Neurogastroenterology and Motility最新文献

{"title":"Changes in the Pannexin Channel in Ileum Myenteric Plexus and Intestinal Motility Following Ischemia and Reperfusion.","authors":"Thaira Thalita Alves Pereira, Cristina Eusébio Mendes, Roberta Figueiroa Souza, Marcos Antônio Ferreira Caetano, Henrique Inhauser Riceti Magalhães, Caroline Bures de Paulo, Ii Sei Watanabe, Patricia Castelucci","doi":"10.1111/nmo.14996","DOIUrl":"https://doi.org/10.1111/nmo.14996","url":null,"abstract":"<p><strong>Background: </strong>Intestinal ischemia affects the functioning of the Enteric Nervous System (ENS). Pannexin-1 channel participates in cell communication and extracellular signaling. Probenecid (PB) is a pannexin-1 channel inhibitor, which can be a potential treatment for intestinal ischemia.</p><p><strong>Aim: </strong>Study the effects of ileal ischemia and reperfusion (I/R) and PB treatment on myenteric neurons and in rats.</p><p><strong>Methods: </strong>Male Wistar rats were used for I/R induction, the ileal vessels were occluded for 45 min and reperfusion was performed after this time. The Sham groups underwent all surgical procedures without obstruction of the ileal vessels. Animals were euthanized 24 h or 14d post-I/R. The PB group received an injection of PB post-I/R. Ileal segments were collected for immunofluorescence analyses to identify neurons calretinin immunoreactive (-ir) and pannexin-1-ir. Neuronal density (cells/field), area (μm²), intestinal motility, and ultrastructural analyses were performed.</p><p><strong>Key results: </strong>The pannexin-1 channel was double-labeled with calretinin-ir neurons. Neuronal density reduced by 21% reduction in calretinin-ir neurons in the I/R 24 h group and recovered 26% in the PB 24 h group. In the 14d group, there was a 23% reduction in calretinin-ir neurons in the I/R 14d group and a recovery of 26% in the PB 14d group. The analysis of the contraction after electrical simulation was lower in the I/R 14 d group and recovered in the PB 14d.</p><p><strong>Conclusions and inferences: </strong>Intestinal I/R affects myenteric neurons and causes morphological and functional changes. PB was able to attenuate the effects of I/R and could constitute a therapeutic tool for intestinal I/R.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14996"},"PeriodicalIF":3.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Milan Score Predicts Objective Gastroesophageal Reflux Disease in Patients With Type 2 Esophagogastric Junction.","authors":"Davide Ferrari, Stefano Siboni, Marco Sozzi, Pierfrancesco Visaggi, Ivan Kristo, Salvatore Tolone, Elisa Marabotto, Daniele Bernardi, Sebastian F Schoppmann, Benjamin D Rogers, Anthony Hobson, Jordan Haworth, Yeong Yeh Lee, Brian E Louie, Takahiro Masuda, Megan L Ivy, Pamela Milito, Erica Centorrino, Dimitrios Theodorou, Tania Triantafyllou, Andrea Pasta, Francesco Calabrese, Vincent Tee, Lorenzo Cusmai, Roberto Penagini, Marina Coletta, Edoardo Savarino, Emanuele Asti, C Prakash Gyawali, Nicola De Bortoli","doi":"10.1111/nmo.14987","DOIUrl":"https://doi.org/10.1111/nmo.14987","url":null,"abstract":"<p><strong>Introduction: </strong>High-resolution manometry (HRM) allows assessment of esophagogastric junction (EGJ) disruption. While type 3 EGJ predicts definitive gastroesophageal reflux disease (GERD), type 2 EGJ is less clearly implicated in GERD pathogenesis. This study aimed to characterize physiologic findings in type 2 EGJ to determine if the HRM-based Milan Score can define GERD within type 2 EGJ.</p><p><strong>Methods: </strong>535 patients with suspected GERD who underwent HRM and reflux monitoring were retrospectively analyzed. Clinical, HRM, and reflux study data were compared between the EGJ morphology subtypes, with objective GERD defined according to Lyon Consensus 2.0. The Milan Score, a novel metric that integrates ineffective esophageal motility, EGJ-contractile integral, EGJ morphology, and straight leg raise response, was abnormal when ≥ 137 (risk rate 50% for GERD). Receiver operating characteristic (ROC) curve analysis was performed to assess the accuracy of the Milan Score to predict objective GERD.</p><p><strong>Results: </strong>Type 3 EGJ was associated with the highest rate of objective GERD, followed by type 2 and type 1 EGJ (p < 0.001), with a corresponding stepwise increase in AET from type 1 to 3 EGJ (p < 0.001). Type 2 EGJ with Milan Score < 137 resembled type 1 EGJ (objective GERD in 23.6% vs. 33.2%, p = 0.09), and type 2 EGJ with score ≥ 137 resembled type 3 EGJ (objective GERD in 88.2% vs. 78.8%, p = 0.11). On ROC analysis, the Milan Score had an area under the curve of 0.858.