</jats:italic> &lt; 0.001).Conclusions &amp; InferencesNovel 4D HRM volume metrics provide objective measurement of esophageal bolus volume and bolus clearance. The clearance ratio has a strong correlation with TBE and could potentially serve as a substitute for TBE to measure esophageal retention.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140809723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological comorbidities are more prevalent amongst pregnant and postpartum patients with irritable bowel syndrome","authors":"Yuying Luo, Christie Lee Luo, Rachel Meislin, Eunyoung Yang, Xiaotao Zhang","doi":"10.1111/nmo.14800","DOIUrl":"https://doi.org/10.1111/nmo.14800","url":null,"abstract":"There is a lack of data on the epidemiology of IBS in pregnant and postpartum patients in the United States.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"864 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of extra‐intestinal symptoms according to irritable bowel syndrome subtype","authors":"Facundo Pereyra, Luis María Bustos Fernández, Francisco Schlottmann, Rafael Zamora, Agustina Marconi, Leandro Steinberg, Lisandro Pereyra","doi":"10.1111/nmo.14796","DOIUrl":"https://doi.org/10.1111/nmo.14796","url":null,"abstract":"BackgroundIrritable bowel syndrome (IBS) is a functional disorder commonly associated with extra‐intestinal symptoms. However, the prevalence of these symptoms according to IBS subtype is not well established.AimTo compare the prevalence of extra‐intestinal symptoms among patients with different subtypes of IBS.MethodsA descriptive cross‐sectional study including patients with IBS according to Rome IV criteria was performed between July 2022 and April 2023. Patients were classified according their subtype of IBS: IBS‐D (diarrhea‐predominant), IBS‐C (constipation‐predominant), and IBS‐M (mixed bowel habits). Patients completed the IBS severity scoring system questionnaire (IBS‐SSS) to determine severity of IBS symptoms and patient health questionnaire‐ 9 (PHQ‐9) to define presence and severity of depressive symptoms. The prevalence of reported extra‐intestinal symptoms was also assessed and compared between groups.Key ResultsA total of 4862 patients with IBS were included; 608 IBS‐D (12.5%), 1978 IBS‐C (40.7%), and 2276 IBS‐M (46.8%). Patients with IBS‐C had significantly lower IBS‐symptoms severity (mean IBS‐SSS 290 vs. 310 and 320 for IBS‐D and IBS‐M, respectively, <jats:italic>p</jats:italic> = 0.03). The prevalence of obesity was also significantly lower in these patients (17.1% vs. 30.9% IBS‐D and 27.9% IBS‐M, <jats:italic>p</jats:italic> = 0.0001). Patients with IBS‐D showed a significantly higher prevalence of food intolerance perception (9.5%, <jats:italic>p</jats:italic> = 0.03), history of cholecystectomy (17.8%, <jats:italic>p</jats:italic> = 0.03), and fecal incontinence (36.2%, <jats:italic>p</jats:italic> = 0.0001) as compared to the other groups. Patients with IBS‐M had significantly higher mean PHQ‐9 score (12.7 vs. 11.1 IBS‐D and 10.5 IBS‐C, <jats:italic>p</jats:italic> = 0.001) and prevalence of depressive symptoms (80.0%, <jats:italic>p</jats:italic> = 0.01). Patients with IBS‐M also had higher prevalence of extra‐intestinal symptoms such as arthralgia (62.4%, <jats:italic>p</jats:italic> = 0.0001), extremity numbness (64.5%, <jats:italic>p</jats:italic> = 0.0001), atopic dermatitis (28.2%, <jats:italic>p</jats:italic> = 0.02), and chronic cervicalgia (81.0%, <jats:italic>p</jats:italic> = 0.01).Conclusions &amp; InferencesThe prevalence of most extra‐intestinal symptoms is higher among patients with IBS‐M. Further research is needed to better characterize IBS subtypes, which could potentially help refining tailored therapeutic strategies.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence and characteristics of disordered eating and orthorexia in irritable bowel syndrome","authors":"Nessmah Sultan, Mandy Foyster, Matilda Tonkovic, Danielle Noon, Helen Burton‐Murray, Jessica R. Biesiekierski, Caroline J. Tuck","doi":"10.1111/nmo.14797","DOIUrl":"https://doi.org/10.1111/nmo.14797","url":null,"abstract":"IntroductionOrthorexia, a harmful obsession with eating healthily, may develop from illnesses characterized by dietary restriction, including irritable bowel syndrome (IBS) and eating disorders (ED). Evidence of disordered eating in IBS exists, but orthorexia has not been assessed. This cross‐sectional study in adults (≥18 years) assessed presence and characteristics of disordered eating and orthorexia in IBS, compared to control subjects (CS) and ED.MethodsIBS participants met Rome IV, and ED participants met DSM‐5 criteria. Disordered eating was assessed using “sick, control, one‐stone, fat, food” (SCOFF, ≥2 indicating disordered eating), and orthorexia by the eating habits questionnaire (EHQ). Secondary measures included stress (PSS); anxiety (HADS‐A); food‐related quality of life (Fr‐QoL), and dietary intake (CNAQ).Key