Neurogastroenterology and Motility最新文献

{"title":"Neuropathic Gastroduodenal Disorders Can Be Diagnosed by Non-Invasive Body Surface Gastric Mapping: A Comparison With Antroduodenal Manometry.","authors":"Christian Sadaka, Binghong Xu, Alain J Benitez, Carolyn M Orians, Corey Bowerman, Jordan Dourlain, Beth Skaggs, Kimberly G Konka, Lexi Roshkovan, Gayl Humphrey, Stefan Calder, Gabriel Schamberg, Greg O'Grady, Armen A Gharibans, Hayat Mousa","doi":"10.1111/nmo.70087","DOIUrl":"10.1111/nmo.70087","url":null,"abstract":"<p><strong>Background: </strong>Antroduodenal manometry (ADM) is the gold standard for diagnosing myopathy and neuropathy in patients with upper gastrointestinal (GI) disorders. However, ADM is invasive and costly. Body surface gastric mapping (BSGM) has emerged as a non-invasive test to assess gastric function. This study evaluates the correlation between BSGM and ADM in children.</p><p><strong>Methods: </strong>Clinically indicated ADM was performed using high-resolution water-perfused motility catheters, with simultaneous BSGM. Real-time symptoms were tracked using a validated symptom logging app at 15-min intervals, and Nausea Severity Scale (NSS) scores were recorded. Protocols involved a 2 h fast, provocative testing, a meal, and over 1 h of post-prandial recordings. ADM tracings were categorized into neuropathy, myopathy, post-prandial hypomotility, or normal. BSGM metrics included principal gastric frequency, BMI-adjusted amplitude, and Rhythm Index. Gastric emptying data were also evaluated.</p><p><strong>Results: </strong>Fifteen subjects were recruited (13 female; ages 10-19 years, BMI 20.6 ± 3.5 kg/m²). ADM results showed neuropathy (n = 4), myopathic CIPO (myopathy) (n = 1), post-prandial hypomotility (n = 4), and normal motility (n = 6). Patients with neuropathy had lower rhythm stability (0.16 ± 0.03 vs. 0.38 ± 0.17; p = 0.001), accompanied by higher nausea scores (8.2 ± 1.2 vs. 3.15 ± 2.9; p < 0.001) and bloating (7.3 ± 0.9 vs. 2.1 ± 2.0; p < 0.001). ADM neuropathy correlated completely with dysrhythmia on BSGM. Normal ADM were consistent with normal BSGM in 83.3% of cases. Delayed gastric emptying did not correlate with a neuropathic diagnosis.</p><p><strong>Conclusion: </strong>Dysrhythmic BSGM phenotype reliably identified gastrointestinal neuropathy with identical results to ADM, with significant correlations to nausea and bloating severity. This study supports considering BSGM as an actionable biomarker when performing ADM is not feasible.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70087"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208956","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 Invisible Link Between Mind and Gut: The Effect of Alexithymia and Adjustment to Illness on Symptom Severity in IBS Patients With Rome IV Criteria.","authors":"Yasemin Karacan, Dilay Demirayak, Ayşe Gül Parlak","doi":"10.1111/nmo.70176","DOIUrl":"https://doi.org/10.1111/nmo.70176","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a gut-brain interaction disorder that significantly impacts quality of life, with symptoms influenced by stress, anxiety, dietary habits, and gut microbiota imbalances. Alexithymia, characterized by difficulties in identifying and expressing emotions, may exacerbate IBS symptoms by impairing stress management and illness perception. Additionally, poor adaptation to chronic illness can increase psychological burden and worsen symptom severity.</p><p><strong>Methods: </strong>This cross-sectional study examined 148 IBS patients diagnosed using Rome IV criteria at a gastroenterology outpatient clinic. Data were collected through validated scales, including the IBS Symptom Severity Score (IBS-SSS), Twenty-Item Toronto Alexithymia Scale (TAS-20), and Chronic Disease Adaptation Assessment Scale (CDAAS). Correlation and multiple regression analyses were conducted to identify key predictors of symptom severity.