</p><p><strong>Conclusion: </strong>While type 2 EGJ includes varying GERD severity, the Milan Score can segregate patients at risk for objective GERD.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14987"},"PeriodicalIF":3.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review: Integrated Models of Care for Managing Irritable Bowel Syndrome.","authors":"Molly M Warner, Olivia Marie Soliman, Megan Crichton, Skye Marshall, Heidi M Staudacher, Jaimon T Kelly","doi":"10.1111/nmo.14989","DOIUrl":"https://doi.org/10.1111/nmo.14989","url":null,"abstract":"<p><strong>Background: </strong>Multidisciplinary integrated models of care show promise for improving symptoms and quality of life (QoL) in adults with irritable bowel syndrome (IBS).</p><p><strong>Aims: </strong>To describe and evaluate the characteristics of integrated models of care for IBS and identify how digital health is being used in these models of care.</p><p><strong>Methods: </strong>Four databases were searched to March 2024 for studies that included adults with IBS who participated in multidisciplinary integrated models of care that delivered non-pharmacological therapies. The template for intervention description and replication (TIDieR) checklist was used to appraise study quality and extract model of care characteristics, which were mapped against the Project INTEGRATE framework to establish topics.</p><p><strong>Results: </strong>Sixteen studies (6 randomized controlled trials, 2 quasi-experimental, 8 cohort studies) reported 14 integrated models of care including 2165 patients of which 918 were IBS patients. Integrated models of care led to improved IBS symptoms (n = 11/13 models of care) and QoL (n = 6/9 models of care). Studies showed moderate compliance with the TIDieR checklist. Five topics were established: clinicians involved, therapies provided, location and mode of delivery, coordinating clinical partnerships, and sharing visions and values of integrated care. Most commonly, a gastroenterologist coordinated care with a psychologist, dietitian, and/or nurse in tertiary care. Psychological, dietary, and physical therapies were provided by n = 11, n = 8, and n = 3 integrated models of care, respectively. Six models of care provided joint consultations or group sessions. Four models of care used digital health such as telephone coaching or online modules.</p><p><strong>Conclusions: </strong>Integrated models of care for IBS exhibited diverse characteristics including the clinicians involved, the therapies provided and the mode of delivery of each therapy. There is a need to evaluate the use of digital health and the delivery of integrated models of care in primary care settings.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14989"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of Irritable Bowel Syndrome Using Brain Functional Connectivity Strength and Machine Learning.","authors":"Qi Zhang, Yue Xu, Dingbo Guo, Hua He, Zhen Zhang, Xiaowan Wang, Siyi Yu","doi":"10.1111/nmo.14994","DOIUrl":"https://doi.org/10.1111/nmo.14994","url":null,"abstract":"<p><strong>Background: </strong>Irritable Bowel Syndrome (IBS) is a prevalent condition characterized by dysregulated brain-gut interactions. Despite its widespread impact, the brain mechanism of IBS remains incompletely understood, and there is a lack of objective diagnostic criteria and biomarkers. This study aims to investigate brain network alterations in IBS patients using the functional connectivity strength (FCS) method and to develop a support vector machine (SVM) classifier for distinguishing IBS patients from healthy controls (HCs).</p><p><strong>Methods: </strong>Thirty-one patients with IBS and thirty age and sex-matched HCs were enrolled in this study and underwent resting-state functional magnetic resonance imaging (fMRI) scans. We applied FCS to assess global brain functional connectivity changes in IBS patients. An SVM-based machine - learning approach was then used to evaluate whether the altered FCS regions could serve as fMRI-based markers for classifying IBS patients and HCs.</p><p><strong>Results: </strong>Compared to the HCs, patients with IBS showed significantly increased FCS in the left medial orbitofrontal cortex (mOFC) and decreased FCS in the bilateral cingulate cortex/precuneus (PCC/Pcu) and middle cingulate cortex (MCC). The machine-learning model achieved a classification accuracy of 91.9% in differentiating IBS patients from HCs.