Neurogastroenterology and Motility最新文献

{"title":"Hypercontractile Esophagus: Clinical Presentation, Role of Provocative Tests in High Resolution Manometry and Long Term Outcome-Results From an Asian Cohort.","authors":"Daphne Ang, Seok-Hwee Koo, Wallace Bok-Thoe Hong, Jonathan Zi-Yang Kuang, Andrew Xia-Huang Tan","doi":"10.1111/nmo.70129","DOIUrl":"https://doi.org/10.1111/nmo.70129","url":null,"abstract":"<p><strong>Background: </strong>Hypercontractile esophagus (HE) is rare. Esophageal high-resolution manometry (HRM) with solid test meal (STM) in Chicago Classification (CCv4.0) may improve diagnostic yield, but outcome data are lacking.</p><p><strong>Aim: </strong>Evaluate the clinical features and long-term outcome of HE, and determine the clinical significance of hypercontractility detected only using STM.</p><p><strong>Methods: </strong>Single-center analysis of all patients with ≥ 2 hypercontractile swallows (HS) (distal contractile integral [DCI] > 8000 mmHg.s.cm) on HRM studies with single water swallows (SWS) and/or STM between June 2014 and December 2021. A telephone survey was conducted between January and June 2023 using Impaction Dysphagia Questionnaire [IDQ], Eckardt scores, and the Gastro-Esophageal Reflux Disease Questionnaire (GERD-Q) to determine long-term outcomes.</p><p><strong>Results: </strong>Forty-eight patients (29 [60.4%] Female, 63.0 [13.4] years) with HS who presented with dysphagia (60%), reflux (37.5%) and chest pain (29.2%) and 58 controls (28 [48.3%] Female, 49 [13.4] years) with dysphagia (n = 43.1%), reflux (n = 41.4%) and chest pain (15.5%) with normal HRM findings were identified from 454 studies performed. More patients had HS with STM versus SWS (n = 41 [85.4%] vs. n = 7 [14.6%], p < 0.001). Dysphagia was significantly associated with mean DCI (B = 0.000, p = 0.035) and maximal DCI (B = 0.000, p = 0.036) during STM. 43% (n = 3/7) and 22% (n = 9/41) of patients with ≥ 2 HS using SWS and STM respectively were on medical therapy at mean (SD) clinic follow-up of 28.7 (29.2) months. At mean (SD) follow-up telephone survey of 61.3 (27.1) months from HRM, symptom scores amongst 36/48 (75%) patients and 58 controls were: IDQ (3.8 [0-4] vs. 1.0 [0-1.3], p = 0.03); Eckardt dysphagia score (0.46 [0.0-1.0] vs. 0.14 [0-0], p = 0.007); GerdQ (6.4 [6.0-6.0] vs. 7.0 [6.0-8.0], pNS) respectively.</p><p><strong>Conclusions: </strong>STM enhanced diagnostic yield of HS and identified more patients who benefitted from medical therapy.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70129"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690990","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":"Effect of STW 5-II (Iberogast-N) on Tolerance to Gastric Gas in Patients With Functional Dyspepsia. The IBO-2 Study.","authors":"Ariadna Aguilar, Luis Alcala-Gonzalez, Claudia Barber, Javier Santos, Beatriz Lobo, Carolina Malagelada, Jordi Serra","doi":"10.1111/nmo.70123","DOIUrl":"https://doi.org/10.1111/nmo.70123","url":null,"abstract":"<p><strong>Background: </strong>STW 5-II has been shown to improve numerous symptoms in functional dyspepsia.</p><p><strong>Aim: </strong>To determine if the herbal medicinal product STW 5-II may improve gastric gas transit and tolerance in patients with functional dyspepsia.</p><p><strong>Methods: </strong>In a parallel, randomized, double-blinded, placebo-controlled study, a gas challenge test was performed in 32 patients with functional dyspepsia and bloating after 2 weeks of treatment with (a) STW 5-II and (b) placebo. The challenge test consisted of continuous infusion of gas into the stomach (100 mL/min for 15 min) with simultaneous nutrient perfusion (315 kcal for 15 min, 210 mL final volume). Gas evacuation, symptom perception, and abdominal distension were continuously registered for 90 min.</p><p><strong>Results: </strong>Gastric gas infusion was followed by a progressive start of gas evacuation from the rectum that was significantly accelerated when patients were on STW 5-II (319 ± 81 mL after 20 min infusion start), compared to placebo (80 ± 39 mL; p = 0.015), but this difference declined during the following 90 min of gas evacuation (final gas retention 470 ± 160 and 662 ± 179, STW 5-II and placebo, respectively, p = 0.431). Gas infusion was associated with a significant rise and posterior progressive decline in abdominal symptom perception (mainly bloating) that was significantly lower in patients treated with STW 5-II (mean score increment 0.8 ± 0.4) than in patients treated with placebo (score increment 2.1 ± 0.4; p = 0.036). There were no significant differences in abdominal distension between groups.