</p><p><strong>Results: </strong>IBS severity was notably high (mean IBS-SSS = 380.1 ± 61.5), with low income (B = 32.337, p = 0.002) and high alexithymia levels (B = 0.991, p = 0.045) emerging as strong predictors of increased symptom burden. Marital status also showed a notable association (B = 22.005, p = 0.085). While overall disease adaptation (CDAAS) was not directly linked to symptom severity, poor physiological adaptation correlated negatively with IBS symptoms, suggesting a critical role in disease perception. A significant inverse relationship was found between meal frequency and symptom severity (r = -0.170, p = 0.039), highlighting the impact of dietary habits on symptom control. The regression model explained 14.9% of variance (adjusted R² = 0.081).</p><p><strong>Conclusion: </strong>IBS symptom severity is partially influenced by socioeconomic status, emotional regulation, and dietary patterns. These findings underscore the need for a multidisciplinary treatment approach integrating dietary modifications, psychological interventions, and tailored patient support to enhance disease management and improve patient outcomes.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70176"},"PeriodicalIF":2.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192181","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":"Genesis of Bolus Pressure During Primary Peristalsis: Key to Understanding \"Functional Dysphagia\".","authors":"Myeongsook Seo, Segyeong Joo, Ali Zifan, Ravinder K Mittal","doi":"10.1111/nmo.70175","DOIUrl":"https://doi.org/10.1111/nmo.70175","url":null,"abstract":"<p><strong>Background: </strong>During swallowing, the bolus passes through the esophagus during the relaxation phase of peristalsis-termed the bolus domain (BD)-before being cleared by sequential contractions. Bolus pressure (BP) in BD results from the compartmentalization of the bolus between the advancing contraction and the lower esophageal sphincter. This study aimed to evaluate the genesis of BP in the BD using high-resolution impedance manometry (HRMZ), distension-contraction plots, and high-frequency ultrasound imaging in healthy subjects and \"functional dysphagia (FD)\" patients.</p><p><strong>Methods: </strong>We analyzed HRMZ recordings from 30 healthy controls and 30 FD patients. Swallows of 5 mL and 10 mL saline were recorded in the supine and Trendelenburg positions. BP was measured in the BD (from upper esophageal sphincter relaxation to the 20-mmHg isocontour onset of contraction). Automated tools extracted BP, luminal cross-sectional area (CSA), and the percentage of BD area with CSA ≤ 50 mm² (no-bolus area). Ultrasound images evaluated the timing of luminal distension and wall changes during the bolus domain and contraction.</p><p><strong>Key results: </strong>Controls showed luminal distension in most of the BD. On the other hand, FD patients exhibited higher BP and a significantly larger percentage of no-bolus areas in the BD (p < 0.001) compared to controls. ROC analysis revealed high diagnostic accuracy in distinguishing patients from controls (AUC = 0.898) for the percentage of no-bolus area in the BD; a 16.5% threshold yielding 86.7% sensitivity and 80.0% specificity. Ultrasound imaging confirmed luminal collapse during the bolus domain in patients with FD.</p><p><strong>Conclusions & inferences: </strong>In patients with FD, bolus pressure is partly related to the compression of the manometry catheter by the esophageal wall. The proportion of BP-positive, bolus-negative areas in the BD distinguishes FD patients and controls.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70175"},"PeriodicalIF":2.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192214","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":"Epidemiology of Meal-Related Abdominal Discomfort or Pain in Irritable Bowel Syndrome.","authors":"Melanie S Cuffe, Vivek C Goodoory, Cho Ee Ng, Christopher J Black, Alexander C Ford","doi":"10.1111/nmo.70174","DOIUrl":"https://doi.org/10.1111/nmo.70174","url":null,"abstract":"<p><strong>Background: </strong>Patients with IBS often report meal-related symptoms, which may negatively affect IBS-related quality of life, psychological health, and lead to food-avoidant behaviors. However, the understanding of the epidemiology of these symptoms is limited.