Neurogastroenterology & Motility

Cover image for Vol. 29 Issue 1

Early View (Online Version of Record published before inclusion in an issue)

Edited By: Jim Galligan, Arjan Bredenoord and Stephen Vanner, Associate Editor(s): Maura Corsetti and Kirsteen Browning, Podcast Editor: Adam Farmer

Impact Factor: 3.31

ISI Journal Citation Reports © Ranking: 2015: 26/79 (Gastroenterology & Hepatology); 57/193 (Clinical Neurology); 92/256 (Neurosciences)

Online ISSN: 1365-2982

VIEW

  1. 1 - 75
  1. ORIGINAL ARTICLES

    1. Brain networks associated with cognitive and hedonic responses to a meal

      T. Pribic, L. Kilpatrick, B. Ciccantelli, C. Malagelada, A. Accarino, A. Rovira, D. Pareto, E. Mayer and F. Azpiroz

      Version of Record online: 23 JAN 2017 | DOI: 10.1111/nmo.13031

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      Meal ingestion induces cognitive and hedonic sensations, and our aim was to identify brain networks related to these sensations. Perceptual and emotional responses to food intake are related to brain connectivity in defined functional networks. Brain imaging may provide objective biomarkers of subjective effects of meal ingestion.

  2. Original Articles

    1. Effect of methylnaltrexone and naloxone on esophageal motor function in man

      E. Scarpellini, A. Pauwels, R. Vos, N. Rommel and J. Tack

      Version of Record online: 22 JAN 2017 | DOI: 10.1111/nmo.12938

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      Influence of methylnaltrexone and naloxone on upper esophageal sphincter resting pressure and relaxation.

  3. ORIGINAL ARTICLES

    1. Methods of anorectal manometry vary widely in clinical practice: Results from an international survey

      E. V. Carrington, H. Heinrich, C. H. Knowles, S. S. Rao, M. Fox, S. M. Scott and The International Anorectal Physiology Working Party Group (IAPWG)

      Version of Record online: 18 JAN 2017 | DOI: 10.1111/nmo.13016

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      This survey shows that there is significant discrepancy in methods for data acquisition, analysis, and interpretation of ARM. This is likely to impact clinical interpretation, transfer of data between institutions, and research collaboration. There is a need for expert international co-operation to standardize ARM.

    2. A baseline impedance analysis in neurologically impaired children: A potent parameter for estimating the condition of the esophageal mucosa

      S. Fukahori, M. Yagi, S. Ishii, K. Asagiri, N. Saikusa, N. Hashizume, M. Yoshida, D. Masui, N. Komatsuzaki, N. Higashidate, H. Nakahara and Y. Tanaka

      Version of Record online: 13 JAN 2017 | DOI: 10.1111/nmo.13012

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      The present study suggested that NI children with reflux esophagitis were likely to suffer mucosal damage up to the proximal esophagus and cut-off BI values may help estimate the presence of reflux esophagitis. BI is a potent parameter reflecting the esophageal mucosal damage in NI children who have difficulty in undergoing endoscopic examinations.

  4. REVIEW ARTICLES

    1. Gastrointestinal disorders in joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type: a review for the gastroenterologist

      A. B. Beckers, D. Keszthelyi, A. Fikree, L. Vork, A. Masclee, A. D. Farmer and Q. Aziz

      Version of Record online: 13 JAN 2017 | DOI: 10.1111/nmo.13013

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      In this review article, we examine the nature of gastrointestinal symptoms and their underlying pathophysiology in JHS/EDS-HT and consider the clinical implications of the diagnosis and treatment of this syndrome for practicing clinicians in gastroenterology.

    2. Established and emerging methods for assessment of small and large intestinal motility

      D. Grønlund, J. L. Poulsen, T. H. Sandberg, A. E. Olesen, A. Madzak, K. Krogh, J. B. Frøkjær and A. M. Drewes

      Version of Record online: 13 JAN 2017 | DOI: 10.1111/nmo.13008

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      This review outlines well-established and emerging methods to evaluate small bowel and colonic motility in clinical settings and in research.

  5. Original Articles

    1. Objectively diagnosing rumination syndrome in children using esophageal pH-impedance and manometry

      M. M. J. Singendonk, J. M. Oors, A. J. Bredenoord, T. I. Omari, R. J. van der Pol, M. J. Smits, M. A. Benninga and M. P. van Wijk

      Version of Record online: 12 JAN 2017 | DOI: 10.1111/nmo.12996

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      Rumination syndrome is characterized by recurrent regurgitation of recently ingested food into the mouth. Differentiation with other diagnoses and gastroesophageal reflux disease (GERD), in particular, is difficult. Recently, objective pH-impedance (pH-MII) and manometry criteria were proposed for adults. We showed that rumination patterns in children are comparable to those seen in adults, albeit with lower gastric pressure increase. We propose that the diagnosis of rumination syndrome in children without evidence of GERD should be based on demonstration of retrograde bolus flow extending to the proximal esophagus, closely related to a gastric pressure increase of > 25 mmHg.

  6. ORIGINAL ARTICLES

    1. Diabetic and idiopathic gastroparesis is associated with loss of CD206-positive macrophages in the gastric antrum

      M. Grover, C. E. Bernard, P. J. Pasricha, H. P. Parkman, S. J. Gibbons, J. Tonascia, K. L. Koch, R. W. McCallum, I. Sarosiek, W. L. Hasler, L. A. B. Nguyen, T. L. Abell, W. J. Snape, M. L. Kendrick, T. A. Kellogg, T. J. McKenzie, F. A. Hamilton, G. Farrugia and NIDDK Gastroparesis Clinical Research Consortium (GpCRC)

      Version of Record online: 9 JAN 2017 | DOI: 10.1111/nmo.13018

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      Animal studies have highlighted an important role of macrophages in development of delayed gastric emptying. However, their role in human gastroparesis is unclear. Upon assessment of full thickness gastric antrum biopsies, both diabetic and idiopathic gastroparesis patients showed a loss of CD206-positive anti-inflammatory macrophages as compared to controls. This correlated with loss of ICC suggesting a role of innate immune cells in pathophysiology of human gastroparesis.

  7. Original Articles

    1. Relation between cognitive and hedonic responses to a meal

      B. Ciccantelli, T. Pribic, C. Malagelada, A. Accarino and F. Azpiroz

      Version of Record online: 5 JAN 2017 | DOI: 10.1111/nmo.13011

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      The cognitive (satiation, fullness) and hedonic responses (satisfaction) to meals with equivalent levels of palatability, that is, equally likable, are dissociable. Hence, the early gustatory experience does not predict postprandial satisfaction.

