Neurogastroenterology and Motility最新文献

{"title":"Beyond Malabsorption: The Need for Symptom-Based Assessment in Suspected Lactose Intolerance. Lessons From a Test-Specific Symptom Assessment.","authors":"Johann Hammer, Heinz F Hammer","doi":"10.1111/nmo.70167","DOIUrl":"https://doi.org/10.1111/nmo.70167","url":null,"abstract":"<p><strong>Background: </strong>Lactose malabsorption is commonly assumed to cause gastrointestinal discomfort, but symptoms often persist despite lactose restriction or enzyme supplementation.</p><p><strong>Objective: </strong>This study aimed to assess symptoms following lactose ingestion, its relationship with malabsorption, and its association with fructose sensitivity and disorders of the gut-brain interactions (DGBIs).</p><p><strong>Design: </strong>In 753 consecutive patients with DGBIs, we performed hydrogen breath tests and used the validated adult Carbohydrate Perception Questionnaire (aCPQ) to assess lactose-induced symptoms. Lactose malabsorption (LM+) was defined as a hydrogen increase of > 20 ppm. Lactose induced burdensome symptoms (LS+) were defined by a visual analogue scale (VAS) increase of > 20 mm. Fructose sensitivity was assessed in 547 patients using the same protocol.</p><p><strong>Results: </strong>LM+ was observed in 40.9% of patients, while 55.4% reported LS+. Interestingly, 45.3% of symptomatic patients had no lactose malabsorption (LM-) and 26.0% of malabsorbers had no symptoms (LS-). LS+ were significantly more likely to exhibit fructose sensitivity (45.2% vs. 24.2% in LS-, p < 0.001). DGBIs were similarly distributed in LS+ patients with and without malabsorption. Functional dyspepsia and irritable bowel syndrome were significantly more frequent in LS+, irrespective of whether lactose was malabsorbed or not, than in those without lactose-induced symptoms (with or without malabsorption).</p><p><strong>Conclusion: </strong>Lactose malabsorption alone is an inadequate predictor of the occurrence of symptoms, emphasizing the need for comprehensive symptom assessment beyond breath test results. This has important implications for the selection of appropriate therapies. The association between lactose and fructose sensitivity suggests a role for visceral hypersensitivity and overlapping mechanisms in symptom development.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70167"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081316","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":"Authors' Reply to Letter-Hypercontractile Esophagus: Clinical Presentation, Role of Provocative Tests in High Resolution Manometry and Long Term Outcome-Results From an Asian Cohort.","authors":"Daphne Ang, Andrew Xia-Huang Tan","doi":"10.1111/nmo.70168","DOIUrl":"https://doi.org/10.1111/nmo.70168","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70168"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081318","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":"Differential Gastric Motility, Gut Hormone, and Appetite Changes Following A Mixed Meal in People With Obesity and Healthy Controls.","authors":"Darius Javidi, Dominic-Luc Webb, Hetzel Olenia Diaz, Moeen Ud-Din, Khalid Elias, Magnus Sundbom, Per M Hellström","doi":"10.1111/nmo.70163","DOIUrl":"https://doi.org/10.1111/nmo.70163","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding meal-induced changes of gut hormones, gastric motility, and appetite is crucial for developing therapies for obesity. We investigated glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), ghrelin, and motilin influences on gastric motility and appetite, to compare healthy individuals and people with obesity.</p><p><strong>Methods: </strong>Subjects (healthy n = 41; obesity n = 32) consumed a 270-kcal meal and a wireless motility capsule. GIP, active GLP-1, acyl-ghrelin, and motilin were measured by electrochemiluminescence. MotiliGI and GIMS software were used for motility analysis, while visual analog scoring measured appetite.</p><p><strong>Results: </strong>Gastric emptying was more rapid in people with obesity than in healthy individuals (p < 0.01). Gastric emptying time was negatively associated with motility index and hunger contractions (p < 0.01, p < 0.05) in healthy individuals, but not in individuals with obesity. In controls, gastric motility index correlated positively with acyl-ghrelin (p < 0.01) and motilin (p < 0.0001), and negatively with GIP (p < 0.05), but not aGLP-1. In people with obesity, no gut hormones correlated with the motility index. In both groups, GIP and aGLP-1 correlated with decreased hunger (p < 0.0001, p = 0.001) and (p < 0.0001, p < 0.05), along with increased satiety in controls (p < 0.0001, p = 0.001) and people with obesity (p = 0.049, p = 0.01). Acyl-ghrelin correlated positively with hunger (p < 0.0001) and negatively with satiety (p = 0.049) in controls, but not in obesity. Motilin was neither associated with hunger nor satiety.