</p><p><strong>Methods: </strong>We compared characteristics of adult patients with Rome IV-defined IBS with and without meal-related abdominal discomfort or pain ≥ 50% of the time. Participants were recruited from the ContactME-IBS research register. We collected data concerning demographics, IBS symptoms, psychological health, quality of life, and impact on work and daily activities using validated questionnaires. We used logistic regression to explore independent predictors of meal-related discomfort or pain ≥ 50% of the time in IBS.</p><p><strong>Key results: </strong>Of 752 respondents with Rome IV IBS, 561 (74.6%) reported meal-related abdominal discomfort or pain ≥ 50% of the time. 89.3% of individuals with meal-related discomfort or pain ≥ 50% of the time were female vs. 80.6% of those without (p = 0.002). Those with meal-related discomfort or pain ≥ 50% of the time were younger (43.7 years vs. 50.1 years, p < 0.001), had a higher prevalence of symptoms meeting criteria for functional dyspepsia (FD), especially postprandial distress syndrome (49.1% vs. 30.2%, p < 0.001), and reported higher gastrointestinal symptom-specific anxiety scores, lower IBS-related quality of life scores, and higher levels of activity impairment (p < 0.001 for all analyses). After logistic regression analysis, females, those meeting criteria for FD, younger individuals, and those reporting higher gastrointestinal symptom-specific anxiety scores were more likely to report meal-related discomfort or pain ≥ 50% of the time.</p><p><strong>Conclusions: </strong>Meal-related abdominal discomfort or pain ≥ 50% of the time was associated with female sex, younger age, and comorbid FD. Better characterization and recognition of patients affected by meal-related discomfort or pain may allow more personalized dietary and psychological interventions.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70174"},"PeriodicalIF":2.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192235","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":"Fibers and Polyphenols in Diverticular Disease: From Pathophysiology to Management.","authors":"Claudia Marinaccio, Annamaria Altomare, Benedetto Neri, Laura Restaneo, Dario Biasutto, Simone Carotti, Michele Cicala, Chiara Fanali, Michele Pier Luca Guarino","doi":"10.1111/nmo.70171","DOIUrl":"https://doi.org/10.1111/nmo.70171","url":null,"abstract":"<p><strong>Backgrounds: </strong>Diverticular disease, particularly symptomatic uncomplicated diverticular disease (SUDD), significantly impacts patient quality of life and is increasing in prevalence, especially in Western countries. While its pathophysiology is multifactorial, diet-specifically low fiber intake-has been implicated as a key modifiable factor in disease development and progression. Fibers influence colonic motility and stool composition, potentially reducing the formation of diverticula and symptom severity. Polyphenols, bioactive compounds with antioxidant and anti-inflammatory properties, may further protect intestinal integrity and modulate gut microbiota.</p><p><strong>Purpose: </strong>This narrative review explores emerging evidence on the role of dietary fiber and polyphenols in SUDD management. Despite promising mechanistic insights, current studies are limited by heterogeneity and methodological constraints. Personalized nutritional strategies focusing on fiber and polyphenol-rich foods warrant further investigation to optimize therapeutic outcomes in SUDD.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70171"},"PeriodicalIF":2.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177003","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":"Evaluating the Quality of Health Information: Comparison of Human and Artificial Intelligence.","authors":"Dhruva Arcot, Neha Pondicherry, Subhankar Chakraborty","doi":"10.1111/nmo.70164","DOIUrl":"https://doi.org/10.1111/nmo.70164","url":null,"abstract":"<p><strong>Background: </strong>Over half of all Americans seek health-related information online, yet the quality of this digital content remains largely unregulated and variable. The DISCERN score, a validated 15-item instrument, offers a structured method to assess the reliability of written health information. While expert-assigned DISCERN scores have been widely applied across various disease states, whether artificial intelligence (AI) can automate this evaluation remains unknown. Specifically, it is unclear whether AI-generated DISCERN scores align with those assigned by human experts. Our study seeks to investigate this gap in knowledge by examining the correlation between AI-generated and human-assigned DISCERN scores for TikTok videos on Irritable Bowel Syndrome (IBS).