  8. ORIGINAL ARTICLES

    1. Could the peristaltic transition zone be caused by non-uniform esophageal muscle fiber architecture? A simulation study

      W. Kou, J. E. Pandolfino, P. J. Kahrilas and N. A. Patankar

      Version of Record online: 5 JAN 2017 | DOI: 10.1111/nmo.13022

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      The effect of varied muscle fiber architecture on esophageal peristalsis was studied based on a fully coupled computational model. Results show that helical fiber architecture featured lesser wall stress and higher distensibility. Non-uniform fiber architecture and dual contraction waves featured a pressure trough between two high-pressure segments. The peristaltic transition zone may be attributable to non-uniform muscle fiber architecture and/or dual contraction waves.

    2. High-resolution electrical mapping of porcine gastric slow-wave propagation from the mucosal surface

      T. R. Angeli, P. Du, N. Paskaranandavadivel, S. Sathar, A. Hall, S. J. Asirvatham, G. Farrugia, J. A. Windsor, L. K. Cheng and G. O'Grady

      Version of Record online: 29 DEC 2016 | DOI: 10.1111/nmo.13010

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      High-resolution electrical mapping has advanced the accurate assessment of gastric dysrhythmias, offering promise as a diagnostic technique, but has been restricted to invasive surgical access to date. This study investigated high-resolution electrical mapping from the gastric mucosal surface as feasibility for endoscopic gastric electrical mapping. Slow-wave activity was consistently recorded from the mucosal surface, and propagation was consistent with reference serosal activation pattern, frequency, and velocity, including during dysrhythmias; however, mucosal waveforms exhibited reduced amplitude and wider downstroke width. This study demonstrates feasibility of endoscopic high-resolution mapping, providing a foundation for advancement of minimally invasive spatiotemporal gastric mapping as a clinical and scientific tool.

  9. Review Articles

    1. Neuroimmune factors in functional gastrointestinal disorders: A focus on irritable bowel syndrome

      G. E. Boeckxstaens and M. M. Wouters

      Version of Record online: 27 DEC 2016 | DOI: 10.1111/nmo.13007

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      Abnormal abdominal pain perception is the most bothersome and difficult to treat symptom of functional gastrointestinal disorders. Peripheral activation and sensitization of sensory afferent nerve endings by pro-inflammatory mediators can lead to aberrant neuroimmune interactions and visceral hypersensitivity. In IBS, pronociceptive mechanisms seem to be upregulated, while antinociceptive mechanisms are downregulated. A better understanding of the factors involved may provide novel therapeutic strategies that elevate symptoms and potentially even cure a subpopulation of patients with IBS.

  10. ORIGINAL ARTICLES

    1. Opioid analgesic use among patients presenting with acute abdominal pain and factors associated with surgical diagnoses

      D. Khemani, M. Camilleri, A. Roldan, A. D. Nelson, S.-Y. Park, A. Acosta and A. R. Zinsmeister

      Version of Record online: 25 DEC 2016 | DOI: 10.1111/nmo.13000

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      The prevalence of chronic opioid use among non-cancer patients presenting with acute abdominal pain (AAP) remains unknown. We used electronic medical records to perform a retrospective, observational cohort study of all (n=16,121) adult patients (88% from Minnesota, Iowa, and Wisconsin) presenting during 2014 with AAP, and focused on 2352 adults with AAP who underwent abdominal CT scan within 24 hours of presentation. Approximately 19% of adults presenting with AAP were opioid users, and constipation was almost three times as likely in opioid users compared to non-opioid users.

  11. Original Articles

    1. Weight loss and waist reduction is associated with improvement in gastroesophageal disease reflux symptoms: A longitudinal study of 15 295 subjects undergoing health checkups

      S.-K. Park, T. Lee, H.-J. Yang, J. H. Park, C. I. Sohn, S. Ryu and D. I. Park

      Version of Record online: 21 DEC 2016 | DOI: 10.1111/nmo.13009

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      Weight loss or waist reduction was associated with improvement in GERD symptoms only in subjects with general or abdominal obesity.

    2. Pediatric rumination subtypes: A study using high-resolution esophageal manometry with impedance

      R. Rosen, L. Rodriguez and S. Nurko

      Version of Record online: 21 DEC 2016 | DOI: 10.1111/nmo.12998

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      Forty-one (55.5%) primary and 33 (44.5%) secondary rumination episodes were seen in 18 patients. Three types of primary rumination were identified in children: i) LES relaxation without retrograde flow preceding the R wave (51% of episodes); ii) LES relaxation after the R wave (20% of episodes); and iii) R waves with no LES relaxation (29% of episodes, A and B). Pediatric rumination can be accurately diagnosed using high-resolution esophageal manometry with impedance.

    3. Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone

      S. Gavini, L. F. Borges, R. T. Finn, W.-K. Lo, H. J. Goldberg, R. Burakoff, N. Feldman and W. W. Chan

      Version of Record online: 16 DEC 2016 | DOI: 10.1111/nmo.13001

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      Gastroesophageal reflux (GER) has been associated with idiopathic pulmonary fibrosis (IPF). We assessed objective measures of GER and their relationship with lung disease severity measured on pulmonary function testing (PFT) in IPF patients. Abnormal bolus reflux as measured on multichannel intraluminal impedance (MII) is associated with more severe dysfunction on PFT. MII parameters of reflux also more strongly correlate with lung disease severity than pH-only measures of acid reflux. MII-pH may be valuable in characterizing GER and help guide IPF management.

    4. Effects of antipsychotics on intestinal motility in zebrafish larvae

      K. A. F. de Alvarenga, E. K. Sacramento, D. V. Rosa, B. R. Souza, V. B. de Rezende and M. A. Romano-Silva

      Version of Record online: 16 DEC 2016 | DOI: 10.1111/nmo.13006

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      Some antipsychotics, such as clozapine, have a variety of side effects requiring further investigation, one of which is gastrointestinal dysmotility. We have established a simple method to screen these properties using zebrafish larvae as a model. The assay is a tool for better understanding the mechanisms whereby these drugs act on the gastrointestinal tract.

