Neurogastroenterology and Motility最新文献

{"title":"The Acceptance, Commitment and COgnitive RemeDiation (ACCORD) Study: Can a Brief Online Cognitive Intervention Improve Outcomes in Patients With Esophageal Disease?","authors":"Madison Simons, Sara H Marchese, Alyse Bedell, Livia Guadagnoli, Sonia Zavala, Dustin A Carlson, Josie McGarva, John Pandolfino, Tiffany Taft","doi":"10.1111/nmo.70150","DOIUrl":"https://doi.org/10.1111/nmo.70150","url":null,"abstract":"<p><strong>Background: </strong>Cognitive and psychological inflexibility are two mental processes that influence how a person interprets and responds to esophageal symptoms. Patients with greater mental inflexibility are at risk for poorer outcomes. Brain-gut behavioral therapies (BGBT) are effective adjunctive treatments in many digestive diseases, with potential to improve mental flexibility. We piloted a brief intervention targeting cognitive and psychological inflexibility in patients with esophageal disease. Secondary aims included improving symptoms, mood, and quality of life (QoL) and reducing hypervigilance and symptom anxiety.</p><p><strong>Methods: </strong>Eighty adults newly diagnosed with achalasia, eosinophilic esophagitis, gastroesophageal reflux, or functional dysphagia from an esophageal clinic participated in a non-randomized, open-label trial. Acceptance, Commitment and COgnitive RemeDiation (ACCORD) was a novel 4-week BGBT administered via telemedicine. Feasibility and acceptability were assessed. Evaluations of esophageal symptom severity, cognitive and psychological flexibility, hypervigilance, symptom anxiety, and QoL occurred at baseline and posttreatment. Last observation carried forward was used for patients with incomplete 6-month data. Bayes Factor evaluated strength of support for study hypotheses.</p><p><strong>Key results: </strong>89.9% of participants completed ACCORD. Moderate to decisive gains occurred for some markers of cognitive flexibility and psychological flexibility, which may demonstrate a delayed but strong improvement. Participants demonstrated strong to decisive reductions in symptoms, symptom anxiety, and decisive increases in health-related quality of life (HRQoL).</p><p><strong>Conclusions and inferences: </strong>A novel, four-session BGBT targeting cognitive and psychological flexibility in patients with esophageal disease was feasible, acceptable, and shows potential to improve symptom severity, symptom anxiety, and HRQoL. ACCORD's use of telemedicine may mitigate access issues related to BGBTs. Further study is warranted.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70150"},"PeriodicalIF":2.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962528","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":"Reassessing the Risk of Esophageal Cancer in Achalasia Post-Therapy: Findings From a Large United States Multi-Centre Retrospective Propensity-Matched Cohort Study.","authors":"Varan Perananthan, Mouhand F Mohammed, Azizullah Beran, Osama Hamid, D Chamil Codipilly, Diana L Snyder, Cadman Leggett, Jeffrey A Alexander, Marcelo Vela, Karthik Ravi","doi":"10.1111/nmo.70151","DOIUrl":"https://doi.org/10.1111/nmo.70151","url":null,"abstract":"<p><strong>Background: </strong>Achalasia is associated with an increased risk of esophageal cancer; though reported incidence rates vary widely (0.4% to 9.2%) due to differences in demographics, follow-up duration, and diagnostic methods. This study evaluates the risk of esophageal cancer and Barrett's esophagus (BE) in achalasia using a large national database and a propensity-matched control cohort.</p><p><strong>Methods: </strong>Achalasia patients were identified utilizing the TriNetX database based on International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes for diagnostic procedures and lower esophageal sphincter (LES) directed therapies, including Heller myotomy, peroral endoscopic myotomy, and pneumatic dilation. A matched control group of celiac disease patients was used. A 1-year lead time was applied to exclude secondary malignant achalasia. Outcomes included the incidence of esophageal cancer and BE, with subgroup analysis in patients following therapy.</p><p><strong>Results: </strong>Among 7863 achalasia patients (mean age 58.0, 51.9% female), the esophageal cancer risk was significantly higher than control (risk ratio 2.87, 95% CI: 1.56-5.27, p < 0.001). The absolute risk was low, with 40 cases (0.51%) over a mean follow-up of 3.18 years. BE risk was also higher in achalasia (risk ratio 1.54, 95% CI: 1.24-1.90, p < 0.001), with 220 cases (2.80%). Subgroup analysis revealed no significant difference in BE risk between POEM and Heller myotomy (risk ratio 1.0, 95% CI: 0.42-2.40, p > 0.99).