</p><p><strong>Methods: </strong>A set of 100 TikTok videos on IBS previously scored using DISCERN by two physicians was chosen. Sixty-nine videos contained transcribable spoken audio, which was processed using a free online transcription tool. The remaining videos either featured songs or music that were not suitable for transcription or were deleted or were not publicly available. The audio transcripts were prefixed with an identical prompt and submitted to two common AI models-ChatGPT 4.0 and Microsoft Copilot for-DISCERN score evaluation. The average DISCERN score for each transcript was compared between the AI models and with the mean of the DISCERN score given by the human reviewers using Pearson correlation (r) and Kruskal Wallis test.</p><p><strong>Results: </strong>There was a significant correlation between human and AI-generated DISCERN scores (r = 0.60-0.65). When categorized by the background of the content creators-medical (N = 26) versus non-medical (N = 43), the correlation was significant only for content made by non-medical content creators (r = 0.69-0.75, p < 0.001). Correlation between ChatGPT and Copilot DISCERN scores was stronger for videos by non-medical content creators (r = 0.66) than those by medical content creators (r = 0.43). On linear regression, ChatGPT's DISCERN scores explained 55.6% of the variation in human DISCERN scores for videos by non-medical creators, compared to 8.9% for videos by medical creators. For Copilot, the corresponding values were 47.2% and 9.3%.</p><p><strong>Conclusion: </strong>AI models demonstrated moderate alignment with human-assigned DISCERN scores for IBS-related TikTok videos, but only when content was produced by non-medical creators. The weaker correlation for content produced by those with a medical background suggests limitations in current AI models' ability to interpret nuanced or technical health information. These findings highlight the need for further validation across broader topics, languages, platforms, and reviewer pools. If refined, AI-generated DISCERN scoring could serve as a scalable tool to help users assess the reliability of health information on social media and curb misinformation.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70164"},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138221","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 Diaphragmatic Breathing Training on the Esophagogastric Junction and Esophageal Motility in Patients With Reflux Symptoms.","authors":"Lucie Zdrhova, Petr Bitnar, Lukas Friedl, Jan Mares, Katerina Madle, Karel Balihar, Pavel Kolar, Jana Kozeluhova, Mark Fox, Jan Martinek","doi":"10.1111/nmo.70172","DOIUrl":"https://doi.org/10.1111/nmo.70172","url":null,"abstract":"<p><strong>Background: </strong>Diaphragmatic breathing training (DBT) improves symptoms in patients with gastroesophageal reflux disease; however, the effect of DBT on the anti-reflux barrier and esophageal motility is unclear. This study aimed to evaluate the changes in specific parameters of EGJ function and esophageal motility before and after DBT using high-resolution manometry (HRM) in patients with reflux symptoms.</p><p><strong>Methods: </strong>Prospectively collected data from adult patients with persistent reflux symptoms who underwent initial and follow-up HRM after at least 3 months of DBT were analyzed. Esophagogastric junction (EGJ) function was assessed using basal lower esophageal sphincter (LES) pressure (LESP), the EGJ contractile integral (EGJ-CI), and integrated relaxation pressure (IRP). Esophageal motility was assessed using the distal contractile integral (DCI) and percentage of ineffective esophageal motility (IEM).