</p><p><strong>Conclusion: </strong>These findings reveal a unique pattern of FCS alterations in brain areas governing pain regulation and emotional processing in IBS patients. The identified abnormal FCS features have the potential to serve as effective biomarkers for IBS classification. This study may contribute to a deeper understanding of the neural mechanisms of IBS and aid in its diagnosis in clinical practice.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14994"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences, Menses-Related Symptoms and Menopause in Disorders of Gut-Brain Interaction.","authors":"Rachel P Sarnoff, Johann P Hreinsson, Joanna Kim, Ami D Sperber, Olafur S Palsson, Shrikant I Bangdiwala, Lin Chang","doi":"10.1111/nmo.14977","DOIUrl":"https://doi.org/10.1111/nmo.14977","url":null,"abstract":"<p><strong>Background: </strong>Disorders of gut-brain interaction (DGBI) predominate in women, but little is known about sex differences in menses-related or menopause symptoms.</p><p><strong>Methods: </strong>Using data from the Rome Foundation Global Epidemiology Survey, we assessed Rome IV DGBI symptoms in individuals in 26 countries who met criteria for ≥ 1 of 5 DGBI: irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional diarrhea (FDr), or functional bloating (FB). Participants included pre- and post-menopausal women with DGBI and age-matched men. Odds ratios estimated sex and age differences for symptom by sex or pre- vs. post-menopause in logistic regression; standardized mean difference (SMD) provided effect sizes.</p><p><strong>Key results: </strong>14,570 participants met criteria for ≥ 1 of the 5 DGBI. Women exceeded men in most symptoms. In FD, women stopped eating due to early satiety more than men (11.1 vs. 8.9 days/month, SMD 0.21). Symptoms were generally increased in premenopausal women and younger men compared to older counterparts; however, only premenopausal IBS, FD, and FC women reported increased constipation-associated symptoms. Compared to premenopausal women, postmenopausal women had increased accidental stool leakage in IBS and FDr, and increased digital manual maneuvers in FC (18% vs. 25% frequency, SMD -0.25). IBS and FD had the most menses-associated symptoms.</p><p><strong>Conclusions and inferences: </strong>Women had higher symptom frequency across the 5 DGBI compared to men. Our findings suggest that premenopausal women have greater visceral perception than postmenopausal women, although increased outlet symptoms in postmenopausal women indicate greater anorectal/pelvic dysfunction. While age alone has some influence on symptoms, female sex hormones may also increase visceral perception.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14977"},"PeriodicalIF":3.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review: Food-induced mucosal alterations visualized using endomicroscopy.","authors":"Lukas Michaja Balsiger, Monica Rusticeanu, Jost Langhorst, Christian Sina, Robert Benamouzig, Clifton Huang, Jan Tack, Ralf Kiesslich","doi":"10.1111/nmo.14930","DOIUrl":"10.1111/nmo.14930","url":null,"abstract":"<p><p>Confocal laser endomicroscopy (CLE) is a novel technique allowing real time in vivo microscopy during standard endoscopy. Recently, acute mucosal alterations after food administration visualized by CLE have been linked to symptoms in irritable bowel syndrome (IBS). Interestingly, the observed reactions occurred in subjects without demonstrable allergic sensitization to food-this is in line with mechanistic research showing local but not systemic allergic sensitization to foods in an animal model for IBS. Here, European experts conducting CLE with food administration provide a narrative review of the available literature and propose practical guidance on the use of this technique. CLE allows physicians to observe acute mucosal reactions after the application of food to the duodenal mucosa in patients with functional gastrointestinal disorders. Some open-label interventions show a symptomatic benefit when patients exclude the nutrient that triggered an acute mucosal reaction. However, many technical, mechanistic, and clinical questions remain unanswered to date. Technically, the interobserver variability and learning curve requires systematic evaluation and criteria or cutoffs for alterations require validation. Mechanistic studies are needed to enhance our understanding of the mechanisms underlying observed alterations. Finally, rigorous blinded controlled studies are needed to assess a link of these observed alterations with symptom generation. CLE offers a platform allowing scientific insights related to food induced acute mucosal alterations. However, many questions remain unanswered, and more research is warranted to understand the role of acute mucosal alterations visualized upon food administration in IBS pathophysiology and treatment.