Neurogastroenterology and Motility最新文献

{"title":"MRI-Based Gastric Function Assessment in Patients With Functional Dyspepsia.","authors":"Vadim Rosca, Donghua Liao, Esben Bolvig Mark, Roxana Rusu, Maria Bitsch Poulsen, Liliana Gheorghe, Vasile Drug, Christina Brock, Jens Brøndum Frøkjær, Asbjørn Mohr Drewes","doi":"10.1111/nmo.70410","DOIUrl":"https://doi.org/10.1111/nmo.70410","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) enables non-invasive, radiation-free assessment of gastric emptying, intragastric liquid distribution, and motility. However, characterization of the stomach function in patients with functional dyspepsia (FD) remains limited. We aimed to apply the Virtual Gaster (VIGA) MRI platform to characterize gastric geometry, emptying dynamics, and motility patterns in patients with FD compared with healthy controls (HCs).</p><p><strong>Methods: </strong>Twenty-six adults with Rome IV-defined FD and twenty HCs underwent static and dynamic gastric MRI during fasting, gastric filling with a liquid meal, and emptying. VIGA was used to quantify compartmental gastric volumes (fundus, corpus, antrum), estimate gastric half-emptying time (T50), and assess motility parameters. Symptoms were evaluated using PAGI-SYM and postprandial visual analog scales.</p><p><strong>Results: </strong>Gastric half-emptying time was shorter in FD than in HCs (47.7 ± 27.8 vs. 68.0 ± 15.7 min; p = 0.008). FD patients showed reduced fundic content volumes with a relative shift of content toward the corpus and antrum (p < 0.05). Gastric dysrhythmias were more frequent in FD (50% vs. 10%; p = 0.006), and distal contraction propagation with rhythmic activity was slower during both accommodation (3.19 ± 0.83 vs. 4.10 ± 1.21 mm/s; p = 0.001) and emptying (3.31 ± 0.61 vs. 3.93 ± 1.02 mm/s; p = 0.01). Exploratory analyses showed moderate inverse correlations between symptom severity, particularly bloating and heartburn, and antral volume or contraction velocity during accommodation.</p><p><strong>Conclusions: </strong>VIGA-enabled gastric MRI identified differences in intragastric liquid distribution, gastric liquid emptying, and distal motility between FD patients and healthy controls. The moderate correlation with symptoms supports its value for characterizing regional gastric physiology in health and disease.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70410"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796107","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":"Beyond the Snapshot: Overcoming GES Limitations to Characterize Gastric Phenotypes and Therapeutic Responses Using a 6-Day Ambulatory Wearable Monitor.","authors":"Brian E Lacy, David J Cangemi, Lindsay Axelrod, Steve Axelrod, Anand Navalgund","doi":"10.1111/nmo.70413","DOIUrl":"10.1111/nmo.70413","url":null,"abstract":"<p><strong>Background: </strong>Gastric emptying scintigraphy (GES) is considered the standard for differentiating gastroparesis from functional dyspepsia and other foregut disorders characterized by nausea and vomiting but provides only a brief physiologic snapshot that may not accurately reflect daily function. We utilized a non-invasive wireless patch system (WPS) to characterize multiday gastric myoelectrical activity, evaluate its relationship with GES, and assess changes following a therapeutic intervention.</p><p><strong>Methods: </strong>Adults referred for GES for symptoms thought to represent gastroparesis were enrolled in a prospective study. Patients wore a WPS for up to 6 days, starting on the day of scintigraphy. Gastric myoelectrical activity was analyzed and categorized into relatively weak, relatively moderate, and relatively strong activity phenotypes. A subset of patients underwent repeat monitoring following individualized therapeutic interventions (e.g., anti-emetics, proton pump inhibitors, lifestyle changes).</p><p><strong>Results: </strong>Forty-eight patients (mean age 44; 79% female) completed the study. GES identified delayed gastric emptying in 18%, rapid in 22%, and normal in 60% of subjects. During the 4-h concurrent GES window, gastric activity in patients with delayed emptying was lower, but this difference did not reach statistical significance (p = 0.08). When compared to the full multiday recording period, GES results showed no correlation with the myoelectric readings. Significant day-to-day variability was observed, both random and systemic. In the latter category, a \"Test-Day\" dip was observed with gastric activity lowest on Day 1 (GES test day) and increasing significantly on subsequent days, stabilizing by Day 4 (p < 0.001). Healthy control subjects recorded during normal daily routines showed no such day-to-day variation. In the retesting cohort, anti-emetics produced robust increases in gastric amplitude, whereas PPIs showed minimal impact.