ResultsIn 202 IBS (192 female), 34 ED (34 female), and 109 CS (90 female), more IBS (33%) and ED (47%) scored SCOFF≥2 compared to CS (16%, <jats:italic>p</jats:italic> &lt; 0.001, chi‐square). IBS and ED had higher orthorexia symptom severity compared to CS (EHQ IBS 82.9 ± 18.1, ED 90.1 ± 19.6, and CS 73.5 ± 16.9, <jats:italic>p</jats:italic> &lt; 0.001, one‐way ANOVA). IBS and ED did not differ for SCOFF or EHQ (<jats:italic>p</jats:italic> &gt; 0.05). Those with IBS and disordered eating had higher orthorexia symptom severity (EHQ 78.2 ± 16.6 vs. 92.4 ± 17.5, <jats:italic>p</jats:italic> &lt; 0.001, independent <jats:italic>t</jats:italic>‐test), worse symptoms (IBS‐SSS 211.0 ± 78.4 vs. 244.4 ± 62.5, <jats:italic>p</jats:italic> = 0.008, Mann–Whitney <jats:italic>U</jats:italic> test), higher stress (<jats:italic>p</jats:italic> &lt; 0.001, independent <jats:italic>t</jats:italic>‐test), higher anxiety (<jats:italic>p</jats:italic> = 0.002, independent <jats:italic>t</jats:italic>‐test), and worse FR‐QoL (<jats:italic>p</jats:italic> &lt; 0.001, independent <jats:italic>t</jats:italic>‐test).Conclusions and InferencesDisordered eating and orthorexia symptoms occur frequently in IBS, particularly in those with worse gastrointestinal symptoms, higher stress, and anxiety. Clinicians could consider these characteristics when prescribing dietary therapies.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucose breath test for the detection of small intestine bacterial overgrowth: Impact of diet prior to the test","authors":"Nastasia Mattio, Pierre Pradat, Christelle Machon, Anne Mialon, Sabine Roman, Charlotte Cuerq, François Mion","doi":"10.1111/nmo.14801","DOIUrl":"https://doi.org/10.1111/nmo.14801","url":null,"abstract":"BackgroundGlucose breath test (GBT) is used for the diagnosis of small intestine bacterial overgrowth. A restrictive diet without fibers and/or fermentable food is recommended on the day before the test. The aim of our retrospective study was to evaluate the impact of two different restrictive diets on the results of GBT.MethodsA change of the pretest restrictive diet was applied in our lab on September 1, 2020. The recommended diet was a fiber‐free diet before this date, and a fiber‐free diet plus restriction of all fermentable food afterward. We thus compared the results of GBT performed before (group A) and after (group B) this pretest diet modification. Demographics, reasons to perform GBT, digestive symptoms, and hydrogen and methane baseline values and variations after glucose ingestion were compared between the two groups.Key Results269 patients underwent GBT in group A, and 316 patients in group B. The two groups were comparable in terms of demographics. Methane and hydrogen baseline values were significantly higher in group A (respectively 14 [18] vs. 8 [14] ppm, <jats:italic>p</jats:italic> &lt; 0.01 and 11 [14] vs. 6 [8] ppm, <jats:italic>p</jats:italic> &lt; 0.01). The percentage of positive tests was higher in group A for methane (43% vs. 28%, <jats:italic>p</jats:italic> &lt; 0.05), and for hydrogen (18% vs. 12%, <jats:italic>p</jats:italic> = 0.03).Conclusion &amp; InferencesThis retrospective study suggests the importance of the restrictive diet prior to GBT. A strict limitation of fibers and fermentable food decreased hydrogen and methane baseline values, and the prevalence of positive GBT. Thus a strict restrictive diet should be recommended on the day before the test, in order to limit the impact of food on hydrogen and methane breath levels, and possibly improve the diagnosis quality of GBT.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of reflux esophagitis after peroral endoscopic myotomy","authors":"Elise M. Wessels, Gwen M. C. Masclee, Barbara A. J. Bastiaansen, Paul Fockens, Albert J. Bredenoord","doi":"10.1111/nmo.14794","DOIUrl":"https://doi.org/10.1111/nmo.14794","url":null,"abstract":"BackgroundPeroral endoscopic myotomy (POEM) is an effective and safe treatment for achalasia, but often leads to posttreatment gastroesophageal reflux disease. The aim of this study was to examine the incidence and severity of reflux esophagitis after POEM and to identify associated predictive factors.MethodsPatients who underwent POEM between August 2011 and December 2022 were included. Multivariate logistic regression was used to assess predictive factors for reflux esophagitis after POEM.Key ResultsIn total, 252 patients were included; of which, 46% were female and age ranged between 18 and 87 years. Reflux esophagitis within 1 year after POEM was observed in 131 patients (52%), which was severe in 29 patients (LA grade C/D, 12%). Length of full‐thickness myotomy (cm; OR 1.11, 95% CI 1.02–1.21), Eckardt scores before POEM (OR 0.84, 95% CI 0.74–0.96), previous pneumatic dilation (OR 0.51, 95% CI 0.29–0.91), and previous laparoscopic Heller myotomy (LHM; OR 0.44, 95% CI 0.23–0.86) were associated with reflux esophagitis after POEM. Alcohol use (none vs &gt; 7 units per week; OR 3.51, 95% CI 1.35–9.11) and overweight (BMI ≥25 kg/m<jats:sup>2</jats:sup>; OR 2.67, 95% CI 1.17–6.09) were positive predictive factors and previous LHM (OR 0.13, 95% CI 0.02–0.95) was a negative predictive factor for severe reflux esophagitis after POEM (LA grade C/D).ConclusionAbout half of the patients develop reflux esophagitis after POEM and 12% is graded as severe. Recognizing predictive factors of reflux esophagitis after POEM treatment leads to better patient selection before POEM and provides an opportunity to take preventive measures or start preemptive treatment.