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14930"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do children with dysphagia and normal esophageal motility according to Chicago Classification always have \"normal\" esophageal motility?","authors":"Karlo Kovacic, Mark Kern, B U K Li, Mychoua Vang, Joshua Noe, Reza Shaker","doi":"10.1111/nmo.14963","DOIUrl":"10.1111/nmo.14963","url":null,"abstract":"<p><strong>Background: </strong>Internationally adopted Chicago Classification (CC) criteria based on adult normative data have been used to diagnose children with esophageal motility disorders undergoing high-resolution esophageal manometry (HREM). The aim of this study was to compare HREM parameters of children without dysphagia and children with dysphagia and normal findings according to CC.</p><p><strong>Methods: </strong>HREM metrics of 41 children (13.2 (9-18) years; 20 female) without dysphagia and 41 children (13.7 (8-18) years; 30 female) with dysphagia and normal diagnosis according to CC were compared. Analyzed data included resting and integrated relaxation pressures (IRP) of upper (UES) and lower (LES) esophageal sphincters, esophageal peristaltic contractile integrals, transition zone (TZ) gaps, distal latency (DL), and manometric esophageal length to height ratio (MELH). 95%ile normative cutoffs were calculated from the cohort without dysphagia.</p><p><strong>Key results: </strong>Proximal contractile integral (PCI), UES and LES mean resting and IRP were not significantly different between the cohorts (p > 0.3). On the contrary, distal contractile integral (DCI), TZ gap and MELH were notably different with p = 0.0002, p = 0.027, and p = 0.033 respectively. According to 95%ile normative cutoffs of DCI, TZ gap and MELH, in cohort with dysphagia 27%, 15%, and 22% of patients respectively were not normal.</p><p><strong>Conclusion & inferences: </strong>First study ever to compare HREM parameters of children without dysphagia to children with dysphagia. Considerable proportion of children with dysphagia may be underdiagnosed according to the adult criteria. This emphasizes the need for universally accepted child-specific diagnostic protocols and norms.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14963"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Third generation sequencing analysis detects significant differences in duodenal microbiome composition between functional dyspepsia patients and control subjects.","authors":"Georgios Tziatzios, Emmanouil Stylianakis, Georgia Damoraki, Paraskevas Gkolfakis, Gabriela Leite, Ruchi Mathur, Mark Pimentel, Evangelos J Giamarellos-Bourboulis, Konstantinos Triantafyllou","doi":"10.1111/nmo.14955","DOIUrl":"10.1111/nmo.14955","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Functional dyspepsia (FD) is a multifactorial disorder as its development may be based on several different pathophysiological mechanisms. Interaction of gut microbiome with the host has been proposed as a potential mechanism involved in the disease's pathogenesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim/methods: &lt;/strong&gt;We aimed to characterize microbiome profiling on duodenal luminal content (DLC) of FD patients and compare it to that of controls (CG) and patients with irritable bowel syndrome (IBS). Outpatients fulfilling Rome IV criteria for FD, IBS, and control group (CG) underwent upper gastrointestinal endoscopy and 2 cc of duodenal aspirate (3rd - 4th part) was aspirated in sterile traps. Duodenal microbiome was assessed after DNA extraction and 16S gene-based sequencing on Oxford Nanopore MinION followed by EPI2ME analysis (ONT/Metrich-ore Ltd). Bioanalysis of the microbiome (alpha-, beta-diversity, comparisons of relative abundances for all taxonomic ranks) was implemented in Python. Multiple group means comparisons were performed with one-way Analysis of Variance (ANOVA) and Kruskal-Wallis test with Tuckey's and Dunn's post hoc tests respectively, in case of significance (P-value &lt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;20 subjects with FD (8 females; age 49.9 ± 13.5 yrs.), 20 with IBS (14 females; age 57.6 ± 14.8 yrs.) and 10 CG (6 females; age 49.2 ± 13.8 yrs.) had their DLC analyzed. The α-diversity index of subjects with FD was significantly lower compared to controls (Shannon's index, p = 0.0218) and similar to that of patients with IBS. Principal Coordinate Analysis (PCoA) generated from species relative abundances (beta-diversity) showed no difference in the DLC profile of subjects with FD and IBS when compared to controls (p = 0.513). Compared