    5. Gastrointestinal symptom severity in irritable bowel syndrome, inflammatory bowel disease and the general population

      A. D. Lee, B. M. Spiegel, R. D. Hays, G. Y. Melmed, R. Bolus, D. Khanna, P. P. Khanna and L. Chang

      Version of Record online: 16 DEC 2016 | DOI: 10.1111/nmo.13003

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      The PROMIS GI scales were used to determine gastrointestinal symptoms severity in patients. Unlike IBD, IBS is not characterized by observable gastrointestinal inflammation, but patients report more severe upper and lower gastrointestinal symptoms.

    6. Surgical management of children with intractable functional constipation; experience of a single tertiary children's hospital

      S. Kuizenga-Wessel, I. J. N. Koppen, L. W. Zwager, C. Di Lorenzo, J. R. de Jong and M. A. Benninga

      Version of Record online: 12 DEC 2016 | DOI: 10.1111/nmo.13005

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      This study describes the experience of a tertiary hospital with the surgical management of children with intractable functional constipation (FC). Surgery can improve symptoms in children with intractable FC. Despite morbidity and complications, parental satisfaction is high.

  12. Hot Topic

    1. Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha

      C. Brock, B. Brock, Q. Aziz, H. J. Møller, M. Pfeiffer Jensen, A. M. Drewes and A. D. Farmer

      Version of Record online: 12 DEC 2016 | DOI: 10.1111/nmo.12999

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      In healthy humans, we found that transcutaneous electrical vagal nerve stimulation increases cardiac vagal tone and decreases tumor necrosis factor-alpha. These preliminary findings warrant further investigation in patients with immune mediated inflammatory disorders such as inflammatory bowel disease.

    2. Cyclic Vomiting Syndrome is characterized by altered functional brain connectivity of the insular cortex: a cross-comparison with migraine and healthy adults

      D.-M. Ellingsen, R. G. Garcia, J. Lee, R. L. Lin, J. Kim, A. H. Thurler, S. Castel, L. Dimisko, B. R. Rosen, N. Hadjikhani, B. Kuo and V. Napadow

      Version of Record online: 1 DEC 2016 | DOI: 10.1111/nmo.13004

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      Cyclic Vomiting Syndrome (CVS) and Episodic Migraine (MIG) may share pathophysiology, but no studies have yet compared these conditions. We found that the mid-posterior insula, a key region for viscero-sensation, shows diminished brain functional connectivity with the Sensorimotor Network in both CVS and MIG, but increased connectivity to the Salience Network for CVS only, compared to age- and sex-matched healthy controls. The results point to both CVS-unique and potentially shared pathophysiology between CVS and episodic migraine.

  13. Original Articles

    1. Anorectal manometry: should it be performed in a seated position?

      G.-j. Wu, F. Xu, L. Lin, P. J. Pasricha and J. D. Z. Chen

      Version of Record online: 1 DEC 2016 | DOI: 10.1111/nmo.12997

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      This study aimed to establish the validity and importance of performing anorectal manometry (ARM) in the physiological seated position instead of frequently used left lateral position. For this, we compared the differences in ARM parameters between water-perfused and solid-state sensors and between lateral and seated positions. The results showed that ARM performed in a seated position using solid-state sensors seems most accurate in assessing rectal pressure, and rectoanal pressure gradient (RAPG) measured under these conditions is predictive of balloon expulsion.

    2. Luminal contents from the gut of colicky infants induce visceral hypersensitivity in mice

      H. Eutamène, C. L. Garcia-Rodenas, S. Yvon, E. d'Aldebert, F. Foata, B. Berger, J. Sauser, V. Theodorou, G. Bergonzelli and E. Mas

      Version of Record online: 1 DEC 2016 | DOI: 10.1111/nmo.12994

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      The infant colic pathophysiology is poorly understood. In this study, luminal contents from colicky infants triggered visceral hyperalgesia in an animal model known to mimic IBS colonic hypersensitivity. Visceral hypersensitivity could be an important etiological factor involved in the prototypical colic crying behavior.

    3. Downregulation of neuronal vasoactive intestinal polypeptide in Parkinson's disease and chronic constipation

      F. Giancola, F. Torresan, R. Repossi, F. Bianco, R. Latorre, A. Ioannou, M. Guarino, U. Volta, P. Clavenzani, M. Mazzoni, R. Chiocchetti, F. Bazzoli, R. A. Travagli, C. Sternini and R. De Giorgio

      Version of Record online: 27 NOV 2016 | DOI: 10.1111/nmo.12995

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      Chronic constipation is usually a severe gastrointestinal dysfunction in patients with Parkinson's disease, but its pathogenesis remains poorly understood. This study evaluated functionally distinct submucosal neurons in relation to colonic motility and anorectal function in PD patients with constipation (PD/CC) vs both CC and controls.

      Colonic motor and rectal sensory functions resulted impaired in most parkinsonian constipated patients. Compared with controls, they display a decreased number of submucosal secretomotor neurons containing VIP immunoreactivity accompanied by a reduced mRNA expression of VIP and VIP receptors.

    4. Patients with Barrett's esophagus are hypersensitive to acid but hyposensitive to other stimuli compared with healthy controls

      C. Lottrup, A. L. Krarup, H. Gregersen, P. Ejstrud and A. M. Drewes

      Version of Record online: 27 NOV 2016 | DOI: 10.1111/nmo.12992

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      We assessed esophageal sensitivity including mechanical, heat, electrical, and acid stimulation in 23 patients with Barrett's esophagus and 12 controls using the multimodal probe. Patients showed hypersensitivity to acid, but hyposensitivity to other stimuli, asymptomatic patients were generally hyposensitive compared to symptomatic patients, and acid sensitivity overall increased with lower mucosal baseline impedance. We suggest that impaired mucosal sensitivity as measured by the proxy baseline impedance explains the acid hypersensitivity and hypothesize central pain modulation to cause the hyposensitivity to other stimuli.

    5. Gender differences in chronic constipation on anorectal motility

      M. Zakari, J. Nee, W. Hirsch, B. Kuo, A. Lembo and K. Staller

      Version of Record online: 27 NOV 2016 | DOI: 10.1111/nmo.12980

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      This is the largest comprehensive study of men with chronic constipation using HD-ARM. Our data suggest that there are significant physiologic and symptomatic differences between the sexes.

    6. Rectal intussusception: can high resolution three-dimensional ano-rectal manometry compete with conventional defecography?

