Neurogastroenterology and Motility最新文献

{"title":"Ameliorating Effects and Autonomic Mechanisms of Transcutaneous Auricular Vagus Nerve Stimulation on Abdominal Pain in Patients With Functional Dyspepsia and Irritable Bowel Syndrome.","authors":"Xiaomeng Sun, Qi Lin, Yuemei Xu, Pingping Hu, Peijing Rong, Jieyun Yin, Lin Lin, Jiande D Z Chen","doi":"10.1111/nmo.70224","DOIUrl":"10.1111/nmo.70224","url":null,"abstract":"<p><strong>Background: </strong>Patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS) often experience abdominal pain and reduced quality of life and need effective treatments. This exploratory study aimed to evaluate whether transcutaneous auricular vagus nerve stimulation (taVNS) could improve abdominal pain and quality of life in patients with FD and IBS, and whether the effects were mediated via the autonomic mechanisms.</p><p><strong>Methods: </strong>A total of 64 patients with abdominal pain (43 FD and 21 IBS) with a pain score of 3 out of 10 or higher were randomized to receive 2 weeks of taVNS or sham-taVNS treatment. The primary outcome was numeric rating scale (NRS) for abdominal pain. The dyspeptic symptom scales (DSS), IBS symptom severity scale score (IBS-SSS), anxiety and depression scores, and the SF36 quality of life scale were assessed before and after the treatment. The electrocardiogram was also recorded for the assessment of autonomic function at baseline and after the treatment.</p><p><strong>Key results: </strong>(1) taVNS reduced the abdominal pain score (p < 0.001 for both FD and IBS), the frequency of abdominal pain (p < 0.001 for both FD and IBS), and overall symptom scores in both FD patients and IBS patients (p < 0.001 for FD and IBS). There was no significant difference in the effect of taVNS on abdominal pain between FD and IBS patients. (2) taVNS improved quality of life compared with baseline in both FD and IBS patients. (3) taVNS decreased anxiety (p < 0.001) and depression (p < 0.001). (4) taVNS increased vagal activity. At the end of the taVNS treatment, the vagal activity was negatively correlated with the pain score (r = -0.491, p = 0.004).</p><p><strong>Conclusions: </strong>Non-invasive taVNS improves abdominal pain, quality of life, and anxiety and depression in patients with FD and patients with IBS, possibly attributed to the enhancement of vagal activity.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry: ChiCTR2400085697.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70224"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874940","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":"Wireless Patch System, a \"Holter Monitor\" for the Stomach: Next Steps in Identifying Gastric Phenotypes or Just Too Much Noise?","authors":"Daniel Martin Simadibrata, Anthony Lembo","doi":"10.1111/nmo.70440","DOIUrl":"10.1111/nmo.70440","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70440"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970466","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":"Age-Related Decreases in Colonic Neurokinin A Content and Release Monitored Using Electrochemical Immunosensors.","authors":"Chloe Miller, Mark Yeoman, Bhavik Anil Patel","doi":"10.1111/nmo.70446","DOIUrl":"10.1111/nmo.70446","url":null,"abstract":"<p><strong>Background: </strong>Aging increases the risk of bowel dysfunction and reduced quality of life. Although Neurokinin A (NKA)-mediated smooth muscle contraction declines with age, it is unclear whether this reflects altered NKA content and/or release. This study examined age-related changes in colonic NKA content and release and assessed whether changes correlated with fecal NKA.</p><p><strong>Methods: </strong>An electrochemical immunosensor was developed and characterized for NKA detection. Distal colon tissue and fecal pellets were collected from 5- and 22-month-old female C57BL6J mice. Basal and mechanically evoked tissue NKA release was recorded in the presence and absence of ondansetron. NKA content in tissue and fecal pellets were measured.