</p><p><strong>Key results: </strong>Data from 53 patients with a median age of 45 years (range 25-77) were analyzed. LES pressure increased after DBT (mean LES pressure 25.6 [SE 1.3] vs. 29.1 [SE 1.4] mmHg after DBT; p = 0.02). This effect was also observed in patients with an initially hypotensive LES, but no effect was found on the size of hiatus hernia. There was a trend to increased EGJ-CI (mean EGJ-CI 52.8 [SE 3.7] vs. 59.9 [SE 4.3] mmHg·cm after DBT, p = 0.07). Esophageal contractility improved (mean DCI 1046.6 [SE 112] vs. 1264.1 [SE 137] mmHg·s·cm after DBT; p < 0.01) with the prevalence of IEM reduced from 38.0% [SE 5] to 29.2% [SE 4] after DBT; p = 0.03.</p><p><strong>Conclusion and inferences: </strong>Diaphragmatic breathing training increased LES pressure and esophageal peristaltic vigor in patients with reflux symptoms.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70172"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124555","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":"Relationship Between Intragastric Meal Distribution, Gastric Emptying, and Gastric Neuromuscular Dysfunction in Chronic Gastroduodenal Disorders.","authors":"Chris Varghese, Armen A Gharibans, Daphne Foong, Gabriel Schamberg, Stefan Calder, Vincent Ho, Reena Anand, Christopher N Andrews, Alan H Maurer, Thomas Abell, Henry P Parkman, Greg O'Grady","doi":"10.1111/nmo.70170","DOIUrl":"10.1111/nmo.70170","url":null,"abstract":"<p><strong>Background: </strong>Chronic gastroduodenal symptoms arise from heterogeneous gastric motor dysfunctions. This study applied multimodal physiological testing using gastric emptying scintigraphy (GES) with intragastric meal distribution (IMD) and Gastric Alimetry body surface gastric mapping (BSGM) to define motility and symptom associations.</p><p><strong>Methods: </strong>Patients with chronic gastroduodenal symptoms underwent simultaneous supine GES and BSGM with a 30 m baseline, 99mTC-labeled egg meal, and 4 h postprandial recording. IMD (ratio of counts in the proximal half of the stomach to the total gastric counts) was calculated immediately after the meal (IMD0), with < 0.568 defining abnormal IMD. BSGM phenotyping followed a consensus approach, based on normative spectral reference intervals.</p><p><strong>Results: </strong>Among 67 patients (84% female, median age 40 years, median BMI 24 kg/m²), median IMD0 was 0.76 (IQR: 0.69-0.86) with 5 (7.5%) meeting abnormal IMD criteria. Delayed gastric emptying (n = 18) was associated with higher IMD0 (median 0.9 vs. 0.7, p = 0.004). On BSGM, 15 patients had abnormal spectrograms (5 [7.5%] high frequency and 10 [14.9%] low rhythm stability and/or amplitude); and in these patients, higher IMD0 (proximal retention) strongly correlated to delayed BSGM meal responses (R = -0.71, p = 0.003). Lower IMD, indicating antral distribution, correlated with higher gastric frequencies (R = -0.27, p = 0.03). BSGM abnormalities paired with abnormal IMD were associated with worse dyspeptic symptoms.</p><p><strong>Conclusion: </strong>Proximal retention of food as assessed by IMD correlated with delayed emptying, and in the presence of neuromuscular spectral abnormalities (abnormal frequencies or rhythms), delayed motility responses on BSGM. Patients with multiple motor abnormalities experience worse dyspeptic symptoms.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70170"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113896","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":"Modeling Postoperative Pathologic Ileus in Mice: A Simplified and Translational Approach.","authors":"Romain Gauthier, Julie Thevenin, Thibault Planchamp, Téo Berthon, Perrine Rousset, Shuai Wang, Astrid Canivet, Claude Knauf, Nathalie Vergnolle, Etienne Buscail, Céline Deraison","doi":"10.1111/nmo.70157","DOIUrl":"https://doi.org/10.1111/nmo.70157","url":null,"abstract":"<p><strong>Background: </strong>Postoperative Ileus (POI) is an iatrogenic complication characterized by a temporary paralysis of gastrointestinal transit, leading to food intolerance, nausea, vomiting, and thus prolonged hospitalization. The severity of POI is influenced by surgical trauma, particularly in intestinal surgeries, which have a high complication rate. To date, no animal model has precisely replicated POI in the context of digestive sutures or anastomoses, procedures common in human digestive resections.