</p><p><strong>Conclusion: </strong>STW 5-II improves tolerance to gastric gas in patients with functional dyspepsia and may be beneficial for the treatment of gas-related abdominal symptoms like bloating.</p><p><strong>Trial registration: </strong>EudraCT number: 2019-003976-38.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70123"},"PeriodicalIF":3.5,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675325","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":"Stereoscopic Quantitative Analysis of Enteric Nervous System in Patients With Slow Transit Constipation.","authors":"Gaoyuan Tian, Bo Wang, Bin Kong, Zefeng Yuan, Yang Yang, Zhuo Wang, Dong Liu, Shipeng Zhao","doi":"10.1111/nmo.70128","DOIUrl":"https://doi.org/10.1111/nmo.70128","url":null,"abstract":"<p><strong>Background: </strong>In previous studies, abnormal changes in the enteric nervous system (ENS) were often found in intestinal specimens from patients with slow transit constipation (STC). However, there are no clear pathological diagnostic criteria for STC due to the lack of accurate quantitative data references. The association of ENS alterations with STC remains unanswered.</p><p><strong>Methods: </strong>Full-thickness colon specimens were obtained from 10 STC patients who underwent subtotal colectomy and 20 colon cancer patients who underwent radical colectomy. Using stereoscopic imaging combined with tissue clearing, immunohistochemistry, and confocal imaging techniques, the differences in ENS quantitative data between STC patients and controls were observed, and the correlation between this change and the clinical symptoms of STC was analyzed.</p><p><strong>Key results: </strong>Quantitative analysis demonstrated significant reductions in both myenteric plexus density (descending: control: Mean ± SD = 27.0% ± 3.0% vs. STC: 22.2% ± 3.5%, p = 0.004; sigmoid: 26.1% ± 5.6% vs. 20.3% ± 4.1%, p = 0.018) and ganglion density (descending: 8.7% ± 2.6% vs. 5.9% ± 2.1%, p = 0.015; sigmoid: 11.5% ± 2.3% vs. 8.7% ± 3.3%, p = 0.042) in STC patients compared to controls. After stretch correction, we observed significant decreases in both neuronal populations (descending: 205.2 ± 23.2 vs. 180.3 ± 18.6, p = 0.016; sigmoid: 168.3 ± 20.0 vs. 137.2 ± 18.0, p = 0.002) and ganglion volumes (descending: 1.53 ± 0.42 vs. 1.19 ± 0.24, p = 0.045; sigmoid: 1.74 ± 0.42 vs. 1.36 ± 0.30, p = 0.031) in STC patients compared to controls. Furthermore, the proportion of neuronal subtypes in STC patients was significantly altered. Notably, several of these neuropathological changes correlated significantly with STC symptom severity.</p><p><strong>Conclusions and inferences: </strong>This study revealed abnormal changes in colonic ENS in STC patients through three-dimensional imaging and quantitative analysis of ENS. There was a certain correlation between ENS changes and constipation symptoms in STC patients, and further studies of other components of ENS are needed to clarify the correlation between STC and ENS.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70128"},"PeriodicalIF":3.5,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675326","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":"Transient Anal Sphincter Relaxations in Fecal Incontinence: Insights From 3D High-Definition Anorectal Manometry.","authors":"Francisco Alejandro Felix-Tellez, Raúl Alberto Jiménez-Castillo, Mercedes Amieva-Balmori, Karla Rocío García-Zermeño, José María Remes-Troche","doi":"10.1111/nmo.70125","DOIUrl":"https://doi.org/10.1111/nmo.70125","url":null,"abstract":"<p><strong>Background: </strong>Fecal incontinence (FI) is a prevalent and multifactorial disorder, often associated with anal sphincter dysfunction. Transient anal sphincter relaxations (TASR) have been proposed as a contributing factor in FI, though their significance remains unclear. This study aimed to assess the prevalence and clinical impact of TASR using high-definition anorectal manometry (3D-HD ARM).</p><p><strong>Methods: </strong>We conducted a cross-sectional study including consecutive FI patients undergoing 3D-HD ARM. TASR was defined as a resting pressure drop below 15 mmHg lasting > 15 s. Manometric parameters, structural assessments, and clinical scores were compared between TASR and non-TASR groups.</p><p><strong>Results: </strong>Of 62 FI patients (74.2% female, mean age 60 years), TASR was detected in 14.5% (95% CI 0.06-0.25). TASR patients exhibited significantly lower maximum squeeze pressure (68.5 ± 25.6 vs. 105.3 ± 56.1 mmHg, p = 0.004) and reduced anal pressure during cough (54.8 ± 28.5 vs. 85.2 ± 35.9 mmHg, p = 0.019). TASR was also associated with pelvic floor akinesia (p = 0.006) and rectoanal coordination disorders (p = 0.037), though no significant structural differences were observed.