      A. Benezech, M. Cappiello, K. Baumstarck, J.-C. Grimaud, M. Bouvier and V. Vitton

      Version of Record online: 27 NOV 2016 | DOI: 10.1111/nmo.12978

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      Three-dimensional high-resolution anorectal manometry (3DHRAM) provides physiological and morphological data about the perineum. The aim of this study was to define a diagnostic strategy using 3DHRAM to identify rectal intussusceptions (RI). On 3DHRAM, an anterior additional high-pressure area associated with an excessive perineal descent allowed the diagnosis of RI with a positive predictive value and a specificity of 100%. 3DHRAM confirmed its interest in the assessment of pelvic floor disorders and could be part of the diagnostic strategy of RI.

    7. The epidemiology of irritable bowel syndrome: Symptom development over a 3-year period in Denmark. A prospective, population-based cohort study

      L. R. Krogsgaard, A. L. Engsbro, M. P. Jones and P. Bytzer

      Version of Record online: 14 NOV 2016 | DOI: 10.1111/nmo.12986

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      IBS symptom development after 1 year influence symptom development after 3 years, with those fulfilling Rome III criteria for IBS after 1 year to be most likely to report IBS symptoms after 3 years.

    8. Acotiamide improves stress-induced impaired gastric accommodation

      K. Ikeo, T. Oshima, H. Sei, T. Kondo, H. Fukui, J. Watari and H. Miwa

      Version of Record online: 14 NOV 2016 | DOI: 10.1111/nmo.12991

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      Pretreatment with acotiamide significantly improved stress-induced impaired gastric accommodation. Acotiamide prolongs gastric accommodation and improves stress-induced impaired gastric accommodation.

    9. Acute sacral nerve stimulation reduces visceral mechanosensitivity in a cross-organ sensitization model

      L. D. Langlois, E. Le Long, M. Meleine, M. Antor, K. Atmani, P. Dechelotte, A. M. Leroi and G. Gourcerol

      Version of Record online: 7 NOV 2016 | DOI: 10.1111/nmo.12987

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      Sacral nerve stimulation reduced colonic nociception in a rat model of cross-organ sensitization. This effect involved an endogenous opioid pathway.

  14. Position Papers

    1. A fresh look at IBS—opportunities for systems medicine approaches

      A. Albusoda, N. Barki, T. Herregods, J. B. J. Kamphuis, T. B. Karunaratne, M. Lazarou, I. Lee, N. Mazurak, E. Perna, A. Polster, T. Pribic, F. Uhlig, H. Wang and P. Enck

      Version of Record online: 7 NOV 2016 | DOI: 10.1111/nmo.12989

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      NeuroGUT is a EU-funded initial training network (ITN) in neurogastroenterology. Neurogut trainees have attended an international conference on irritable bowel syndrome (IBS) in Bologna in 2016 and critically evaluated the current knowledge on IBS for their respective research activities. They summarize that there is a gap open that should be filled with systems medicine.

  15. Original Articles

    1. Rotenone and elevated extracellular potassium concentration induce cell-specific fibrillation of α-synuclein in axons of cholinergic enteric neurons in the guinea-pig ileum

      D. F. Sharrad, B. N. Chen, W. P. Gai, N. Vaikath, O. M. El-Agnaf and S. J. H. Brookes

      Version of Record online: 7 NOV 2016 | DOI: 10.1111/nmo.12985

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      Impairment of bioenergetic homeostatic mechanisms and misfolding of a-synuclein are implicated in the pathogenesis of Parkinson's disease. Here, we show that rotenone and elevated extracellular potassium cause cell-specific fibrillation of a-synuclein in cholinergic enteric neurons in the guinea pig ileum. Like the central nervous system, the enteric nervous system shows selective vulnerability to stressors implicated in the pathogenesis of Parkinson's disease.

    2. Low-residue diet fed to rabbits induces histomorphological and biomechanical remodeling of small intestine

      Y. Liu, J. Zhao, D. Liao, L. Bao and H. Gregersen

      Version of Record online: 27 OCT 2016 | DOI: 10.1111/nmo.12983

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      This study demonstrated that low-residue diet in rabbits for one month induces intestinal histomorphometric and biomechanical remodelling, specifically mucosal changes and intestinal softening. The intestine is a complex mechanical organ. It is important to consider food-induced changes to all aspects of intestinal function.

    3. P2X3 receptor-mediated visceral hyperalgesia and neuronal sensitization following exposure to PTSD-like stress in the dorsal root ganglia of rats

      Y.-Q. He, X.-Q. Lang, L. Lin, L. Ji, X.-Y. Yuan, Q. Chen, Y.-M. Ran, H.-S. Chen, L. Li, J.-M. Wang, Z.-G. Wang, H. Gregersen, D.-W. Zou, H.-P. Liang and M. Yang

      Version of Record online: 25 OCT 2016 | DOI: 10.1111/nmo.12976

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      Patients with posttraumatic stress disorder share co-morbidity with chronic pain conditions. The purpose was to study the underlying mechanisms of increased pain sensitivity in rats following exposure to posttraumatic stress disorder conditions. Motoric responses to colorectal distention were reduced initially in stress-exposed rats but increased afterwards to higher levels. Stress-exposure initially exhibited reduced dorsal root ganglion P2X3 ionic channel expression, which was followed by increased P2X3 expression. The data indicate an important role of P2X3 signaling in visceral pain.

    4. Tumor necrosis factor alpha derived from classically activated “M1” macrophages reduces interstitial cell of Cajal numbers

      S. T. Eisenman, S. J. Gibbons, P. -J. Verhulst, G. Cipriani, D. Saur and G. Farrugia

      Version of Record online: 25 OCT 2016 | DOI: 10.1111/nmo.12984

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      In diabetic mice, M1 macrophages are associated with delayed gastric emptying, whereas M2 macrophages are associated with normal gastric emptying. TNF-α, a factor present in M1-conditioned medium, reduced Kit-positive ICC numbers and TNF-α neutralizing antibodies blocked the effect of M1 medium. TNF-α derived from M1 macrophages injures ICC in vitro and TNF-α may be important in diseases like diabetic gastroparesis.

    5. The impact of irritable bowel syndrome on daily functioning: Characterizing and understanding daily consequences of IBS

      S. Ballou and L. Keefer

      Version of Record online: 25 OCT 2016 | DOI: 10.1111/nmo.12982

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      This study characterizes daily impairment in patients with IBS. The majority of respondents reported impairment in at least five domains of daily living. Rates of impairment were highest among participants who met questionnaire-based criteria for psychiatric diagnoses.