</p><p><strong>Methods: </strong>To induce POI, mice underwent different surgeries. The surgical procedure involved a midline laparotomy, externalization of the small intestine following external manipulation through moistened cotton applicators, mimicking the surgeon's action when searching for an intestinal lesion. An ileo-ileal anastomosis was also performed to ensure relevance to human surgical intervention. Intestinal transit was measured by assessing gastric emptying, gastrointestinal transit time (gavage with charcoal, fecal output), and gut motility (isotonic contraction). Postoperative inflammation is assessed in different tissue layers and areas of theintestine.</p><p><strong>Key results: </strong>The externalization of the small intestine with caecum and manipulation for 10 min induced a pathological postoperative ileus. This simple gesture induced a decrease in intestinal transit comparable to the surgical intervention, ileo-ileal anastomosis. The model showed decreased gastric emptying and reduced ileal muscle contraction, accompanied by neutrophil and monocyte/macrophage infiltration in the external muscularis.</p><p><strong>Conclusions and inferences: </strong>The developed procedure enables inducing postoperative ileus in mice in a very simple and reproducible way that does not require any specific equipment, mimics clinical practice, and reproduces traits of human pathology.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70157"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124482","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":"Rome Constipation Symptoms Augmented by Painful Defecation Predicts Specific Subtypes of Refractory Constipation.","authors":"Christian Lambiase, Massimo Bellini, Francesco Rettura, Riccardo Morganti, Stefan-Lucian Popa, Giuseppe Chiarioni","doi":"10.1111/nmo.70160","DOIUrl":"https://doi.org/10.1111/nmo.70160","url":null,"abstract":"<p><strong>Introduction: </strong>Functional defecation disorders (FDD) are a prevalent etiology of refractory constipation. The diagnosis of FDD requires specific physiology testing, including anorectal manometry (ARM) and balloon expulsion test (BET). The aims of our study were to evaluate whether the complaint of painful defecation added to the Rome III symptoms questionnaire could help to differentiate subtypes of refractory chronic constipation.</p><p><strong>Materials and methods: </strong>One hundred and ninety-eight constipated patients (Rome III Criteria) who had failed a 30-day fiber/laxative trial were enrolled. Before entering the study (T0) the patients underwent a digital rectal examination, including the assessment of tenderness elicited by traction of the puborectalis muscles (DRE-tenderness). Patients reporting painful defecation (occurring at least once per week) were specifically assessed at T0. Thirty days after T0, the patients underwent: DRE with DRE-tenderness evaluation. ARM + BET. Barium defecography (when ARM and BET were discordant). Colonic transit time evaluation with radiopaque markers. Based on these tests, the patients were classified into five subgroups: dyssynergic defecation (DD), inadequate defecatory propulsion (IDP), isolated structural outlet obstruction (mostly large rectocele), isolated slow transit constipation, and normal transit constipation. The association between symptoms and diagnostic outcomes was assessed using multivariate analysis based on binary logistic regression.</p><p><strong>Results: </strong>Eighty-one patients (40.9%) reported weekly episodes of painful defecation, while 86 patients (43.3%) reported DRE-tenderness. Ninety-six patients (48.5%) showed features of FDD: 70 DD and 26 IDP; 25 (12.6%) showed isolated structural outlet obstruction, and 23 (11.6%) showed isolated slow transit constipation. No predictors were found for IDP.</p><p><strong>Conclusions: </strong>The subjective complaint of painful defecation added to the Rome III criteria is critical to improve the identification of specific subtypes of refractory chronic constipation, thus improving care and potentially decreasing the need for physiology testing.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70160"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080338","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}