</p><p><strong>Conclusion: </strong>TASR was identified in 15% of FI patients, with associated anal sphincter dysfunction and pelvic floor abnormalities. The use of 3D-HD ARM may enhance TASR detection, suggesting a potential role in FI pathophysiology. Further studies are needed to determine its clinical significance and impact on treatment response, particularly regarding biofeedback therapy.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70125"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649981","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":"Characteristics of Clinical Studies on Gastroparesis Registered in ClinicalTrials.gov-A Cross-Sectional Analysis.","authors":"Akanksha Togra, Richard McCallum","doi":"10.1111/nmo.70119","DOIUrl":"https://doi.org/10.1111/nmo.70119","url":null,"abstract":"<p><strong>Background: </strong>Gastroparesis (GP) is a chronic gastrointestinal motility disorder marked by delayed gastric emptying in the absence of mechanical obstruction. Despite its debilitating nature and high unmet therapeutic need, the clinical research landscape in GP remains underexplored. This study aimed to assess the trends, characteristics, and funding patterns of GP-related clinical trials registered on ClinicalTrials.gov (CTG).</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using data from CTG between September 27, 2007, and April 30, 2024. Trials were identified using specific search terms and categorized by study type, phase, funding source, and status. Comparisons were made between GP trials and all registered trials on CTG. Statistical analyses included frequency distributions and odds ratios (OR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 249 GP studies were registered, comprising only 0.059% of all CTG studies, with 68 ongoing as of April 2024. Interventional studies represented 77.1% of all GP trials, but this proportion declined significantly in ongoing studies (OR 0.23; 95% CI: 0.13-0.41). Registry-based studies increased significantly among ongoing trials (OR 3.4; 95% CI: 1.56-7.57). Industry and NIH-funded trials accounted for 27.3% and 8.4%, respectively, while the majority (77.1%) were funded by other sources. Completion rates for GP studies were significantly lower (39.8%) than the overall CTG average (50.3%), and GP trials had higher discontinuation (18.5% vs. 8.8%) and unknown status rates (41.8% vs. 14.8%). Ongoing GP studies also showed a marked decline in early-phase trials, particularly Phase 1 (OR 0.05; 95% CI: 0.03-0.08), while Phase 2 studies were more common when compared with all CTG studies.</p><p><strong>Conclusion: </strong>Despite increasing overall research activity on CTG, clinical trials in GP have remained relatively stagnant, with fewer interventional and early-phase trials in recent years. The high discontinuation and low completion rates, along with limited industry sponsorship, highlight significant barriers to advancing GP therapeutics. Attention is needed from the industry and policymakers to bring focus on the development of therapeutic solutions for improved clinical outcomes.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70119"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659687","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":"Functional Lumen Imaging Probe as Part of Multimodality Assessment of Esophagogastric Junction Opening Is Important in Longitudinal Follow-Up of Patients With Treated Achalasia.","authors":"Amrit K Kamboj, Shubham Sood, Brandon Truong, Louis M Wong Kee Song, Michael Wells, Dennis Wigle, D Chamil Codipilly, Diana L Snyder, Jeffrey A Alexander, Cadman Leggett, Ryan J Lennon, Andree Koop, Marcelo Vela, Karthik Ravi","doi":"10.1111/nmo.70121","DOIUrl":"https://doi.org/10.1111/nmo.70121","url":null,"abstract":"<p><strong>Background: </strong>Functional lumen imaging probe (FLIP) utility is established in treatment-naïve achalasia but less clear following lower esophageal sphincter (LES) directed therapy.</p><p><strong>Methods: </strong>Achalasia patients with LES directed therapy across three tertiary care centers between 2017 and 2024 with post-treatment FLIP and timed barium esophagram (TBE) were retrospectively identified. Reduced esophagogastric junction (EGJ) opening was defined by distensibility index (DI) < 2 mm²/mmHg and diameter < 12 mm. Abnormal emptying on TBE was defined as column height ≥ 5 cm at 5 min and/or retained tablet. Eckardt scores ≤ 3 defined clinical response.