Neurogastroenterology and Motility最新文献

{"title":"Genome-Wide DNA Methylation Identifies Potential Disease-Specific Biomarkers and Pathophysiologic Mechanisms in Irritable Bowel Syndrome, Inflammatory Bowel Disease, and Celiac Disease.","authors":"Swapna Mahurkar-Joshi, Mike Thompson, Elizza Villarruel, James D Lewis, Lisa D Lin, Mary Farid, Hamed Nayeb-Hashemi, Tina Storage, Guy A Weiss, Berkeley N Limketkai, Jenny S Sauk, Emeran A Mayer, Lin Chang","doi":"10.1111/nmo.14980","DOIUrl":"10.1111/nmo.14980","url":null,"abstract":"<p><strong>Background and aims: </strong>Irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and celiac disease (CeD) present with similar gastrointestinal (GI) symptoms. DNA methylation-based biomarkers have not been investigated as diagnostic biomarkers to classify these disorders. We aimed to study DNA methylation profiles of IBS, IBD, CeD, and healthy controls (HC), develop machine learning-based classifiers, and identify associated gene ontology (GO) terms.</p><p><strong>Methods: </strong>Genome-wide DNA methylation of peripheral blood mononuclear cells from 315 patients with IBS, IBD, CeD, and HC was measured using Illumina's 450K or EPIC arrays. A methylation dataset on 304 IBD and HC samples was used for external validation. Differential methylation was measured using general linear models. Classifiers were developed using penalized generalized linear models using double cross-validation controlling for confounders. Functional enrichment was assessed using GO.</p><p><strong>Results: </strong>Three hundred and fifteen participants (148 IBS, 47 IBD, 34 CeD, and 86 HC) had DNA methylation data. IBS-IBD and IBD-CeD showed the highest number of differentially methylated CpG sites followed by IBD-HC, CeD-HC, and IBS-HC. IBS-associated genes were enriched in cell adhesion and neuronal pathways, while IBD- and CeD-associated markers were enriched in inflammation and MHC class II pathways, respectively (p < 0.05). Classification performances assessed using area under the receiver operating characteristic curves (AUC) for IBS-IBD, IBS-CeD, and IBD-CeD were 0.80 (95% CI = 0.7-0.87, p = 6.75E-10), 0.78 (95% CI = 0.68-0.86, p = 4.57E-10), and 0.73 (95% CI = 0.62-0.83, p = 0.03), respectively. The performance of IBD-HC was successfully validated using external data (AUC = 0.74 [95% CI = 68-0.80, p < 0.001]).</p><p><strong>Conclusions: </strong>Blood-based DNA methylation biomarkers can potentially distinguish chronic GI disorders that present with similar symptoms. GO suggested functional significance of the classifiers in disease-specific pathology.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14980"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824373","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":"Sex Differences, Menses-Related Symptoms and Menopause in Disorders of Gut-Brain Interaction.","authors":"Rachel P Sarnoff, Johann P Hreinsson, Joanna Kim, Ami D Sperber, Olafur S Palsson, Shrikant I Bangdiwala, Lin Chang","doi":"10.1111/nmo.14977","DOIUrl":"10.1111/nmo.14977","url":null,"abstract":"<p><strong>Background: </strong>Disorders of gut-brain interaction (DGBI) predominate in women, but little is known about sex differences in menses-related or menopause symptoms.</p><p><strong>Methods: </strong>Using data from the Rome Foundation Global Epidemiology Survey, we assessed Rome IV DGBI symptoms in individuals in 26 countries who met criteria for ≥ 1 of 5 DGBI: irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional diarrhea (FDr), or functional bloating (FB). Participants included pre- and post-menopausal women with DGBI and age-matched men. Odds ratios estimated sex and age differences for symptom by sex or pre- vs. post-menopause in logistic regression; standardized mean difference (SMD) provided effect sizes.</p><p><strong>Key results: </strong>14,570 participants met criteria for ≥ 1 of the 5 DGBI. Women exceeded men in most symptoms. In FD, women stopped eating due to early satiety more than men (11.1 vs. 8.9 days/month, SMD 0.21). Symptoms were generally increased in premenopausal women and younger men compared to older counterparts; however, only premenopausal IBS, FD, and FC women reported increased constipation-associated symptoms. Compared to premenopausal women, postmenopausal women had increased accidental stool leakage in IBS and FDr, and increased digital manual maneuvers in FC (18% vs. 25% frequency, SMD -0.25). IBS and FD had the most menses-associated symptoms.