</p><p><strong>Conclusion: </strong>In the gastric phase, people with obesity show rapid gastric emptying with altered hormone and motility meal responses. In healthy individuals, GIP promotes satiety, and ghrelin and motilin promote hunger through actions on motility. Like GIP, GLP-1 promotes satiety along with trending suppression of gastric motility.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70163"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081312","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":"Letter to the Editor: Hypercontractile Esophagus: Clinical Presentation, Role of Provocative Tests in High Resolution Manometry and Long Term Outcome-Results From an Asian Cohort.","authors":"Gizem Dağcı, Bilger Çavuş, Örmeci Çiftçibaşı Aslı","doi":"10.1111/nmo.70166","DOIUrl":"https://doi.org/10.1111/nmo.70166","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70166"},"PeriodicalIF":2.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069994","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":"Association of Depression, Anxiety, and Somatic Symptom With Refractory Constipation.","authors":"Zhifeng Zhao, Bin Bai, Shiqi Wang, Yin Zhou, Pengfei Yu, Qingchuan Zhao, Bin Yang","doi":"10.1111/nmo.70162","DOIUrl":"https://doi.org/10.1111/nmo.70162","url":null,"abstract":"<p><strong>Background: </strong>Chronic constipation (CC) is a prevalent clinical complaint with a subset of patients showing ineffective responses to conventional treatment. Considering the association between CC and psychological disorders, we investigated the correlation between anxiety, depression, and somatic symptoms with refractory constipation.</p><p><strong>Method: </strong>This retrospective study included 610 patients. The clinical characteristics, including somatic symptom (PHQ-15), depression (PHQ-9), anxiety (GAD-7), quality of life (PAC-QOL), constipation (KESS), demographic variables, anatomical abnormalities, and symptoms were investigated. Then we analyzed the general characteristics, compared the distribution of anxiety, depression, and somatic symptom, compared the clinical parameters of refractory and non-refractory constipation groups, conducted subgroup analysis, correlation analysis, and logistic regression to determine the independent related factors of somatic symptom.</p><p><strong>Results: </strong>Demographic analysis identified that 36.0% of patients were refractory constipation (p < 0.001), and no significant differences in psychological disorders' distribution across CC subtypes. Subgroup analysis affirmed consistent findings across diverse categories. Correlation analysis revealed significant associations between psychological disorders and both KESS and PAC-QOL scores within both treatment groups (p < 0.05). Logistic regression analysis highlighted mild and severe GAD-7, severe PHQ-9, and PHQ-15 as independent risk factors for refractory constipation. The constructed model demonstrated a significant predictive value with an AUC of 0.81.</p><p><strong>Conclusion: </strong>This study identified anxiety, depression, and somatic symptom as independent risk factors for refractory constipation and underscored the strong association of psychological disorders with symptoms and distress irrespective of treatment outcomes. The integration of mental disorder assessment and consideration within therapeutic strategies might promote more targeted and effective interventions for CC patients.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70162"},"PeriodicalIF":2.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070008","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":"Effects of Improved Sleep and Gastric Vagotomy on Serum Inflammatory Mediators in Peptic Ulcer Rats.","authors":"Huang Du, Lianxiang Peng, Guohua Gong, Shuping Xiao, Rongpan Lin, Kangming Huang, Mingxia Wu, Nating Wei, Wangfeng Cai, Hongbin Chen","doi":"10.1111/nmo.70136","DOIUrl":"https://doi.org/10.1111/nmo.70136","url":null,"abstract":"<p><strong>Objective: </strong>Vagotomy is a method used to treat peptic ulcers, but its mechanism of action in terms of inflammatory mediators and neurophysiology remains unclear. This study investigates the effects of vagotomy and improved sleep on serum inflammatory mediators in rats.</p><p><strong>Methods: </strong>One hundred and eighty healthy rats were allocated into five groups, each consisting of 36 rats: control, sleep disturbance, ulcer, improved sleep and vagotomy. They underwent various treatments, including sleep deprivation, ulcer induction with acetic acid, and vagotomy. We measured gastric vagal nerve activity, gastric acid secretion, and serum inflammatory mediators (IL-1β, IL-6, IL-8, TNF-α), comparing these parameters across groups.