</p><p><strong>Key results: </strong>The study included 222 patients (46% peroral endoscopic myotomy, 46% laparoscopic Heller myotomy, 8% pneumatic dilation) with a median of 1.4 years to post-treatment TBE/FLIP. Abnormal emptying on TBE was associated with a narrower median EGJ diameter (13.2 vs. 14.8 mm, p = 0.008), a greater frequency of EGJ diameter < 12 mm (36% vs. 21%, p = 0.012), and a smaller change in EGJ diameter (+4.6 vs. +8.6 mm, p = 0.002). Abnormal emptying on TBE occurred more frequently in patients with EGJ DI < 2 mm²/mmHg (8.5% vs. 2.6%, p = 0.052), but was not associated with median EGJ DI (4.5 vs. 5.1 mm²/mmHg, p = 0.29) nor median change in EGJ DI (+2.9 vs. +3.9 mm²/mmHg, p = 0.25). Patients with reduced EGJ DI or EGJ diameter more often had abnormal TBE (37% vs. 22%, p = 0.012). Only the change in DI (+3.8 vs. +1.5 mm²/mmHg, p = 0.012) and diameter (+8.2 vs. +1.6 mm, p = 0.002) on FLIP was associated with a clinical response based on Eckardt ≤ 3.</p><p><strong>Conclusions and inferences: </strong>FLIP following achalasia therapy generally correlates with TBE, although discrepant findings are not uncommon. In particular, FLIP EGJ-diameter has a strong association with esophageal emptying on TBE. Both TBE and FLIP have limited association with clinical response based on Eckardt, with change in DI and diameter on FLIP most strongly associated. Consequently, FLIP as part of multimodal assessment appears useful in the longitudinal follow-up of treated achalasia.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70121"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637652","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":"Improved Performance of an Updated Artificial Intelligence Model for Interpretation of Functional Lumen Imaging Probe Panometry Studies.","authors":"Ofer Z Fass, Kristjana Kristinsdottir, Evandros Kaklamanos, Priyanka Soni, Kenneth Hudson, Mozziyar Etemadi, John E Pandolfino, Dustion A Carlson","doi":"10.1111/nmo.70120","DOIUrl":"https://doi.org/10.1111/nmo.70120","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70120"},"PeriodicalIF":3.5,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626769","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-Dependent Circadian Rhythm Impact on Murine Gastrointestinal Transit.","authors":"Shreya S Bellampalli, Gennadiy Fonar, Michael Grynyshyn, Arnaldo Mercado-Perez, Karan H Muchhala, Gianrico Farrugia, Aleksey V Matveyenko, David R Linden, Arthur Beyder","doi":"10.1111/nmo.70114","DOIUrl":"10.1111/nmo.70114","url":null,"abstract":"<p><strong>Background: </strong>The circadian rhythm regulates gastrointestinal motility. In humans and preclinical models, such as rodents, whole gut transit (WGT) is slower during the rest phase compared to the active phase. Investigators typically study GI transit in rodents during the day, which is their rest phase, rather than during the night, which is their active phase. A circadian rhythm reversal in which mice are in a dark room during the working day (reverse light) allows studies on nocturnal animals during their active phase and has been previously shown to reduce WGT time. GI motility is often disrupted in individuals with disorders of gut-brain interaction (DGBI), which are female predominant. However, the effect of circadian rhythm on regional transit and sex dependence of the differences is not known, as most motility studies looking at circadian rhythm reversal are done in male mice.</p><p><strong>Methods: </strong>We tested C57BL/6 wild-type male and female mice in rest (12 h of light during the day) and active (reverse cycle for 2 weeks: 12 h of dark during the day) phases. We noted female estrous cycle by visual inspection. We performed carmine WGT by monitoring time-lapse videos of pellet production. We performed fluorescence imaging of excised intestines 30 min after gavage to assess percent fluorescence for each GI region and then examined small intestinal transit (SIT) by measuring geometric center and leading edge. For colonic transit, we monitored bead expulsion time from distal colon to anus.</p><p><strong>Key results: </strong>Compared to rest phase, in the active phase, like male mice, female mice had (1) faster WGT, (2) increased frequency of pellet expulsion in the first 3 h of transit, (3) and greater total pellet production. Both male and female mice in their active phase exhibited (4) more contrast emptied from the stomach and they had (5) further leading edge of fluorescence and (6) geometric center, in SIT, and (7) faster colonic bead expulsion times. There were no significant sex differences in the active phase of WGT. In SIT, male mice had further leading edge in the rest phase than female mice, but this difference was not seen in the active phase, and in colonic transit, male mice in both the active and rest phases had faster bead expulsion than female mice.