</p><p><strong>Results: </strong>Sensor fabrication was validated by electrochemical and EDX analyses. The immunosensor detected NKA with a detection limit of 2.76 pM and high selectivity. Basal and mechanically evoked NKA release were significantly reduced with age. Ondansetron inhibited mechanically stimulated NKA release in 5-month-old but not 22-month-old colons. Tissue NKA content declined with age. The proportion of total NKA released decreased from 65% ± 22% in young tissue to 30% ± 23% in aged tissue. Fecal NKA levels were similarly reduced in older mice.</p><p><strong>Conclusions: </strong>Reduced NKA release with aging is associated with lower tissue content. The electrochemical immunosensor provides a simple, cost-effective method for NKA quantification and could be adapted for other gastrointestinal neuropeptides. The decrease in fecal NKA levels supports further investigation of fecal NKA as a noninvasive marker of age-related changes in bowel function.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70446"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031260","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":"Response to: Pairing the Auckland Classification With a Brief Psychosocial Context Layer.","authors":"Mikaela Law, Christopher N Andrews, Greg O'Grady","doi":"10.1111/nmo.70430","DOIUrl":"10.1111/nmo.70430","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70430"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970477","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":"Patients' Real-World Experiences With Pharmacologic Therapies for Irritable Bowel Syndrome With Constipation: A Mixed-Methods Analysis and Classification of Social Media and E-Forum Posts.","authors":"Carine Khalil, Karisma K Suchak, Ivan Flores Amaro, Zoe Krut, Jordy O'Campo, Karen O'Connor, Allistair Clark, David P Rosenbaum, Sharon Funk, Graciela Gonzalez-Hernandez, Brennan M R Spiegel, Christopher V Almario","doi":"10.1111/nmo.70432","DOIUrl":"10.1111/nmo.70432","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome with constipation (IBS-C) is a common disorder of gut-brain interaction that significantly impairs quality of life. Although multiple US Food and Drug Administration (FDA)-approved medications have demonstrated efficacy in randomized controlled trials, less is known about patients' real-world experiences and factors influencing treatment decisions. Here, we conducted social media netnography-a qualitative approach for examining patient perspectives posted online on social media platforms and e-health forums, exploring the perspectives and experiences of IBS-C patients who report using FDA-approved therapies.</p><p><strong>Methods: </strong>We examined publicly available posts from X and online health e-forums (Reddit, WebMD, ibspatient.org) made between 9/19/2007 and 9/12/2024. Overall, 7328 relevant posts referencing FDA-approved IBS-C medications (linaclotide, lubiprostone, plecanatide, tegaserod, tenapanor) were included. We employed qualitative (open coding) and quantitative approaches (natural language processing and artificial intelligence) to analyze the posts.</p><p><strong>Results: </strong>Four major themes emerged: (i) perceived medication efficacy; (ii) treatment-related burden; (iii) intentional non-adherence; and (iv) barriers to adherence. Patients described heterogeneous efficacy, ranging from meaningful symptom relief to limited or no benefit. Patients discussed the biopsychosocial burden of IBS-C medications (e.g., nausea, frustration, social anxiety from potential diarrheal side effects), highlighting various barriers to adherence. Barriers such as cost, insurance coverage, and personal beliefs also influenced decisions, often prompting discontinuation, dose adjustments, or pursuit of alternative therapies.</p><p><strong>Conclusions: </strong>Social media provides unique insights into IBS-C patients' real-world experiences with FDA-approved therapies. Findings highlight variability in efficacy, biopsychosocial impacts, and adherence challenges, underscoring the need for shared decision making and proactive management of barriers to optimize outcomes.