</p><p><strong>Results: </strong>Gastric acid secretion was elevated in the sleep disturbance and ulcer group but decreased in the improved sleep group (p < 0.01). Gastric vagal nerve activity was heightened in the sleep disturbance and ulcer group, with some improvement in the improved sleep group. Serum inflammatory mediators' mRNA expression was increased in both the ulcer and sleep disturbance group, while it decreased in the improved sleep and vagotomy group (p < 0.01). The vagotomy group showed no significant inflammation in the gastric mucosa, while some recovery was observed in the ulcer area's mucosa in the improved sleep group.</p><p><strong>Conclusion: </strong>Improved sleep can enhance vagal nerve excitability, decrease inflammatory mediator release, and support the healing of peptic ulcers.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70136"},"PeriodicalIF":2.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058596","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":"Impact of Ammonia Exposure on the Enteric Nervous System in the Ileum of Pigs From Birth.","authors":"Valentina Rafaela Herrera Millar, Mirko Sergio, Katarzyna Palus, Giorgio Mirra, Chiara Cialini, Margherita Pallaoro, Lucia Aidos, Laura Mangiavini, Chiara Bazzocchi, Eleonora Buoio, Annamaria Costa, Silvia Clotilde Bianca Modina, Alessia Di Giancamillo","doi":"10.1111/nmo.70156","DOIUrl":"https://doi.org/10.1111/nmo.70156","url":null,"abstract":"<p><strong>Background: </strong>Best Available Techniques have been introduced in the EU to counteract pollution related to intensive farming and its effect on the health of animals and workers. It is known that high levels of ammonia (NH₃) worsen the productive performance of animals, but the exact mechanism of interaction with the intestine is still unknown. Therefore, this study aimed to investigate the effect of NH₃ on the gut of pigs exposed to different levels since birth.</p><p><strong>Methods: </strong>Two farms with different manure removal systems were considered (Recirculation and Vacuum), where two different NH₃ levels were detected: high and low ammonia (recirculating slurry system, RS, and vacuum slurry system, VS, respectively). The entire production cycle was considered, and a fecal score and microbiological analyses of the feces were performed. After slaughtering, the ileum of 12 animals was sampled to evaluate ileum morphology and the expression of some neurotransmitters.</p><p><strong>Key results: </strong>No differences were found in Peyer's patches morphology. The mucus layer thickness was higher, and the acidic mucins were lower in the RS animals. Results revealed changes in the number and area of neuronal and glial cells, and an upregulation of choline acetyltransferase (ChAT) and galanin (GAL) genes was observed.</p><p><strong>Conclusions and inferences: </strong>The alteration of the Enteric Nervous System (ENS) highlighted a connection between high levels of environmental NH₃ and neuroplasticity. Furthermore, the upregulation of ChAT and GAL genes suggests a key role in visceral pain, creating a link between peristalsis and chronic diarrhea observed in healthy pigs. Lastly, these findings are important for both animal health and human workplace safety.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70156"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040809","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":"Retinoic Acid Inhibition Alters Intestinal Composition in Zebrafish: A Non-genetic Model to Study Hirschsprung Disease?","authors":"Naomi J M Kakiailatu, Wei Zhang, Laura E Kuil, Eric Bindels, Joke T M Zink, Michael Vermeulen, Emma de Pater, Veerle Melotte, Maria M Alves","doi":"10.1111/nmo.70155","DOIUrl":"https://doi.org/10.1111/nmo.70155","url":null,"abstract":"<p><strong>Background: </strong>Retinoic acid (RA) is pivotal for the development of the enteric nervous system (ENS), guiding the migration and differentiation of vagal neural crest cells in the gastrointestinal tract. Despite its recognized influence on other intestinal cell types, the specific roles of RA on these cells are less understood. This study investigates the extensive impact of RA inhibition on the intestinal composition using zebrafish, while also considering its potential use as a model for Hirschsprung disease (HSCR).</p><p><strong>Methods: </strong>Zebrafish larvae were treated with diethylaminobenzaldehyde (DEAB), an inhibitor of RA synthesis, to induce phenotypes resembling total colonic aganglionosis. Single-cell RNA sequencing was performed to compare the intestinal cell composition of DEAB-treated zebrafish with wildtype and a ret mutant HSCR model.</p><p><strong>Results: </strong>Inhibition of RA reduced ENS cell numbers but also induced significant changes within non-neuronal cell populations. Notably, there was an increase in epithelial cells, a decrease in immune cells, and suppression of inflammatory pathways. Additionally, we observed increased myofibroblast numbers and decreased fibroblasts, which might suggest fibrosis. Comparative analysis of the ret mutant and DEAB-treated models showed profound effects on non-neuronal cells, yet most of these changes differed between the two models, underscoring the distinct roles of RA and Ret signaling on intestinal development.