</p><p><strong>Conclusions and inferences: </strong>Women had higher symptom frequency across the 5 DGBI compared to men. Our findings suggest that premenopausal women have greater visceral perception than postmenopausal women, although increased outlet symptoms in postmenopausal women indicate greater anorectal/pelvic dysfunction. While age alone has some influence on symptoms, female sex hormones may also increase visceral perception.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14977"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922389","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":"Prospective Evaluation of Autonomic Function and Intestinal Blood Flow in Health and Irritable Bowel Syndrome Shows Differences Limited to Patients With Constipation Predominance.","authors":"Yoav Mazor, Margaret M Leach, Michael Jones, Anastasia Ejova, Charles Fisher, David Joffe, Paul Roach, John Kellow, Allison Malcolm","doi":"10.1111/nmo.14975","DOIUrl":"10.1111/nmo.14975","url":null,"abstract":"<p><strong>Background: </strong>Autonomic dysfunction may contribute to symptom generation in irritable bowel syndrome (IBS), possibly driven by psychological morbidity and activation of the hypothalamic-pituitary-adrenal axis. Previous data are conflicting, perhaps due to lack of accounting for differential bowel patterns in IBS (constipation vs. diarrhea) or by diverse methodologies used to measure autonomic function. Our aim was to determine if autonomic response differed between IBS subtypes and healthy controls.</p><p><strong>Methods: </strong>Forty female volunteers (20 IBS and 20 healthy) underwent comprehensive autonomic testing, fasting and postprandially, and in response to cold pressor and deep breathing challenges. Pulse transit time (PTT) and ultrasound measurements of intestinal blood flow were used as measures of systemic and local autonomic function, respectively. Outcomes were adjusted for baseline psychological comorbidities and gastric emptying (measured concurrently with scintigraphy).</p><p><strong>Key results: </strong>Findings, confined to IBS patients with predominant constipation (IBS-C), included (1) lower fasting and a trend to larger postprandial increase in superior mesenteric artery end-diastolic velocity; (2) lower fasting PTT, suggesting higher sympathetic tone, but no difference in postprandial PTT change; and (3) attenuated increase in postprandial aortic peak systolic velocity. Response to systemic autonomic challenges did not differ between IBS and health. Some psychological factors mediated differences between groups in the fasting, but not postprandial, state.</p><p><strong>Conclusions and inferences: </strong>IBS-C patients display systemic and local autonomic imbalance providing some support for recent therapies aimed at modulating autonomic state specifically in this patient group (e.g., acustimulation).</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14975"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770744","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":"Evaluation of Perceived Competence and Satisfaction in Neurogastroenterology and Motility Training During the Gastroenterology Fellowship in Spain.","authors":"Luis G Alcala-Gonzalez, Javier Alcedo, Cecilio Santander, José Francisco Suárez, Jordi Serra","doi":"10.1111/nmo.14985","DOIUrl":"10.1111/nmo.14985","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated the level of achievement of the published recommendations of the European and American neurogastroenterology and motility (NGM) Societies, on the competence in managing NGM disorders in a European Country with regulated gastroenterology training program.</p><p><strong>Methods: </strong>We conducted a nationwide survey to gastroenterologists in Spain. Information regarding demographics, training center characteristics, NGM training, self-reported interest, satisfaction with the Tier 1 skills recommended by the ANMS-ESNM, and perceived competence in the diagnosis and management of diseases in the spectrum of NGM was obtained.