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70432"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888269","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":"Response to Comment on \"Substance Use Disorders Are Associated With Increased Long-Term Risks of Gastroesophageal Reflux Disease Phenotypes: A Global Propensity-Matched Cohort Study\".","authors":"Yan Sun, Ronnie Fass","doi":"10.1111/nmo.70435","DOIUrl":"10.1111/nmo.70435","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70435"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970489","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":"Ineffective Esophageal Motility Defined by Chicago Classification v4.0 Identifies a Clinically and Endoscopically Relevant Phenotype in Eosinophilic Esophagitis.","authors":"Mentore Ribolsi, Elisa Marabotto, Nicola De Bortoli, Pierfrancesco Visaggi, Giovanni De Carlo, Michele Cicala, Edoardo Vincenzo Savarino","doi":"10.1111/nmo.70442","DOIUrl":"10.1111/nmo.70442","url":null,"abstract":"<p><strong>Backgrounds: </strong>Esophageal motility abnormalities may contribute to symptoms in eosinophilic esophagitis (EoE), but most available evidence is based on Chicago Classification version 3.0 (CCv3.0).</p><p><strong>Aim: </strong>We evaluated the prevalence and clinical relevance of motility disorders defined according to CCv4.0 in patients with EoE.</p><p><strong>Methods: </strong>We retrospectively included consecutive untreated patients with EoE who underwent upper endoscopy and high-resolution manometry at four Italian tertiary centers between 2016 and 2024. Manometric tracings were reanalyzed according to both CCv3.0 and CCv4.0. Associations between ineffective esophageal motility (IEM), symptoms, diagnostic delay, and Endoscopic Reference System (EREFS) findings were assessed.</p><p><strong>Results: </strong>106 patients were included in the analysis. CCv4.0 identified IEM in 15 patients (14.2%), compared with 29 (27.4%) using CCv3.0, while normal motility increased from 60.4% to 75.5%. Food impaction occurred in 14/15 patients with CCv4.0-defined IEM. CCv4.0-defined IEM was independently associated with food impaction (OR 6.92, 95% CI 1.37-34.94; p = 0.019), whereas CCv3.0-defined IEM was not. According to CCv4.0, IEM was strongly associated with both inflammatory (93.3% vs. 57.5%; OR 10.35, 95% CI 1.30-82.55; p = 0.008) and fibrostenotic endoscopic phenotypes (73.3% vs. 35.0%; OR 5.11, 95% CI 1.49-17.53; p = 0.009), whereas no significant associations were observed using CCv3.0.</p><p><strong>Conclusions: </strong>CCv4.0 reduces the prevalence of IEM and identifies a more clinically and endoscopically relevant hypomotility phenotype in EoE, characterized by a strong association with food impaction and both inflammatory and fibrostenotic endoscopic features. These findings support the clinical relevance of the more stringent CCv4.0 criteria for functional phenotyping in EoE.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70442"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990842","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":"Discordance Between Functional Lumen Imaging Probe and Timed Barium Esophagram in Patients With a Chicago Classification v4.0 Manometric Diagnosis of Esophagogastric Junction Outflow Obstruction.","authors":"Roma N Ahuja, Mehr Hakim, Ashton C Ellison, Chanakyaram A Reddy, Vani J A Konda, Rhonda F Souza, Stuart J Spechler, Anh D Nguyen","doi":"10.1111/nmo.70433","DOIUrl":"10.1111/nmo.70433","url":null,"abstract":"<p><strong>Background: </strong>A conclusive diagnosis of esophagogastric junction outflow obstruction (EGJOO) requires confirmation of the manometric diagnosis either by timed barium esophagram (TBE) or functional lumen imaging probe (FLIP). However, the comparative performance of these tests for confirming EGJOO is not well defined. We aimed to assess the rate of agreement between FLIP and TBE in confirming a Chicago Classification version 4.0 (CCv4.0) manometric EGJOO diagnosis.</p><p><strong>Methods: </strong>We included symptomatic patients with a CCv4.0 EGJOO manometric diagnosis who had confirmatory testing with both FLIP and TBE. FLIP metrics, TBE findings, tablet retention on esophagram, and Rapid Drink Challenge (RDC) results were recorded.