</p><p><strong>Discussion: </strong>The elevated cancer risk in achalasia over a short follow-up period warrants reconsideration of current endoscopic surveillance guidelines, despite the low absolute risk of esophageal cancer and BE.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70151"},"PeriodicalIF":2.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962513","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":"Cologastric Inhibition: Upper Gastrointestinal Dysfunction With Slow Colonic Transit.","authors":"Nada Abdelnaem, John Damianos, Michael Camilleri","doi":"10.1111/nmo.70145","DOIUrl":"https://doi.org/10.1111/nmo.70145","url":null,"abstract":"<p><strong>Introduction: </strong>Upper and lower gastrointestinal (GI) dysfunctions frequently coexist, potentially mediated by gastrocolonic or cologastric neural reflexes. This study aims to assess the prevalence of impaired gastric accommodation (GA) and delayed gastric emptying (GE) among patients with slow colonic transit (CT), dyssynergic defecation (DD), and to evaluate relationships between CT or DD with impaired GA and delayed GE.</p><p><strong>Methods: </strong>We reviewed records of 178 adult patients at Mayo Clinic (2005-2025) with documented slow CT or DD (respectively based on scintigraphy and high-resolution anorectal manometry [ARM] and balloon expulsion [BE]) who underwent ^99mTc-SPECT measurement of GA and scintigraphic GE of 320-kcal, 30% fat egg meal. Slow CT was defined by geometric center (GC) at 48 h < 2.1 for males and < 1.9 for females. Abnormal GA ratio was assessed as reduced < 2.62 or increased > 3.85, and delayed GE % < 75% at 4 h. Correlations were assessed using Spearman rank test.</p><p><strong>Results: </strong>Reduced GA was found in 23.7% with DD and 26.7% with slow CT, while increased GA was observed in 30.1% and 24.4%, respectively. Delayed GE was present in 20.5% DD patients and 35.6% slow CT patients. GC 48 h and 24 h were positively correlated with GE% 4 h (Rs = 0.279, and Rs = 0.294 respectively, both p < 0.001) suggesting slow CT retards GE. GC 48 h was moderately correlated with resting anal pressure (Rs = 0.259, p < 0.001) and negatively with the rectoanal pressure gradient (Rs = -0.166, p = 0.027). No significant correlations were observed between CT and GA.</p><p><strong>Conclusion: </strong>Slow CT is associated with slower GE, suggesting cologastric reflex inhibition, but not with GA. There is a high prevalence of impaired GA and delayed GE in slow CT and DD.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70145"},"PeriodicalIF":2.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962351","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":"A Randomized Waitlist-Controlled Trial of a Positive Psychology Intervention for Irritable Bowel Syndrome: The WISH Proof-of-Concept Trial.","authors":"Elizabeth N Madva, Jeff C Huffman, Crystal Castillo, Lauren E Harnedy, Tesiya Franklin, M Tim Song, Helen Burton-Murray, Brian Healy, Kyle Staller, Stephen Bartels, Braden Kuo, Laurie Keefer, Christopher M Celano","doi":"10.1111/nmo.70146","DOIUrl":"https://doi.org/10.1111/nmo.70146","url":null,"abstract":"<p><strong>Background: </strong>Though greater positive psychological well-being (PPWB) is associated with both improved physical and mental health in irritable bowel syndrome (IBS), it has not yet been explored as a primary target of brain-gut behavior therapies (BGBTs). Accordingly, we developed a novel, 9-week, phone-delivered BGBT to cultivate PPWB in IBS, and examined its feasibility, acceptability, and preliminary effects in a randomized waitlist-controlled proof-of-concept trial.</p><p><strong>Methods: </strong>Twenty-two adults with IBS meeting Rome IV criteria were randomized, stratified by gender and IBS subtype, to the intervention (n = 12) or waitlist-control (WLC; n = 10) groups. Participants completed specific positive psychology (PP) activities and phone sessions weekly with an interventionist. Intervention feasibility was assessed by the proportion of completed sessions, and acceptability by weekly ease/utility ratings. Exploratory psychological and health-related self-report measures were collected pre- and post-intervention.</p><p><strong>Key results: </strong>Participants (N = 22; ages 19-79; 55% female) completed 85% of sessions, above our a priori feasibility threshold of 65%. The intervention was rated as easy to complete (mean = 7.2/10, 95% CI: [6.70, 7.75]) and subjectively helpful (mean = 7.6/10, 95% CI: [7.14, 8.01]). Of the 18 participants who completed the intervention, 11 (61%) no longer met criteria for IBS post-intervention. Compared to the WLC, the intervention led to promising but nonsignificant improvements in exploratory clinical outcomes including IBS symptom severity, IBS health-related quality of life, and resilience, with effect sizes ranging from 0.1 to 0.7.