</p><p><strong>Results: </strong>Surveys of 222 participants were analyzed (age 31 ± 3 years, 68% female, 77% specialists, 23% residents). During GI training, the average time spent on NGM was 4 (IQR 2-8) weeks, and 14% of participants reported they did not have any (0 weeks total) specific time dedicated to NGM in their training center. Ninety-two (41%) participants reported low satisfaction in the NGM skills obtained during training. There was a disparity in the skills acquired, being greatest for gastroesophageal reflux disease and lowest for colonic inertia (97% and 19% confident, respectively). Multiple regression analysis showed that the weeks of specific training in NGM was an independent factor associated with perceived satisfaction in the skills obtained (IC 95% 1.8-2.9, p < 0.001).</p><p><strong>Conclusion: </strong>Our data reveal a relevant deficit in training on NGM during gastroenterology fellowships and highlight the urgent need to extend and standardize the time allocated to learning NGM in the training programs, as training time correlates with satisfaction in the skills obtained.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14985"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907437","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":"Functional Lumen Imaging Probe Panometry Findings in Obese Patient Populations.","authors":"Anh D Nguyen, Anjali Bhatt, Ambreen Merchant, Daisha J Cipher, Ashton Ellison, Chanakyaram A Reddy, Dan Davis, Rhonda F Souza, Vani J A Konda, Stuart J Spechler","doi":"10.1111/nmo.14979","DOIUrl":"10.1111/nmo.14979","url":null,"abstract":"<p><strong>Background: </strong>Few data are available on functional lumen imaging probe (FLIP) findings specifically in obese patients. We aimed to evaluate FLIP metrics in obese patients who had not undergone bariatric surgery and in those who had sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). We also sought correlations of FLIP abnormalities with esophageal symptoms and HRM findings.</p><p><strong>Methods: </strong>We identified obese patients who had FLIP performed during workups either for a first bariatric operation (surgery-naïve patients), or for surgical revision of SG and RYGB operations that resulted in inadequate weight loss. We recorded esophageal symptoms, HRM data, and FLIP metrics.</p><p><strong>Key results: </strong>We identified 228 eligible patients (87 surgery-naïve, 90 SG, 51 RYGB). Dysphagia and chest pain were frequent symptoms in all groups. Median EGJ diameter and EGJ-DI were similar in surgery-naïve and postsurgical patients, but subgroup analysis of symptomatic patients with no HRM diagnosis revealed reduced EGJ opening in 12%. Abnormal FLIP response patterns were common (69% surgery-naïve, 74% SG, 65% RYGB) with higher ACR rates in SG (46.7% vs. 29.9%, p = 0.026) and RYGB (41.2% vs. 29.9%, p = 0.189) and lower SRCR rates in SG (11.1% vs. 24.1%, p = 0.021) and RYGB (5.9% vs. 24.1%, p = 0.006) compared to surgically naïve patients. There were no significant associations between FLIP contractile response patterns and symptoms or HRM diagnoses.</p><p><strong>Conclusions: </strong>Dysphagia and chest pain are common in obese patients, and most obese patients (with or without bariatric surgery) have FLIP contractile response abnormalities that do not correlate with HRM findings. FLIP findings appear to be especially valuable in obese patients who have esophageal symptoms with no HRM diagnosis.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14979"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794972","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":"Variation of Stomach Shapes in Gastric Emptying Scintigraphy: Correlation With Gastric Emptying Results, Body Weight, and Symptoms.","authors":"Susie O Lee, Remy Arwani, Shelby McNeilly, Samantha Kunkel, Simin Dadparvar, Alan H Maurer, Henry P Parkman","doi":"10.1111/nmo.14968","DOIUrl":"10.1111/nmo.14968","url":null,"abstract":"<p><strong>Background: </strong>Although different gastric shapes are encountered in gastric emptying scintigraphy (GES), it is not known whether gastric shape is related to gastric emptying (GE) or symptoms.</p><p><strong>Aim: </strong>To investigate different stomach shapes observed during GES and examine their associations with GE, body weight, and gastrointestinal (GI) symptoms.</p><p><strong>Methods: </strong>This was a retrospective review of GES studies performed at our institution. Patients with prior gastric surgery were excluded. A classification of gastric shapes included: crescentic, J-shaped, reversed-L, cylindrical, and bag-like. Gastric shapes were correlated with GE, BMI, and GI symptoms using PAGI-SYM.