</p><p><strong>Conclusions: </strong>Mice in the active phase have faster regional transit in small and large bowel than mice in the rest phase that collectively contributes to faster WGT times in the active phase of both male and female mice. These findings highlight the importance of circadian biology in sex-dependent rodent GI transit.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70114"},"PeriodicalIF":3.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584280","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":"Intrarectal Injections of Botulinum Toxin for the Treatment of Urge Fecal Incontinence: Long-Term Results of an FI-Toxin Cohort Study.","authors":"Charlotte Desprez, Charlène Brochard, Véronique Vitton, Isabelle Etienney, Frank Zerbib, Gérard Amarenco, Francois Mion, Michel Queralto, Guillaume Gourcerol, Laurent Siproudhis, Henri Damon, Julie Philip, Elie Lacroix, André Gillibert, Anne-Marie Leroi","doi":"10.1111/nmo.70025","DOIUrl":"10.1111/nmo.70025","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of intrarectal botulinum toxin A (BoNT/A) injections in patients with urge fecal incontinence (FI) were evidenced in a large, multicenter, randomized, placebo-controlled study (FI-TOXIN). The aims of the present study were to evaluate the long-term efficacy and safety of intrarectal BoNT/A injections in a real-world setting in patients who participated in the FI-TOXIN study.</p><p><strong>Methods: </strong>Data collected from patients who had previously participated in the FI-TOXIN study in 8 French centers from November 2015 to November 2020 were retrospectively analyzed. Given the transient effect of BoNT/A, patients who had received the first injection in the FI-TOXIN study could be re-injected if symptoms recurred. Information on re-injections, satisfaction of patients, severity of FI symptoms, adverse effects, and the switch to another treatment was retrospectively collected from medical charts between M6 (end of the double-blind phase) and M54 of the inclusion in the FI-TOXIN study.</p><p><strong>Key results: </strong>Of the 191 patients in the initial FI-TOXIN cohort, 147 (77.0%) were included at M6. Between M6 and M54, 114 of these patients received 233 injections (68 first injections, 165 re-injections). Satisfaction information was available for 70 patients, of whom 43/70 (61.4%) were satisfied with all their injections. The treatment failed in 52/147 (35.4%) of the patients, with rejections of the treatment by patients due to insufficient perceived efficacy (34 patients), adverse effects or poor tolerance (11 patients), or switch to a surgical treatment (23 patients). Nonsevere adverse events were recorded after 45/233 (19.3%) injections. The two severe adverse events (cervical cancer and psychiatric hospitalization) were unrelated to the treatment.</p><p><strong>Conclusions: </strong>Intrarectal injections of BoNT/A displayed moderate long-term efficacy without major adverse effects.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70025"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795799","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":"Decoding Gastric Reflexes: The Role of Mechanosensitive Enteric Neurons in Stomach Motility.","authors":"Gemma Mazzuoli-Weber, Sophia Mayr, Kristin Elfers","doi":"10.1111/nmo.70011","DOIUrl":"10.1111/nmo.70011","url":null,"abstract":"<p><p>This review focuses on mechanosensitive enteric neurons (MEN) in the guinea pig stomach and their roles in gastric motor reflex pathways. The guinea pig model is advantageous for studying gastric physiology, as its stomach structure and function closely resemble those of humans. Gastric motility involves distinct functional regions: the fundus and proximal corpus act as reservoirs, while the distal corpus and antrum handle food mixing and propulsion. Mechanosensitivity in both gastric cholinergic and nitrergic enteric neurons plays a critical role in adapting muscle activity in response to gastric content volume. These neurons enable reflex circuits involved in the accommodation reflex, with cholinergic excitatory and nitrergic inhibitory pathways promoting relaxation. This review summarizes the anatomical, functional, and neurochemical characteristics of MEN across gastric regions, their direct and indirect interactions with smooth muscle, and the role of distinct neurotransmitters in modulating gastric motility. The need for future studies on mechanosensitive pathways and involved neuronal receptors is highlighted to enhance our understanding, finally aiding therapeutic development.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70011"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542637","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}