</p><p><strong>Conclusions and inferences: </strong>This 9-week, phone-delivered intervention targeting greater PPWB in IBS was feasible, well-accepted, and associated with promising improvements in key IBS-related outcomes, highlighting the need for further testing.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70146"},"PeriodicalIF":2.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962370","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 Carbonated Water on Esophageal Motility in Different Body Positions: A Study Based on High-Resolution Manometry.","authors":"Kun-Ching Chou, Ping-Huei Tseng, Hsu-Heng Yen, Tung-Lung Wu, Siou-Ping Huang","doi":"10.1111/nmo.70149","DOIUrl":"https://doi.org/10.1111/nmo.70149","url":null,"abstract":"<p><strong>Background: </strong>Carbonated water has long been a popular beverage, but its impact on esophageal motility remains unclear. This study aimed to evaluate the effect of carbonated water using high-resolution esophageal manometry (HRM).</p><p><strong>Methods: </strong>A standard HRM protocol, incorporating measurements in both supine and upright positions per the updated Chicago Classification v4.0, along with additional carbonated water swallows, was performed in our motility laboratory. Ineffective esophageal motility (IEM) was diagnosed based on > 70% ineffective swallows or ≥ 50% failed peristalsis in the supine position and categorized as \"Supine IEM (SI)\". Patients who met the IEM diagnostic criteria in the upright position but not in the supine position were classified as \"Upright Ineffective (UI)\" for further comparison.</p><p><strong>Key results: </strong>A total of 62 patients were found to have ineffective motility, with 30 diagnosed with IEM (SI group) and 32 categorized as UI. Compared with the standard water swallows, carbonated water increased the median DCI in the upright position (130 vs. 208 mmHg·cm·s, p < 0.001). It also reduced the proportion of failed peristalsis (85% vs. 65%, p < 0.01) and ineffective swallows (94% vs. 69%, p < 0.001) during upright swallows. The number of ineffective motility cases was reduced from 30 to 26 in the SI group, indicating a 13% improvement, and from 32 to 22 in the UI group, representing a 31% improvement (p < 0.01).</p><p><strong>Conclusions and inferences: </strong>Carbonated water significantly improves esophageal motility, particularly in the upright position. This effect is more pronounced in patients with upright ineffective motility.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70149"},"PeriodicalIF":2.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962333","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":"Exploring Associations of Different Types of Childhood Trauma With Symptomatology in Irritable Bowel Syndrome.","authors":"Tetyana Bureychak, Jenny Sjödahl, Nawroz Barazanji, Gustav Orell, Olivia Book, Rozalyn Simon, Olga Bednarska, Adriane Icenhour, Susanna Walter","doi":"10.1111/nmo.70148","DOIUrl":"https://doi.org/10.1111/nmo.70148","url":null,"abstract":"<p><strong>Background: </strong>The connection between childhood trauma and irritable bowel syndrome (IBS) is well documented. However, knowledge regarding distinct associations between different subtypes of childhood trauma and both intestinal and extraintestinal symptoms is widely lacking. The current cross-sectional study aimed to elucidate the impact of different types of childhood trauma on IBS symptomatology.</p><p><strong>Methods: </strong>In 169 women with moderate to severe IBS and 39 healthy women (HCs), childhood trauma was assessed using the Childhood Trauma Questionnaire. Gastrointestinal, extraintestinal, and psychological symptoms were evaluated via symptom diaries and questionnaires.</p><p><strong>Key results: </strong>The overall prevalence of childhood trauma was significantly higher in women with IBS compared to HCs, with odds ratio (OR) 3.41 (95% CI, 1.35-8.60, p = 0.009) and with the highest rates observed for emotional and sexual abuse. Overall childhood trauma was positively associated with symptom severity (r = 0.305, p = 0.016). Among trauma types, emotional abuse was the strongest predictor of IBS, with a 6-fold increased odds of disorder, OR 6.69 (95% CI, 1.97-22.68, p = 0.002). Women with IBS and a history of emotional abuse reported longer episodes of abdominal pain, more defecation urgency, and higher levels of anxiety and depression.