    6. Early satiety and postprandial fullness in gastroparesis correlate with gastroparesis severity, gastric emptying, and water load testing

      H. P. Parkman, E. K. Hallinan, W. L. Hasler, G. Farrugia, K. L. Koch, L. Nguyen, W. J. Snape, T. L. Abell, R. W. McCallum, I. Sarosiek, P. J. Pasricha, J. Clarke, L. Miriel, J. Tonascia, F. Hamilton and The NIDDK Gastroparesis Clinical Research Consortium (GpCRC)

      Version of Record online: 25 OCT 2016 | DOI: 10.1111/nmo.12981

  16. Review Articles

    1. Plasticity of gastrointestinal vagal afferent satiety signals

      A. J. Page and S. J. Kentish

      Version of Record online: 25 OCT 2016 | DOI: 10.1111/nmo.12973

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      Vagal afferents are an important link between the gastrointestinal tract and the central nervous system, relaying information on the quantity and type of food consumed and initiating processes leading to behavioral changes in food intake. Whilst this system is effective in the regulation of food intake it is susceptible to disruption in various disease states including obesity. Understanding the mechanisms responsible for these detrimental effects is essential to establish more effective pharmacotherapies or lifestyle strategies for the treatment of obesity.

  17. Original Articles

    1. Baseline impedance measured during high-resolution esophageal impedance manometry reliably discriminates GERD patients

      K. Ravi, D. M. Geno, M. F. Vela, M. D. Crowell and D. A. Katzka

      Version of Record online: 24 OCT 2016 | DOI: 10.1111/nmo.12974

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      Previous studies have demonstrated that baseline impedance measured during ambulatory impedance pH monitoring has reliable diagnostic accuracy for GERD. In this study of 29 patients with at least moderate acid reflux and 26 controls, baseline impedance measured during the initial landmark period of a high-resolution esophageal manometry (HRIM) study demonstrated excellent diagnostic accuracy for GERD, with an AUC of 0.931 on ROC analysis. These findings suggest that HRIM determined baseline impedance may represent an accurate, cost-effective, and less invasive tool for the diagnosis of GERD.

  18. Review Articles

    1. Rumination syndrome: pathophysiology, diagnosis, and treatment

      I. Absah, A. Rishi, N. J. Talley, D. Katzka and M. Halland

      Version of Record online: 20 OCT 2016 | DOI: 10.1111/nmo.12954

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      This review critically appraises recent studies of pathophysiology and therapy for rumination syndrome.

  19. Original Articles

    1. Jackhammer esophagus: Observations on a European cohort

      T. V. K. Herregods, A. J. P. M. Smout, J. L. S. Ooi, D. Sifrim and A. J. Bredenoord

      Version of Record online: 17 OCT 2016 | DOI: 10.1111/nmo.12975

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      The aim of our study was to describe a large cohort of patients with jackhammer esophagus and to investigate whether manometric findings can be associated with the presence of symptoms. Most patients with jackhammer esophagus suffered from dysphagia (67.6%) and/or chest pain (47.1%). The symptom chest pain was not associated with any of the manometric findings, whereas the symptom dysphagia was associated with strong contractions of the lower esophageal sphincter, signs of a possible outflow obstruction, and a very high distal contractile integral.

    2. BDNF modulates intestinal barrier integrity through regulating the expression of tight junction proteins

      Y.-B. Yu, D.-Y. Zhao, Q.-Q. Qi, X. Long, X. Li, F.-X. Chen and X.-L. Zuo

      Version of Record online: 17 OCT 2016 | DOI: 10.1111/nmo.12967

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      Brain-derived neurotrophic factor, a member of neurotrophins family, was originally known for its effects on the development and regeneration of central nervous system. In our study, we showed for the first time that BDNF may play a role in regulating intestinal epithelial barrier via affecting the expression of tight junction proteins.

    3. Effects of varying dietary content of fermentable short-chain carbohydrates on symptoms, fecal microenvironment, and cytokine profiles in patients with irritable bowel syndrome

      T. N. Hustoft, T. Hausken, S. O. Ystad, J. Valeur, K. Brokstad, J. G. Hatlebakk and G. A. Lied

      Version of Record online: 16 OCT 2016 | DOI: 10.1111/nmo.12969

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      The results from this study support the efficacy of a low-FODMAP diet in alleviating IBS symptoms, demonstrate intersubject differences in FOS sensitivity, and support the “FODMAP concept” that global restriction is more efficient than a limited restriction. Our findings also suggest that a low-FODMAP diet induces changes in inflammatory cytokines, microbiota profile, and SCFAs, which may have consequences for gut health.

    4. Benchmarks for the interpretation of esophageal high-resolution manometry

      R. Yadlapati, R. N. Keswani, K. B. Dunbar, A. J. Gawron, C. P. Gyawali, P. J. Kahrilas, P. O. Katz, D. Katzka, S. J. Spechler, R. Tatum and J. E. Pandolfino

      Version of Record online: 13 OCT 2016 | DOI: 10.1111/nmo.12971

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      Currently, there is a gap in competency-based training and assessment for esophageal high-resolution manometry (HRM). Using formal standard setting techniques among a group of esophageal experts, we created an exam for the interpretation of esophageal HRM. In addition, we established minimum competency cut scores for esophageal HRM skills at the trainee, physician interpreter, and master level.

    5. Impact of symptom burden and health-related quality of life (HRQOL) on esophageal motor diagnoses

      C. A. Reddy, A. Patel and C. P. Gyawali

      Version of Record online: 9 OCT 2016 | DOI: 10.1111/nmo.12970

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      The interrelationship between esophageal symptom characteristics, symptom burden, and motor diagnoses (Chicago Classification v 3.0) were further studied by obtaining validated self-report questionnaires in 211 patients undergoing esophageal high-resolution manometry (HRM). Chicago Classification diagnoses (outflow obstruction, major disorders) were associated with the highest symptom burden. Symptom characteristics were best characterized by pathophysiologic categorization of motor disorders into outflow obstruction, hypermotility disorders, and hypomotility disorders. Contraction wave abnormalities in patients without a motor disorder (according to Chicago Classification) had distinct symptom characteristics and symptom burden that aligned best with hypermotility disorders.