</p><p><strong>Results: </strong>397 GES studies were reviewed (317 females, age 40.0 ± 20.3 years, BMI 27.8 ± 13.8 kg/m²). Gastric shapes were: 41.8% crescentic/comma-shaped, 34.0% J-shaped, 19.9% reversed L-shape, 2.8% cylindrical, and 1.5% bag-like. BMI was highest in crescentic/comma-shaped stomachs (30.1 ± 12.4 kg/m²) and lowest in bag-like stomachs (25.2 ± 9.9 kg/m²; p = 0.022). Delayed GE was most pronounced in bag-like stomachs (34.4 ± 33.1% retention at 4 h) and lowest in reversed-L shape (10.3 ± 15.6% retention at 4 h; p = 0.008). Regurgitation severity was greatest in bag-like stomachs (2.2 ± 1.5) compared to milder symptoms in reversed-L shape (1.3 ± 1.4; p = 0.029). Heartburn severity was increased in bag-like stomachs (2.3 ± 1.6) while patients with cylindrical stomachs reported least heartburn severity (1.1 ± 1.3; p = 0.11).</p><p><strong>Conclusions: </strong>A classification system based on five gastric shapes observed during GES showed that crescent-shaped stomach was the most common shape and correlated with higher BMIs. Delayed GE was most pronounced in bag-like stomachs and lowest in reversed-L stomachs. Regurgitation and heartburn severity were greatest in bag-like stomachs with milder symptoms in reversed-L stomachs. Thus, gastric shape during GES is associated with gastric emptying, BMI, and symptom severity.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14968"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716312","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":"Cardiac Vagal Efficiency Is Enhanced by Percutaneous Auricular Neurostimulation in Adolescents With Nausea: Moderation by Antidepressant Drug Exposure.","authors":"Jacek Kolacz, Olivia K Roath, Gregory F Lewis, Katja Karrento","doi":"10.1111/nmo.15007","DOIUrl":"https://doi.org/10.1111/nmo.15007","url":null,"abstract":"<p><strong>Objectives: </strong>Percutaneous electrical nerve field stimulation (PENFS) is an effective treatment for disorders of gut-brain interaction (DGBI), proposed to influence vagal pathways. Cardiac metrics such as respiratory sinus arrythmia (RSA) and vagal efficiency (VE) can noninvasively assess parasympathetic output. Commonly used antidepressant drugs inhibit vagal signaling and may interfere with PENFS. This study examined immediate effects of active compared to sham PENFS on cardiac vagal function in adolescents with chronic nausea with and without concurrent drug therapy.</p><p><strong>Materials and methods: </strong>Participants (n = 84) were randomized to active (3.2 V, 1-10 Hz) or sham PENFS within an 8-week prospective, double-blind clinical trial. Subjects underwent posture challenges to elicit a vagal response before and after PENFS device placement mid-way through the study. RSA, mean heart period (HP), and VE were calculated from electrocardiogram recordings. Exposure to antidepressant drugs was recorded.</p><p><strong>Results: </strong>The mean (SD) age was 15.61 (2.07) years (83% female). Fifty percent were treated with antidepressants. PENFS neurostimulation enhanced VE in patients without antidepressant exposure (mean increase after PENFS stimulation =7.56 [95% CI: 0.26, 14.86], d = 0.30, 17% increase) but not in those treated with antidepressants (mean change = -5.30 [95% CI:-14.28, 3.68]). Sham PENFS did not produce significant VE changes regardless of medication use (both p > 0.40). There were no significant effects on RSA or HP.</p><p><strong>Conclusions: </strong>Acute enhancement of cardiac VE is demonstrated with PENFS in patients not exposed to chronic antidepressant drug therapy. Findings indicate that VE is a sensitive metric for rapid assessment of PENFS effects but raise concern for possible interaction or interference by standard of care medications.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov #: 1064187-2.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e15007"},"PeriodicalIF":3.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066886","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":"Serotonin Receptors Polymorphisms Are Associated With Cyclic Vomiting Syndrome.","authors":"Agata Binienda, Maciej Salaga, Milan Patel, Jakub Włodarczyk, Jakub Fichna, Thangam Venkatesan","doi":"10.1111/nmo.15012","DOIUrl":"https://doi.org/10.1111/nmo.15012","url":null,"abstract":"<p><strong>Background: </strong>Cyclic vomiting syndrome (CVS) is a disorder characterized by sudden, recurrent episodes of severe nausea and vomiting. The pathophysiology of CVS is not known but genetic factors that regulate emetic neurocircuitry have been proposed. The aim of this study was to investigate whether different variations in genes encoding serotonin receptors (HTRs) are associated with susceptibility to CVS and/or CVS symptoms.