</p><p><strong>Conclusions: </strong>Our findings support the significant role of childhood trauma in IBS pathology and increased symptom burden. They further indicate the specific relevance of emotional abuse influencing not only gastrointestinal symptoms but also extraintestinal and psychological complaints. These findings may help contribute to the identification of a distinct phenotype of IBS patients with a history of traumatic emotional abuse during childhood.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70148"},"PeriodicalIF":2.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962343","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":"pHoenix Score: Validation of a Novel Metric to Improve Diagnosis of Gastroesophageal Reflux Disease Using 24-Hour pH Monitoring.","authors":"Andrés R Latorre-Rodríguez, Sai Pidathala, Ross M Bremner, Sumeet K Mittal","doi":"10.1111/nmo.70147","DOIUrl":"https://doi.org/10.1111/nmo.70147","url":null,"abstract":"<p><strong>Background: </strong>The pHoenix score (pHx-S) is a simple pH-monitoring metric developed to improve gastroesophageal reflux disease (GERD) diagnosis by integrating upright and supine acid exposure time (AET) to reduce \"inconclusive\" cases compared to AET alone. Since the pHx-S was derived from 48-h wireless studies, we aimed to validate its use in transnasal catheter-based 24-h pH monitoring.</p><p><strong>Methods: </strong>We conducted a single-center, cross-sectional study of patients undergoing 24-h pH monitoring for suspected GERD (2016-2024). Diagnostic cutoffs for the pHx-S were ≤ 7.06 (normal), 7.06-8.45 (inconclusive), and ≥ 8.45 (pathological). Its predictive performance was validated against the DeMeester score (DMS) and compared to total AET. We also evaluated the impact of meal period inclusion/exclusion on the DMS, AET, and pHx-S.</p><p><strong>Results: </strong>Of 318 individuals (199 [62.6%] women; median age, 58 [46-67] years), 170 (53.5%) presented with pathological acid exposure based on DMS. Using total AET alone, 150 (47.2%), 35 (11%), and 133 (41.8%) were classified as normal, inconclusive, and pathological, respectively. Using the pHx-S, 148 cases (46.5%) were classified as normal and 155 (48.7%) as pathological. Notably, only 15 cases (4.7%) were considered borderline using the pHx-S, a 57.1% reduction (p = 0.015) compared to total AET. Sensitivity/specificity of the pHx-S were 97.6%/97.3% (lower threshold) and 91.2%/100% (upper threshold). Inclusion/exclusion of meals had minimal impact on diagnosis by DMS, AET, or pHx-S.</p><p><strong>Conclusions: </strong>The pHx-S improves GERD diagnosis by reducing inconclusive cases, simplifying the calculation, accounting for the disease spectrum, and eliminating the need for meal recording compliance with comparable accuracy to the DMS.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70147"},"PeriodicalIF":2.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962325","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":"Phosphorylation of Pyruvate Dehydrogenase as a Marker of Neuronal Inactivity in the Enteric Nervous System.","authors":"Eve Wemelle, Jonathon L McClain, Brian D Gulbransen","doi":"10.1111/nmo.70135","DOIUrl":"https://doi.org/10.1111/nmo.70135","url":null,"abstract":"<p><strong>Background: </strong>The enteric nervous system (ENS) regulates essential gut functions through interactions between neurons and glial cells. While tools for studying neuronal activation are well-established, methods for tracking neuronal inactivation remain underdeveloped. Phosphorylated pyruvate dehydrogenase (pPDH) has emerged as a marker of neuronal inactivity in the brain. This study investigates whether pPDH can similarly serve as a reliable marker of neuronal inactivity in the ENS.</p><p><strong>Methods: </strong>Whole-mount preparations of the colonic myenteric plexus from mice were treated with veratridine (neuronal activator) or tetrodotoxin (neuronal inhibitor). Immunohistochemistry was used to label neurons with HuC/D and quantify pPDH (inactivity marker) and pERK (activation marker) labelling. Fluorescent signals were analyzed to assess changes in marker expression under different conditions.</p><p><strong>Results: </strong>TTX treatment increased pPDH labelling, as evidenced by higher fluorescence intensity and a greater percentage of pPDH-positive neurons. In contrast, veratridine reduced pPDH levels, indicating its sensitivity to neuronal activity changes. Together, pPDH and pERK provide reliable measures of neuronal inactivation and activation, respectively, in the ENS.