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of function lumen imaging probe measurements of anal sphincter function in fecal incontinence","authors":"Alexander O'Connor, Donghua Liao, Asbjørn Mohr Drewes, Abhiram Sharma, Dipesh H. Vasant, John McLaughlin, Edward Kiff, Karen Telford","doi":"10.1111/nmo.14791","DOIUrl":"https://doi.org/10.1111/nmo.14791","url":null,"abstract":"BackgroundThe functional lumen imaging probe (FLIP) is a test of anal sphincter distensibility under evaluation by specialist centers. Two measurement protocols termed “stepwise” and “ramp” are used, risking a lack of standardization. This study aims to compare the performance of these protocols to establish if there are differences between them.MethodsPatients with fecal incontinence were recruited and underwent measurement with both protocols at a tertiary pelvic floor referral unit. Differences in minimum diameter, FLIP bag pressure, and distensibility index (DI) at rest and during squeeze were calculated at various FLIP bag volumes.Key ResultsTwenty patients (19 female, mean age 61 [range: 38–78]) were included. The resting minimum diameter at 30 and 40 mL bag volumes were less in the stepwise protocol (mean bias: −0.55 mm and −1.18 mm, <jats:italic>p</jats:italic> &lt; 0.05) along with the DI at the same bag volumes (mean bias: −0.37 mm<jats:sup>2</jats:sup>/mmHg and −0.55 mm<jats:sup>2</jats:sup>/mmHg, <jats:italic>p</jats:italic> &lt; 0.05). There was also a trend towards greater bag pressures at 30 mL (mean bias: +2.08 mmHg, <jats:italic>p</jats:italic> = 0.114) and 40 mL (mean bias: +2.81 mmHg, <jats:italic>p</jats:italic> = 0.129) volumes in the stepwise protocol. There were no differences between protocols in measurements of minimum diameter, maximum bag pressure, or DI during voluntary squeeze (<jats:italic>p</jats:italic> &gt; 0.05).Conclusion and InferencesThere are differences between the two commonly described FLIP measurement protocols at rest, although there are no differences in the assessment of squeeze function. Consensus agreement is required to agree the most appropriate FLIP measurement protocol in assessing anal sphincter function.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of bidirectional gut-brain axis and anorectal function in Parkinson's disease with constipation","authors":"Yun Yan, Karunaratne Tennekoon, Audrey Eubanks, Anam Herekar, Dhanush Shimoga, Deepak Ayyala, Colin McLeod, Julie A. Kurek, John C. Morgan, Satish S. C. Rao, Amol Sharma","doi":"10.1111/nmo.14728","DOIUrl":"https://doi.org/10.1111/nmo.14728","url":null,"abstract":"Parkinson's disease (PD) is a neurodegenerative movement disorder with prodromal and highly prevalent gastrointestinal (GI) symptoms, especially constipation. Although PD models suggest gut-brain axis dysfunction, the mechanistic underpinnings and their correlation with GI symptoms are poorly understood.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138715293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of hypothalamic Orexin-A in stress-induced gastric dysmotility: An agonistic interplay with corticotropin releasing factor","authors":"Osman Sinen, İrem Akçalı, Simla Su Akkan, Mehmet Bülbül","doi":"10.1111/nmo.14719","DOIUrl":"https://doi.org/10.1111/nmo.14719","url":null,"abstract":"Central Orexin-A (OXA) modulates gastrointestinal (GI) functions and stress response. This study aimed to investigate whether OXA and CRF interact at hypothalamic level.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"242 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138716010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological distress and coping efficacy in children with disorders of gut–brain interaction","authors":"Neha R. Santucci, Carlos Alberto Velasco-Benitez, Natoshia Cunningham, Jesse Li, Lin Fei, Qin Sun, Miguel Saps","doi":"10.1111/nmo.14724","DOIUrl":"https://doi.org/10.1111/nmo.14724","url":null,"abstract":"Multiple psychological factors influence disorders of gut–brain interaction (DGBIs). We aimed to evaluate psychological distress in Colombian schoolchildren with and without DGBIs.","PeriodicalId":19104,"journal":{"name":"Neurogastroenterology & Motility","volume":"173 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138575443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}