    6. Muscle layer histopathology and manometry pattern of primary esophageal motility disorders including achalasia

      N. Nakajima, H. Sato, K. Takahashi, G. Hasegawa, K. Mizuno, S. Hashimoto, Y. Sato and S. Terai

      Version of Record online: 3 OCT 2016 | DOI: 10.1111/nmo.12968

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      We aimed to analyze the relation between high-resolution manometry (HRM) findings and histopathology of muscularis externa in esophageal motility disorders. ICCs were preserved in high numbers in type III achalasia compared to other achalasia types. In some patients with JE and NE, eosinophilic infiltration of the esophageal muscle layer was shown, possibly related to the hypercontraction on HRM. Histopathological examination of the muscle layer in esophageal motility disorders may elucidate the pathology.

    7. Reproducibility of high-definition (3D) manometry and its agreement with high-resolution (2D) manometry in women with fecal incontinence

      S. Chakraborty, K. J. Feuerhak, A. R. Zinsmeister and A. E. Bharucha

      Version of Record online: 2 OCT 2016 | DOI: 10.1111/nmo.12950

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      In this study, we evaluated the intra-individual reproducibility of high definition anorectal manometry (HD-ARM) in women with fecal incontinence and compared pressures measured with HD-ARM and high-resolution manometry (HR-ARM). Anal pressures at rest and during squeeze measured with HD-ARM were reproducible on the same and different days, but those during evacuation were not. Resting and squeeze pressures measured with HD-ARM and HR-ARM were also concordant. These findings support the use of HD-ARM for longitudinal assessments of anal resting and squeeze pressures.

    8. May cannabinoids prevent the development of chemotherapy-induced diarrhea and intestinal mucositis? Experimental study in the rat

      R. Abalo, J. A. Uranga, I. Pérez-García, R. de Andrés, R. Girón, G. Vera, A. E. López-Pérez and M. I. Martín-Fontelles

      Version of Record online: 30 SEP 2016 | DOI: 10.1111/nmo.12952

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      In this article, we have characterized the effects of the antineoplastic drug 5-fluorouracil using X-rays and conventional histology in the rat, and have evaluated whether cannabinoids might be useful for treating 5-FU-induced diarrhea. A low dose of the non-selective cannabinoid agonist WIN partially prevented the development of diarrhea, probably through actions on motility, but did not prevent 5-FU-induced mucositis. This is the first experimental study on the effects of cannbinoids on chemotherapy-induced diarrhea.

    9. Functional gastrointestinal disorders in Greek Children based on ROME III criteria: identifying the child at risk

      I. Bouzios, G. Chouliaras, G. P. Chrousos, E. Roma and V. Gemou-Engesaeth

      Version of Record online: 28 SEP 2016 | DOI: 10.1111/nmo.12951

  20. Review Articles

    1. Sleep disturbances in irritable bowel syndrome: a systematic review

      Q. Tu, M. M. Heitkemper, M. E. Jarrett and D. T. Buchanan

      Version of Record online: 28 SEP 2016 | DOI: 10.1111/nmo.12946

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      Sleep disturbances are well-documented among persons with irritable bowel syndrome (IBS). Some researchers have provided evidence of a positive association between poorer subjective sleep quality and increased severity and frequency in gastrointestinal (GI) symptoms in those with IBS, but findings from studies using objective sleep and activity measures are inconclusive. This systematic review of the literature between 1990 and 2015 evaluates the evidence of sleep disturbances in adults with IBS and their relationship with GI symptoms.

  21. Original Articles

    1. The association between Ehlers-Danlos syndrome—hypermobility type and gastrointestinal symptoms in university students: a cross-sectional study

      A. Fikree, R. Aktar, J. K. Morris, R. Grahame, C. H. Knowles and Q. Aziz

      Version of Record online: 28 SEP 2016 | DOI: 10.1111/nmo.12942

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      Comparison of GI symptoms in students with and without EDS-HT. The most common upper GI symptoms in EDS-HT were abdominal pain (42.6%), postprandial fullness (34.4%), early satiety (31.5%) and bloating (26.4%). However, only postprandial fullness (34.4% vs 15.9%, P=.01) and early satiety (EDS-HT: 31.5% vs 17%, P=.03) were significantly increased when compared with non-EDS-HT students (Table 3).

    2. Do Jackhammer contractions lead to achalasia? A longitudinal study

      L. Huang, M. Pimentel and A. Rezaie

      Version of Record online: 23 SEP 2016 | DOI: 10.1111/nmo.12953

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      Jackhammer esophagus (JE) is a rare and intermittent hypercontractile esophageal motility disorder. In this retrospective study, we have found that some patients with JE can transition to type III achalasia over time, and that this transformation may be more common in those patients who have impaired lower esophageal sphincter relaxation at initial JE diagnosis.

    3. Continuous wavelet analysis of postprandial EGGs suggests sustained gastric slow waves may be slow to develop in infants with colic

      G. W. Reynolds, R. G. Lentle, P. W. M. Janssen and C. M. Hulls

      Version of Record online: 20 SEP 2016 | DOI: 10.1111/nmo.12948

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      Continuous wavelet transforms (CWT) of EGG recordings from breastfed babies were used to test the hypothesis that infant colic is associated with abnormal patterns of gastric motility. Univariate and multivariate comparisons of the characteristics of the principal three frequency ranges 1.4–2.5, 2.5–4.0, and 4.0–15 cpm allowed discrimination between colicky and non-colicky babies. The authors conclude that CWT of EGG signals is sufficiently sensitive to detect abnormal electrophysiological patterns in colicky babies.

  22. Review Articles

    1. Exploring hypotheses and rationale for causes of infantile colic

      M. Camilleri, S.-Y. Park, E. Scarpato and A. Staiano

      Version of Record online: 20 SEP 2016 | DOI: 10.1111/nmo.12943

  23. Original Articles

    1. High-resolution impedance manometry parameters enhance the esophageal motility evaluation in non-obstructive dysphagia patients without a major Chicago Classification motility disorder

      D. A. Carlson, T. Omari, Z. Lin, N. Rommel, K. Starkey, P. J. Kahrilas, J. Tack and J. E. Pandolfino

      Version of Record online: 20 SEP 2016 | DOI: 10.1111/nmo.12941

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      We aimed to perform a collaborative analysis of high-resolution impedance manometry metrics to evaluate patients without non-obstructive dysphagia with a major esophageal motility disorder. The esophageal impedance integral (EII) ratio and bolus flow time demonstrated the strongest symptom correlations and differed between dysphagia patients and asymptomatic controls. The EII ratio also differed between dysphagia and non-dysphagia patient–controls, suggesting it may aid characterization of symptomatic patients with otherwise non-diagnostic manometry.