</p><p><strong>Conclusions: </strong>The WPS effectively captures distinct gastric phenotypes and quantifies physiologic responses to therapy in both gastric and intestinal regions, demonstrating its clinical utility as a robust tool for evaluating and managing foregut symptoms in real-world settings. Importantly, the multiday WPS highlights significant day-to-day physiologic variability in gastric activity that extends beyond the single-day GES 'snapshot'.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70413"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670268","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":"Letter to Editor Concerning: Evaluating AI Accuracy in the Diagnosis and Treatment of Disorders of Gut-Brain Interaction.","authors":"Sandal Rabia, Sana Mehsud, Haroon Ahmad Yousaf, Maheen Hamid","doi":"10.1111/nmo.70411","DOIUrl":"10.1111/nmo.70411","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70411"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620848","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":"\"Magnesium-Rich Mineral Water Improves Stool Consistency and Bowel Habits in Healthy Subjects: A Randomized Controlled Trial\": Authors' Reply.","authors":"Hideki Yoneda, Toshihiko Tomita, Shinichiro Shinzaki","doi":"10.1111/nmo.70428","DOIUrl":"https://doi.org/10.1111/nmo.70428","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70428"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795950","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":"Biofeedback Therapy and Pelvic Floor Physical Therapy in the Treatment of Constipation and Fecal Incontinence Are Very Different in Real-World Practice.","authors":"Calvin Joomann Park, Satish Rao, Büşra İnal, Roshini Nadarajah, Tracey Cragg, Michael P Jones, Allison Malcolm","doi":"10.1111/nmo.70412","DOIUrl":"10.1111/nmo.70412","url":null,"abstract":"<p><strong>Background: </strong>International guidelines recommend anorectal biofeedback therapy or pelvic floor physical therapy for the treatment of constipation and fecal incontinence (FI). However, the similarities and differences between these therapies are unclear.</p><p><strong>Objective: </strong>This practitioner survey aimed to evaluate the practice patterns of biofeedback therapists (BTs) and pelvic floor physical therapists (PTs).</p><p><strong>Settings: </strong>This survey was targeted at BTs and PTs in community and hospital settings.</p><p><strong>Methods: </strong>We conducted an international online survey about training, equipment, techniques, and practice patterns of BTs and PTs in treating patients with constipation and FI, distributed through specialist societies and known contacts. Language style was adjusted to the participants' preferences.</p><p><strong>Results: </strong>We received 289 responses from 226 (78.2%) PTs and 63 (21.8%) BTs from Australia/New Zealand (119; 41.2%), the USA (90; 31.1%), and the rest of the world (80; 27.7%). The use of biofeedback in treating anorectal disorders often or always differed; BTs 80.4% versus PTs 51.8% (OR 4.50 (2.48-8.17)). Equipment for delivering biofeedback differed: electromyography (BTs 32.1% versus PTs 77.1%; OR 0.14 (0.07-0.27)), manometry (BTs 71.4% versus PTs 4.8%; OR 45.94 (18.35-115.02)), and ultrasound (BTs 0% versus PTs 50.3%). Ancillary device use differed (e.g., footstool (BTs 68.8% versus PTs 88.7%; OR 0.32 (0.18-0.55)), release device (BTs 6.5% versus PTs 27.9%; OR 0.06 (0.03-0.13)), trigger point (BTs 4.9% versus PTs 28.9%; OR 0.04 (0.02-0.11))). Techniques used differed: abdominal massage (BTs 31.1% versus PTs 59.6%; OR 0.27 (0.15-0.46)), balloon expulsion BTs 65.6% versus PTs 9.4% (OR 14.82 (7.95-27.65)).</p><p><strong>Limitations: </strong>The uneven distribution of respondents between countries and groups and reliance on self-reporting limits the generalizability of this exploratory study.</p><p><strong>Conclusions: </strong>BTs and PTs reported vast differences in the delivery of care for anorectal disorders. PTs use biofeedback less often and, when delivering biofeedback, use less manometry and more electromyography and ultrasound. Recognition of these differences may better inform referring providers and facilitate a more collaborative, standardized approach in the future.