</p><p><strong>Conclusion: </strong>These findings highlight RA's pivotal role in maintaining intestinal structure and immune homeostasis, while further supporting the importance of considering both neuronal and non-neuronal cell populations in HSCR research.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70155"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040742","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":"Manometric Parameters of Esophagogastric Junction Competence: A Systematic Literature Review.","authors":"Arianna Vittori, Francesca Senzani, Andrés R Latorre-Rodríguez, Stefano Siboni, Marco Sozzi, Renato Salvador, Emanuele Asti, Sumeet K Mittal","doi":"10.1111/nmo.70158","DOIUrl":"https://doi.org/10.1111/nmo.70158","url":null,"abstract":"<p><strong>Background: </strong>Although endoscopy and pH monitoring are gold standards for diagnosing gastroesophageal reflux disease (GERD), manometry provides additional insights into esophagogastric junction (EGJ) morphophysiology. This systematic review aims to summarize the diagnostic performance of manometric parameters that have been explored as GERD predictors.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, Embase, and EBSCO (1970-2024) identified studies comparing manometric metrics in adults (≥ 18-years-old) with or without GERD using pH monitoring or Lyon criteria as reference standards. Manometry metrics were compared between groups, diagnostic performance was synthesized, and risk of bias was assessed.</p><p><strong>Key results: </strong>We found 59 eligible studies (50 cross-sectional, nine cohort; 10,672 patients). Thresholds for competent lower esophageal sphincter (LES) included overall length < 2 to 3 cm (sensitivity [SE] 2.6%-64%, specificity [SP] 81.5%-98.9%) and abdominal length < 1 cm (SE 4.5%-70%, SP 45%-98.4%). Parameters that differed significantly between GERD and non-GERD groups included: LES pressure in 16/40 studies, EGJ contractile integral (EGJ-CI) in 14/17 studies, and LES pressure integral (LESPI) in 3/4 studies. EGJ morphology differed between the groups using the 2017 Consensus in 6/7 studies and using Akimoto classification in 1/1 study. Transabdominal pressure gradient was significantly different between groups in 5/5 studies. Among novel metrics, total EGJ-CI (SE 81%, SP 52%) and the straight leg raise maneuver (SE 71%-79%, SP 75%-85%) performed best.</p><p><strong>Conclusions and inferences: </strong>Although none of the manometric EGJ metrics reliably predict GERD, some of them show potential in assessing EGJ competence, which could guide treatment as endoscopic and surgical options for restoring competence expand.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70158"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040739","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":"Modulation of Jejunal Glucose Absorption as a Central Mechanism in the Antidiabetic Action of Myrtle Berry Seeds Aqueous Extract.","authors":"Soumaya Hajaji, Mohamed-Amine Jabri, Fatma Arrari, Hichem Sebai","doi":"10.1111/nmo.70154","DOIUrl":"https://doi.org/10.1111/nmo.70154","url":null,"abstract":"<p><strong>Background: </strong>Reduction of intestinal glucose absorption plays a key role in the antidiabetic action of certain antihyperglycemic agents. This study assesses the impact of the myrtle berry seeds aqueous (MBSAE) in managing diabetes and its related complications, placing particular emphasis on its ability to block glucose absorption across the jejunal epithelium.</p><p><strong>Methods: </strong>Using the Ussing chamber system, we assessed the effect of MBSAE on electrogenic glucose transport across the mice jejunal epithelium. To complement these ex vivo findings, we used an alloxan-induced diabetic rat model to evaluate the extract's systemic effects.</p><p><strong>Results: </strong>The extract significantly reduced glucose-induced short-circuit currents, suggesting a direct inhibitory effect on intestinal glucose absorption, potentially via SGLT1 modulation. Therefore, MBSAE treatment significantly reduced plasma glucose and improved lipid profiles, hepatic and renal function, as well as hematological markers. It also helped restore antioxidant defenses by increasing SOD, CAT, and GPx activities, as well as GSH and thiol group levels, while reducing MDA and reactive oxygen species in both liver and kidney tissues. Inflammatory markers like TNF-α, IL-6, and IL-1β were also lowered after treatment.</p><p><strong>Conclusion: </strong>Altogether, these results point toward a multi-targeted antidiabetic action of MBSAE. By limiting intestinal glucose absorption, the extract may help to reduce postprandial glycemic excursions and offer a novel gut-targeted approach to diabetes management.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70154"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040730","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}