</p><p><strong>Conclusions: </strong>This study establishes pPDH as a robust marker for neuronal inactivation in the ENS, complementing existing activation markers like pERK. These findings provide a novel framework for exploring neuron-glia communication and neuronal dynamics in the gut.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70135"},"PeriodicalIF":2.9,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862263","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":"Immunization With Bovine Milk Casein Results in Enteric Nervous System Pathology in a Mouse Model of Neuroinflammation.","authors":"Rittika Chunder, Alicia Weier, Young An, Angelika Zoons, Maik Hintze, Stefanie Kuerten","doi":"10.1111/nmo.70142","DOIUrl":"https://doi.org/10.1111/nmo.70142","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system (CNS) with evidence of autoimmune attack also on the enteric nervous system (ENS). The role of different dietary antigens, including bovine milk proteins, in the exacerbation of MS symptoms has previously been discussed.</p><p><strong>Methods: </strong>In a mouse model of neuroinflammation, we characterized the extent of ENS pathology in animals that were immunized with different bovine milk antigens using electron microscopy, immunohistochemistry, molecular biology, and cell culture as key methods.</p><p><strong>Results: </strong>Our data demonstrate that immunization of mice with bovine milk casein resulted in ENS pathology, which is in line with our previous findings where casein-immunized mice also exhibited demyelination in the CNS. Furthermore, development of ENS pathology was most likely due to a combination of cellular and humoral factors, as confirmed by our observation of CD3⁺ T cell infiltration in the tunica muscularis and binding of serum antibodies from casein-immunized mice to glial cells in the myenteric plexus.</p><p><strong>Conclusion: </strong>The findings presented in this paper reflect that exposure to bovine casein can result in axolysis in the myenteric plexus possibly as a result of molecular mimicry and antibody cross-reactivity between casein and antigen(s) expressed by the ENS.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70142"},"PeriodicalIF":2.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855884","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":"Electroacupuncture Improves Anorectal Function in Neurogenic Fecal Incontinence Rats, Related to Reversing Anal Sphincter Atrophy and Enhancing Muscle Satellite Cell Activity.","authors":"Jinchao He, Qunbo Wan, Liqing Du, Qin Qin, Ling Zhao, Qingjun Dong","doi":"10.1111/nmo.70138","DOIUrl":"https://doi.org/10.1111/nmo.70138","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic fecal incontinence (NFI) is a disorder of anal dysfunction caused by nerve damage. Electroacupuncture (EA), grounded in Traditional Chinese Medicine (TCM) theory, has demonstrated efficacy in treating various degenerative disorders and is extensively utilized in the clinical management of neurogenic FI. The proliferation and differentiation of muscle satellite cells (SCs) are crucial in the onset and progression of this condition. However, the specific mechanism of electroacupuncture in treating neurogenic fecal incontinence is not yet clear. This study sought to determine whether EA could enhance anal function in rats with neurogenic FI and to elucidate its mechanisms of action.</p><p><strong>Methods: </strong>We observed the effect of electroacupuncture on anorectal function in rats with neurogenic fecal incontinence and its mechanism of action.</p><p><strong>Key results: </strong>The morphology and arrangement of anal sphincter muscle fibers were altered due to pudendal nerve injury. The expression levels of two atrophy markers, Muscle-specific RING finger protein 1 (MuRF-1) and Atrogin-1, were elevated in the anal sphincter muscles, and shifts were seen from slow-twitch to fast-twitch muscle fibers. Post EA treatment, the expression levels of atrophy markers were reversed; the proportion of slow-twitch fibers in the muscles increased, and the expressions of Pax3 and Myod1, which had decreased 3 weeks post-injury, significantly increased and gradually normalized.</p><p><strong>Conclusions & inferences: </strong>These results indicate that EA effectively ameliorates anal function in rats with neurogenic FI, primarily through mechanisms that involve the activation of muscle SCs.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70138"},"PeriodicalIF":2.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817206","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}