    2. The importance of a high rectal pressure on strain in constipated patients: implications for biofeedback therapy

      Y. Mazor, R. Hansen, G. Prott, J. Kellow and A. Malcolm

      Version of Record online: 20 SEP 2016 | DOI: 10.1111/nmo.12940

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      In this study, we identify a subgroup of patients with dyssynergic symptoms but without a formal Rome III diagnosis of functional defecation disorders, who are characterized by a high rectal pressure on strain. Although these patients displayed some physiological differences to the patients with lower straining rectal pressure, they suffer similarly. Importantly, we show that these patients can respond favorably to anorectal biofeedback treatment.

    3. The added diagnostic value of postreflux swallow-induced peristaltic wave index and nocturnal baseline impedance in refractory reflux disease studied with on-therapy impedance-pH monitoring

      M. Frazzoni, N. de Bortoli, L. Frazzoni, S. Tolone, M. Furnari, I. Martinucci, V. G. Mirante, S. Marchi, V. Savarino and E. Savarino

      Version of Record online: 12 SEP 2016 | DOI: 10.1111/nmo.12947

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      On-therapy impedance-pH monitoring establishes the relationship between PPI-refractory heartburn and reflux. Post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) were highly efficient in distinguishing PPI-refractory non-erosive reflux disease (NERD) from functional heartburn (FH) and refractory reflux esophagitis (RRE) from healed reflux esophagitis (HRE). Abnormal PSPW index and MNBI characterize reflux-related PPI-refractory heartburn.

    4. Morphometric profile of large intestinal neuronal plexuses in normal perinatal autopsies and Hirschsprung disease

      H. Subramanian, B. A. Badhe, P. C. Toi and K. Sambandan

      Version of Record online: 12 SEP 2016 | DOI: 10.1111/nmo.12939

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      Morphometric assessment of neuronal plexuses with image capture and analysis in 40 normal and 40 Hirschsprung colons was used to derive objective reference values based on clearly defined evaluation techniques.

    5. The feasibility, usability, and clinical utility of traditional paper food and symptom journals for patients with irritable bowel syndrome

      J. K. Zia, C.-F. Chung, J. Schroeder, S. A. Munson, J. A. Kientz, J. Fogarty, E. Bales, J. M. Schenk and M. M. Heitkemper

      Version of Record online: 12 SEP 2016 | DOI: 10.1111/nmo.12935

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      The aim of this study was to evaluate the feasibility, usability, and clinical utility of paper food and gastrointestinal symptom journals as data collection tools for patients with irritable bowel syndrome (IBS). Paper journaling of food and symptoms appears to be a feasible and usable data collection tool for IBS patients. Over half perceive journaling as at least somewhat clinically useful.

    6. Supernatants of irritable bowel syndrome mucosal biopsies impair human colonic smooth muscle contractility

      M. P. Guarino, G. Barbara, A. Cicenia, A. Altomare, M. R. Barbaro, S. Cocca, A. Scirocco, C. Cremon, S. Emerenziani, V. Stanghellini, M. Cicala and C. Severi

      Version of Record online: 12 SEP 2016 | DOI: 10.1111/nmo.12928

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      The aim of the study was to investigate the effects of IBS mucosal supernatants on human colonic muscle contractility. Supernatants were obtained from biopsies of IBS patients and asymptomatic subjects. IBS supernatants reduced colonic contractility mucosal likely through muscular intracellular oxidative stress damage. Depending on the IBS subtype, further different neuromotor mechanisms are involved.

    7. Pepsin in saliva as a biomarker for oropharyngeal reflux compared with 24-hour esophageal impedance/pH monitoring in pediatric patients

      J. E. Fortunato, R. B. D'Agostino Jr. and M. O. Lively

      Version of Record online: 7 SEP 2016 | DOI: 10.1111/nmo.12936

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      Pepsin in saliva is a proposed biomarker for oropharyngeal reflux, which may be present in saliva from subjects with GER. The concentration of salivary pepsin decreases rapidly as a function of time after the reflux event. Therefore, saliva samples must be obtained soon after reflux occurs.

    8. Fecal incontinence in irritable bowel syndrome: Prevalence and associated factors in Swedish and American patients

      M. Simrén, O. S. Palsson, S. Heymen, A. Bajor, H. Törnblom and W. E. Whitehead

      Version of Record online: 31 AUG 2016 | DOI: 10.1111/nmo.12919

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      We studied one US (n=304) and one Swedish IBS cohort (n=168), and fecal incontinence (FI) ≥ one day per month was reported by 19.7% (USA) and 13.7% (Sweden) of IBS patients.FI was associated with loose, frequent stools, urgency, and adverse impact on quality of life, psychological symptoms, and work productivity.

    9. Propofol inhibits carbachol-induced chloride secretion by directly targeting the basolateral K+ channel in rat ileum epithelium

      S.-H. Tang, H.-Y. Wang, H. Sun, N. An, L. Xiao, Q. Sun and D.-B. Zhao

      Version of Record online: 30 AUG 2016 | DOI: 10.1111/nmo.12934

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      The aim of this study was to investigate the effects of propofol on carbachol (CCh)-evoked short-circuit currents (Isc). The results show that propofol inhibits CCh-induced intestinal secretion by directly targeting basolateral K+ channels.

    10. Proton pump inhibitor monotherapy and the risk of cardiovascular events in patients with gastro-esophageal reflux disease: a meta-analysis

      S. Sun, Z. Cui, M. Zhou, R. Li, H. Li, S. Zhang, Y. Ba and G. Cheng

      Version of Record online: 30 AUG 2016 | DOI: 10.1111/nmo.12926

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      In the light of the results of our meta-analysis, PPI therapy is associated with a 70% increased risk of cardiovascular events in patients with GERD. Omeprazole could significantly increase the risk of cardiovascular events. Thus, we believe that doctors should be advised to carefully consider the use of PPIs in clinical situations, and try to choose the best treatment option for each patient.

    11. Colonic content: effect of diet, meals, and defecation

      R. A. Bendezú, M. Mego, E. Monclus, X. Merino, A. Accarino, J. R. Malagelada, I. Navazo and F. Azpiroz

      Version of Record online: 21 AUG 2016 | DOI: 10.1111/nmo.12930

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      Ingestion of unabsorbable residues and defecation produce profound changes in colonic content. The rapid turnover of colonic biomass (about 1/3 daily) indicates a high adaptation potential of microbiota to the intraluminal environment.