</p><p><strong>Key results: </strong>Among 101 total patients with manometric EGJOO, 30 had EGJOO confirmed by FLIP alone, 4 by TBE alone, and 11 by both FLIP and TBE; 56 had both negative FLIP and TBE. The FLIP and TBE positive concordance rate was 73.3%, and negative concordance rate was 65.1%. FLIP and TBE were both positive or both negative in 67/101 patients (overall concordance rate 66.3%) with a κ value of 0.22 (95% CI 0.01-0.44). Addition of barium tablet to TBE improved the κ value to 0.43 (95% CI 0.25-0.61). RDC agreed with FLIP in 45.7% and with TBE in 44.7% of patients, with RDC results frequently being indeterminant (39.4%).</p><p><strong>Conclusions: </strong>Discrepancies between FLIP and TBE for confirming EGJOO occur in one third of cases, and RDC results are often inconclusive. Additional testing may be needed to confirm manometric EGJOO despite a negative confirmatory test if clinical suspicion remains high.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70433"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892193","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":"Effect of Age and Age-Defined Menopausal Status on Linaclotide Efficacy and Safety in Adults With Irritable Bowel Syndrome With Constipation or Chronic Idiopathic Constipation: Post Hoc Analyses of Phase 2b/3 Studies.","authors":"Lin Chang, Kyle Staller, Lesley A Houghton, Niha Yerneni, Sally Higgins, Wendy Chen, James Wu, Alexander C Ford, Paul Feuerstadt, Darren M Brenner","doi":"10.1111/nmo.70429","DOIUrl":"10.1111/nmo.70429","url":null,"abstract":"<p><strong>Background: </strong>This post hoc study explored the effect of age and age-defined menopausal status on linaclotide efficacy and safety in adults with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC).</p><p><strong>Methods: </strong>Data were pooled from eight randomized, placebo-controlled studies of linaclotide 72 μg (CIC), 145 μg (CIC), or 290 μg (IBS-C). Patients were stratified by age (< 65 years; ≥ 65 years) and female patients by age-defined menopausal status (premenopausal: ≤ 45 years; postmenopausal: > 45 years) as a surrogate for clinically confirmed menopausal status. Efficacy endpoints included change from baseline and time to response in complete spontaneous bowel movement (CSBM) frequency and abdominal symptoms.</p><p><strong>Results: </strong>Linaclotide increased weekly CSBM frequency from baseline versus placebo across age (IBS-C, < 65 years, placebo: 0.8; 290 μg: 2.3; ≥ 65 years, placebo: 0.9; 290 μg: 2.6; CIC, < 65 years, placebo: 0.7; 72 μg: 1.7; 145 μg: 2.0; ≥ 65 years, placebo: 0.9; 72 μg: 1.5; 145 μg: 2.3) and menopausal subgroups. Abdominal symptoms reduced from baseline versus placebo across all subgroups. Median time (weeks) to an increase from baseline in weekly CSBM rate of ≥ 1 was shorter with linaclotide versus placebo across age (IBS-C, < 65 years, placebo: 4.0; 290 μg: 2.0; ≥ 65 years, placebo: 3.0; 290 μg: 2.0; CIC, < 65 years, placebo: 4.0; 72 μg: 3.0; 145 μg: 2.0; ≥ 65 years, placebo: 5.0; 72 μg: 3.0; 145 μg: 1.5) and age-defined menopausal subgroups.</p><p><strong>Conclusion: </strong>In this exploratory post hoc analysis, linaclotide was associated with improvements in bowel and abdominal symptoms across age and age-defined menopausal subgroups, with a safety profile consistent with previous studies, suggesting that age and menopausal status did not meaningfully influence treatment outcomes.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 9","pages":"e70429"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900853","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":"Response to the Letter to the Editor Titled \"Concerning: Menstrual-Associated Gastrointestinal Symptoms and Their Impact on IBS Diagnosis in Adolescents\".","authors":"Samantha Arrizabalo, Krisia Banegas, Carlos Alberto Velasco-Benitez, Daniela Alejandra Velasco-Suarez, Manuel Linares, Miguel Saps","doi":"10.1111/nmo.70421","DOIUrl":"10.1111/nmo.70421","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70421"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707274","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}