</p><p><strong>Methods: </strong>This case-control study included 70 patients with CVS:16 male and 54 female, and 2504 healthy controls from the 1000 Genomes Project database. Single-nucleotide polymorphisms (SNPs) in genes encoding serotonin receptors (HTR1B, HTR1D, HTR3B and HTR3C) and correlations between SNPs and the symptoms of CVS were determined.</p><p><strong>Key results: </strong>Our study discovered that patients with GG, AA and GG genotypes of HTR1B/D rs6296, rs6298 and rs6300, respectively, as well as the CC genotype of HTR3B rs176744 are associated with an increased risk (p < 0.001), whereas allele C in rs3788987 (HTR3B, p < 0.01) and allele A in rs6766410 (HTR3C, p < 0.05) were associated with a decreased risk of CVS. In addition, statistical analysis indicated that CVS patients with GA or AA genotypes of HTR1D rs676643 gene have a seven-fold increase in risk of depression compared to patients with GG genotype (p < 0.01).</p><p><strong>Conclusions and inferences: </strong>Our study revealed for the first time that variations in 5-HTR genes may contribute to CVS susceptibility and CVS-related symptoms.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e15012"},"PeriodicalIF":3.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066955","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":"Utility of a ¹³C-Spirulina Stable Isotope Gastric Emptying Breath Test in Diabetes Mellitus.","authors":"Revati Varma, Catherine E Williams, Ethan S McClain, Kent R Bailey, Tamas Ordog, Adil E Bharucha","doi":"10.1111/nmo.15008","DOIUrl":"10.1111/nmo.15008","url":null,"abstract":"<p><strong>Background: </strong>The carbon-13 spirulina gastric emptying breath test (GEBT) is approved to identify delayed, but not accelerated, gastric emptying (GE). We compared the utility of the GEBT to scintigraphy for diagnosing abnormal GE in patients with diabetes mellitus.</p><p><strong>Methods: </strong>Twenty-eight patients with diabetes ate a 230-kcal test meal labeled with technetium 99 m and ¹³C-spirulina, after which 10 scintigraphic images and breath samples (baseline, 15, 30, 45, 60, 90, 120, 150, 180, 210, and 240 min) were collected on 2 occasions 1 week apart. We assessed the accuracy of ¹³C-spirulina GEBT excretion rate (percent dose multiplied by 1000 [kPCD] min^-1) values to predict scintigraphic half-life and distinguish between normal, delayed, and accelerated GE and the intraindividual reproducibility of the GEBT.</p><p><strong>Key results: </strong>Scintigraphy revealed normal, delayed, and accelerated GE, respectively, in 17 (30%), 29 (52%), and 10 (18%) test results. GE T½ values measured with scintigraphy and GEBT were highly concordant within individuals; the intraindividual reproducibility was 34% (scintigraphy) and 15% (GEBT). Compared to current criteria, the kPCD150 (150 min) and kPCD180 values provided equally sensitive (90%) and more specific (81% vs. 67%) approach for distinguishing between delayed versus normal/accelerated GE. A new metric (kPCD60-kPCD15 min) was 90% sensitive and 83% specific for distinguishing between accelerated versus normal/delayed GE. These findings were used to create nomograms and an algorithm for interpreting GEBT results.</p><p><strong>Conclusions and inferences: </strong>Among patients with poorly controlled diabetes, the ¹³C-spirulina GEBT can accurately and precisely assess GE and effectively distinguish between normal, delayed, and accelerated GE.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e15008"},"PeriodicalIF":3.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053034","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 the Complex Interplay Between Ineffective Esophageal Motility and Reflux Burden.","authors":"Lorenzo Marchetti, Mentore Ribolsi","doi":"10.1111/nmo.15010","DOIUrl":"https://doi.org/10.1111/nmo.15010","url":null,"abstract":"<p><p>The role of esophageal motility in determining GERD severity has been widely explored. Kamboj et al. show that IEM diagnosis is associated with increased GERD severity. We aim to further highlight the impact of IEM in reflux burden, as demonstrated by several recent studies in patients with both typical and atypical symptoms.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e15010"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053032","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}