    12. Increased yield pressure in the anal canal during sacral nerve stimulation: a pilot study with the functional lumen imaging probe

      S. Haas, D. Liao, H. Gregersen, L. Lundby, S. Laurberg and K. Krogh

      Version of Record online: 21 AUG 2016 | DOI: 10.1111/nmo.12929

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      Spatio-temporal diameter map of the anal canal from a single subject. The changing colors from blue to red illustrate increasing diameter.

    13. Impact of prenatal and postnatal exposure to the pesticide chlorpyrifos on the contraction of rat ileal muscle strips: involvement of an inducible nitric oxide synthase-dependent pathway

      W. Darwiche, S. Delanaud, S. Dupont, H. Ghamlouch, W. Ramadan, W. Joumaa, V. Bach and J. Gay-Quéheillard

      Version of Record online: 21 AUG 2016 | DOI: 10.1111/nmo.12918

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      The present study showed that the exposure to chlorpyrifos (CPF), a widely used insecticide, from the first day of gestation to early adulthood, in a rat model, is associated with low EFS-induced ileal contraction, elevated iNOS expression, partial inhibition of AChE activity, and low ileal muscle thickness.

    14. Prolonged measurement improves the assessment of the barrier function of the esophago-gastric junction by high-resolution manometry

      D. Jasper, N. Freitas-Queiroz, M. Hollenstein, B. Misselwitz, P. Layer, T. Navarro-Rodriguez, M. Fox and J. Keller

      Version of Record online: 14 AUG 2016 | DOI: 10.1111/nmo.12925

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      Total-esophagogastric junction contractile integral (EGJ-CI), a new metric summarizing EGJ contractility over the entire length of standard HRM, was tested in 65 healthy controls and 452 GERD patients and proved to be superior over conventional metrics and other HRM metrics for prediction of pathological reflux. In particular, the negative predictive value approached 90% if total-EGJ-CI was within the upper two-thirds of the normal range. These findings suggest that GERD is highly unlikely if the EGJ can maintain normal contractility over several minutes.

    15. Temporal and spectral properties of esophageal mucosal blood perfusion: a comparison between normal subjects and nutcracker esophagus patients

      A. Zifan, Y. Jiang and R. K. Mittal

      Version of Record online: 10 AUG 2016 | DOI: 10.1111/nmo.12917

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      The goal of our study was to perform a detailed time and spectral domain analysis of the esophageal mucosal blood perfusion (EMBP) waveform from of NE patients and controls to determine the optimal EMBP biomarkers that combined with suitable statistical learning models may produce robust discrimination between the two groups.

    16. Stigmatization toward irritable bowel syndrome and inflammatory bowel disease in an online cohort

      T. H. Taft, A. Bedell, J. Naftaly and L. Keefer

      Version of Record online: 8 AUG 2016 | DOI: 10.1111/nmo.12921

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      Stigma toward chronic illness is a pervasive public health issue. This is the first study to evaluate stigmatizing beliefs toward IBS and IBD.

    17. A meta-analysis of reflux genome-wide association studies in 6750 Northern Europeans from the general population

      F. Bonfiglio, P. G. Hysi, W. Ek, V. Karhunen, N. V. Rivera, M. Männikkö, H. Nordenstedt, M. Zucchelli, F. Bresso, F. Williams, H. Tornblom, P. K. Magnusson, N. L. Pedersen, J. Ronkainen, P. T. Schmidt and M. D'Amato

      Version of Record online: 3 AUG 2016 | DOI: 10.1111/nmo.12923

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      We report a meta-analysis of GERD GWA studies from three independent population-based cohorts identifying 30 independent suggestive signals of association, showing concordant risk directions and functional effects on gene expression.

    18. Spatiotemporal characteristics of the pharyngeal event-related potential in healthy subjects and older patients with oropharyngeal dysfunction

      L. Rofes, O. Ortega, N. Vilardell, L. Mundet and P. Clavé

      Version of Record online: 2 AUG 2016 | DOI: 10.1111/nmo.12916

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      Appropriate oropharyngeal sensory feedback is essential for safe and efficient swallowing. Non-dysphagic older patients present impaired cortical activation compared with young healthy volunteers in response to pharyngeal electrical stimulus. Older patients with dysphagia also present disturbances in the pharyngo-cortical connection together with a disrupted pattern of cortical activation. Swallowing therapy in older people with dysphagia should include strategies aiming to stimulate the pharyngeal sensory afferents to promote recovery of the swallowing function.

    19. Validation of criteria for the definition of transient lower esophageal sphincter relaxations using high-resolution manometry

      S. Roman, R. Holloway, J. Keller, F. Herbella, F. Zerbib, Y. Xiao, L. Bernard, A. J. Bredenoord, S. Bruley des Varannes, M. Chen, M. Fox, P. J. Kahrilas, R. K. Mittal, R. Penagini, E. Savarino, D. Sifrim, J. Wu, E. Decullier, J. E. Pandolfino and F. Mion

      Version of Record online: 31 JUL 2016 | DOI: 10.1111/nmo.12920

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      A consensus definition of transient lower espohageal sphincter relaxation (TLESR) using high resolution manometry is proposed. TLESR is defined as LES relaxation occurring in absence of swallowing, lasting more than 10 seconds and associated with crural definition inhibition. Reflux on impedance, esophageal shortening, common cavity, upper esophageal sphincter relaxation without swallow and secondary peristalsis are alternate diagnostic criteria.

    20. You have full text access to this OnlineOpen article
      Effects of scFOS on the composition of fecal microbiota and anxiety in patients with irritable bowel syndrome: a randomized, double blind, placebo controlled study

      F. Azpiroz, C. Dubray, A. Bernalier-Donadille, J.-M. Cardot, A. Accarino, J. Serra, A. Wagner, F. Respondek and M. Dapoigny

      Version of Record online: 31 JUL 2016 | DOI: 10.1111/nmo.12911

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      Our aim was to evaluate the effects of short-chain fructooligosaccharides (scFOS) on rectal sensitivity, fecal microbiota, and symptoms in patients with irritable bowel syndrome. Rectal sensitivity improved with scFOS and placebo alike; however, scFOS, but not placebo, significantly increased fecal Bifidobacteria and reduced anxiety score.

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