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70412"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648948","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":"Reply to \"Comment on 'Effects of a Supervised Telerehabilitation-Based Exercise Program on Constipation Symptoms and Quality of Life in Adults With Chronic Constipation: A Randomized Controlled Trial'\".","authors":"Ömer Faruk Can, Raziye Şavkın, Ufuk Kutluana","doi":"10.1111/nmo.70420","DOIUrl":"10.1111/nmo.70420","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70420"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707270","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":"Gastrointestinal Symptom-Specific Anxiety Predicts Positive SCOFF Screens in Adults With Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder and May Overestimate Eating Disorder Risk.","authors":"Reem Altuwayjiri, Lee David Martin, Natalia Zarate-Lopez, Chiara Vari, Rabia Topan, Qasim Aziz, Asma Fikree","doi":"10.1111/nmo.70417","DOIUrl":"10.1111/nmo.70417","url":null,"abstract":"<p><strong>Background/aims: </strong>The Sick, Control, One, Fat, Food (SCOFF) is a questionnaire that screens for risk of eating disorders. Some symptoms and psychological factors associated with disorders of gut-brain interaction (DGBI) may resemble the features of eating disorders, potentially overestimating the risk of eating disorders in populations with high DGBI prevalence such as those with Hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorder (hEDS/HSD). This study aimed to identify factors associated with screening positive on SCOFF among adult with hEDS/HSD to explore the questionnaire's suitability for this population.</p><p><strong>Methods: </strong>A secondary analysis of data from 670 adults with hEDS/HSD recruited from Ehlers-Danlos Support UK and tertiary Neurogastroenterology. χ² tests and logistic regression were used to examine factors associated with positive SCOFF screening result and positive responses to individual SCOFF questions.</p><p><strong>Results: </strong>DGBI presence did not predict a positive SCOFF screen. However, high gastrointestinal symptom-specific anxiety (GSA) (AOR: 3.19, p < 0.001), fear of aversive consequences from eating (AOR: 1.97, p = 0.013), and anxiety (AOR = 2.53, p < 0.001) were significant predictors. Notably, high GSA strongly predicted a positive response to questions two (Do you worry you have lost Control over how much you eat?) and five (Would you say that Food dominates your life?) (Q2 AOR = 2.58, p = 0.006, Q5 AOR = 5.98, p < 0.001).</p><p><strong>Conclusions: </strong>In hEDS/HSD, high GSA strongly predicted a positive SCOFF screening outcome, suggesting that SCOFF's questions might detect behaviors associated with worries around GI symptoms rather than an eating disorder. Positive screens in this population should be interpreted with caution and accompanied by GSA-focused assessments to enhance biopsychosocial management.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70417"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722136","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":"Transition of Care, the Missing Link Between Pediatric and Adult Care in Neurogastroenterology and Motility Disorders.","authors":"Max J Schmulson","doi":"10.1111/nmo.70414","DOIUrl":"10.1111/nmo.70414","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70414"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673878","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":"Applying Rome IV Criteria to AI Models: Lessons From Pediatric Practice.","authors":"Manuel Linares, Antonia Rovira, Miguel Saps","doi":"10.1111/nmo.70423","DOIUrl":"https://doi.org/10.1111/nmo.70423","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70423"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760182","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":"Comment on \"Effects of a Supervised Telerehabilitation-Based Exercise Program on Constipation Symptoms and Quality of Life in Adults With Chronic Constipation: A Randomized Controlled Trial\".","authors":"S Purna Chandra Shekhar, Siva Bali Reddy Katasani, Anjani Kumar","doi":"10.1111/nmo.70419","DOIUrl":"https://doi.org/10.1111/nmo.70419","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 8","pages":"e70419"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759518","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}