to controls, the relative abundance (RA) of Chloroflexota phylum was lower in subjects with FD (p = 0.017) and IBS (p = 0.026), respectively. Additionally, the RA of the Rhodothermota and Thermotogota phyla was lower in FD (p = 0.017 and p = 0.018, respectively) but not in IBS patients (p = 0.15 and p = 0.06, respectively) compared to controls. Interestingly, the RA of specific taxa from Chloroflexota, Rhodothermota and Thermotogota phyla were consistently lower in subjects with FD when compared to CG but similar to IBS, during analysis of all the subsequent major ranks of taxonomy. At the class level, there were significant differences in Syntrophobacteria, Acidithiobacillia, Cytophagia and Flavobacteriia between the FD and CG groups (p &lt; 0.05), but no such difference between FD and IBS was found. Finally, multiple significant differences at the order, family, genus and species level between the FD and CG groups were also detected. A positive relationship between the RA of Streptococcus and those from genus Granulicatella was observed both in FD (p = 0.014) and IBS (p = 0.014) patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion & inferences: &lt;/strong&gt;The microbiome profiling from duodenal lumin","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14955"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569329","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 history and use of the timed barium esophagram in achalasia, esophagogastric junction outflow obstruction, and esophageal strictures.","authors":"Wojciech Blonski, John Jacobs, John Feldman, Joel E Richter","doi":"10.1111/nmo.14928","DOIUrl":"10.1111/nmo.14928","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is one of the most common complaints that gastroenterologists encounter in the outpatient setting. To evaluate this common complaint, patients are often sent for a barium esophagram, a test that is widely available, inexpensive, and easy to perform. This simple test provides a reliable method to evaluate esophageal anatomy and structural abnormalities.</p><p><strong>Purpose: </strong>This narrative reviews the history of the development and validation of the timed-barium esophagram (TBE), along with its strengths and limitations, and discusses its use in the pre- and posttreatment assessment of patients with achalasia, esophagogastric junction outflow obstruction (EGJOO), and esophageal strictures. Providing excellent anatomic detail of the esophagus and an accurate assessment of esophageal emptying, over time, the TBE has become part of the standard workup in our Swallowing Center for patients with dysphagia.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14928"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term, automated stool monitoring using a novel smart toilet: A feasibility study.","authors":"Jin Zhou, Yuying Luo, Julia W Darcy, Kyle J Lafata, Jose R Ruiz, Sonia Grego","doi":"10.1111/nmo.14954","DOIUrl":"10.1111/nmo.14954","url":null,"abstract":"<p><strong>Background: </strong>Patients' report of bowel movement consistency is unreliable. We demonstrate the feasibility of long-term automated stool image data collection using a novel Smart Toilet and evaluate a deterministic computer-vision analytic approach to assess stool form according to the Bristol Stool Form Scale (BSFS).</p><p><strong>Methods: </strong>Our smart toilet integrates a conventional toilet bowl with an engineered portal to image feces in a predetermined region of the plumbing post-flush. The smart toilet was installed in a workplace bathroom and used by six healthy volunteers. Images were annotated by three experts. A computer vision method based on deep learning segmentation and mathematically defined hand-crafted features was developed to quantify morphological attributes of stool from images.</p><p><strong>Key results: </strong>474 bowel movements images were recorded in total from six subjects over a mean period of 10 months. 3% of images were rated abnormal with stool consistency BSFS 2 and 4% were BSFS 6. Our image analysis algorithm leverages interpretable morphological features and achieves classification of abnormal stool form with 94% accuracy, 81% sensitivity and 95% specificity.</p><p><strong>Conclusions: </strong>Our study supports the feasibility and accuracy of long-term, non-invasive automated stool form monitoring with the novel smart toilet system which can eliminate the patient burden of tracking bowel forms.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14954"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562475","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}