Gastrointestinal Motility Test Research Articles

Unveiling the therapeutic potentialities and chemical characterization of methanolic Merremia vitifolia (Burm.f) Hallier f. stem extract: A Multi-faceted investigation via in vitro, in vivo, and in silico approaches

Current study focused on Merremia vitifolia an ethnomedicinal plant, aiming to explore its medicinal properties comprehensively. Through qualitative and quantitative analysis, the study investigated the phytochemical components of M. vitifolia stem extract and assessed its antioxidant, anti-inflammatory, analgesic, antidepressant, anxiolytic, locomotor, and antidiarrheal activities. The evaluation involved a combination of in vitro, in vivo, and in silico approaches.In-vitro antioxidant activity was determined using the DPPH scavenging assay, while anti-inflammatory activity was assessed via a protein denaturation assay. In-vivo experiments included tests for antidepressant effects (FST, TST), anxiolytic effects (EPM, HBT), locomotor effects (OFT, HCT), and analgesic activity (formalin-induced licking test and acetic acid-induced writhing test). Additionally, the antidiarrheal effect was evaluated through castor oil-induced diarrhea and gastrointestinal motility tests. Fifteen bioactive compounds were identified based on their biological activities from GC/MS data and subjected to in silico molecular docking; ADME/T profiling and pass prediction.MEMVS had an IC50 value of 74.97 μg/mL and MEMVS elicited 77.17 ± 0.39 % inhibition protein denaturation compared to standard (87.23 ± 0.30 %) at 500 μg/mL. In addition, MEMVS induced a dose-dependent reduction in analgesic, neuropharmacological assay, inhibition in diarrheal feces count, and intestinal motility with a significant value (aP< 0.001). In computer-aided investigation, all compounds adhere to Lipinski's rule of five and demonstrate highest binding affinity to isolates compared to standard drugs, confirming laboratory findings.Research findings suggest that MEMVS holds promising potential, as a multifaceted therapeutic agent, exhibiting antioxidant, analgesic, anti-inflammatory, anti-diarrheal and neuropharmacological properties. However, further investigation is needed to fully harness its medicinal benefits.

Gastrointestinal dysmotility is associated with proton pump inhibitor refractory esophagitis in patients with systemic sclerosis.

Patients with systemic sclerosis present with severe gastroesophageal reflux disease, often refractory to proton-pump inhibitors (PPI) treatment. The aim of the present study was to identify factors associated with PPI-refractory esophagitis. We performed a cross-sectional study in a single-center cohort of patients diagnosed with systemic sclerosis. We included patients who underwent an esophagogastroduodenoscopy while on PPI treatment. Patients with PPI-refractory erosive esophagitis were compared with those with endoscopically normal esophageal mucosa. A total of 69 patients were included, from these, 23 patients (33%) had PPI-refractory esophagitis (Grade A, n = 11; Grade B, n = 7; Grade C, n = 2; Grade D, n = 3) and 46 (67%) had an endoscopically normal esophageal mucosa. On univariate analysis, patients with PPI-refractory esophagitis were more frequently diffuse SSc subset (43% vs 17%; p= 0.041). Evaluating gastrointestinal motility tests, neither absent esophageal contractility (39% vs 25%, p= 0.292) nor hypotensive lower esophageal sphincter (47% vs 44%, p= 0.980) were significantly associated with PPI-refractory esophagitis. Gastrointestinal dysmotility, defined as abnormal gastric emptying and/or small bowel dilated loops, was significantly associated with PPI-refractory esophagitis (66 vs 8%, p = <0.001). On a multivariate regression model to evaluate the association between motility test results adjusted for the diffuse subset, gastrointestinal dysmotility (β = 0.751, p= 0.010) was independently associated with PPI-refractory esophagitis, while absent esophageal contractility (β = 0.044, p= 0.886) or a hypotensive LES were not (β=-0.131, p= 0.663). Our findings suggest that gastric and small intestinal motor dysfunction may be an important contributor to the development of PPI-refractory esophagitis in patients with systemic sclerosis.

Evaluation of antidiarrheal properties of leaf extracts of Acioa barteri (Chrysobalanaceae) in Wister albino mice

Diarrhea remains one of the most important health issues worldwide, with high morbidity and mortality rates, accounting for more than two million deaths annually. Oral rehydration therapy (ORT) is central to the management of diarrhea, and is sufficient to prevent complications due to dehydration in most patients while the disease runs its course. However, ORT has no effect on the duration of the disease or frequency of bowel motions, and any agent that could meet these needs would therefore be a useful addition to ORT. The aim of the study is to evaluate the antidiarrheal properties of the leaf extract of Acioa barteri (Chrysobalanaceae) in Winster albino mice. The pulverized leaves were extracted by cold maceration using methanol with for three (3) days.Castor oil (1ml/kg) was used to induce diarrhea in mice through the oral route of administration followed by two different doses of plant extract (250mg/kg and 500mg/kg) administered orally to the test groups while Loperamide (2mg/kg body weight) was used as the positive control. Gastrointestinal motility test (Charcoal meal test) and Castor oil induced enteropooliong were also used to evaluate the antidiarrheal activity of A. barteri. All samples were administered once, and the duration of the study was six hours. The result shows that in castor oil induced diarrhea, the extract, 250mg/kg and 500mg/kg showed significant inhibition of defecation by 43.52 % and 71.48 % respectively and 2mg/kg of loperamide showed an inhibition of 70.80 %. The gastrointestinal motility test of the extract, 250mg/kg and 500mg/kg showed significant inhibition of defecation by 40.66% and 80.48% respectively while 2mg/kg of loperamide showed an inhibition of 78.92 %. From the result of the castor oil induced enteropooling, the extract, 250mg/kg and 500mg/kg showed significant inhibition of defecation by 51.27 % and 82.41 % respectively and 2mg/kg of loperamide showed an inhibition of 79.89%. The result clearly indicates antidiarrheal properties of Acioa barteri leaf extract, which could be a therapeutic option against diarrheal disease and useful therapeautic addition to the oral rehydration therapy.

Tolerability and Feasibility of the Upper Esophageal Sphincter Assist Device in Preventing Acute and Chronic Allograft Rejection Among Lung Transplant Recipients.

We aimed to evaluate a novel upper esophageal sphincter (UES) assist device loaner program for the prevention of acute cellular rejection and chronic lung allograft dysfunction among lung transplant (LTx) recipients. Laryngopharyngeal reflux can lead to chronic microaspiration and LTx rejection. The UES assist device applies external pressure at the level of UES to decrease reflux. We prospectively enrolled and issued UES assist devices to consecutive transplant patients referred for gastrointestinal motility testing from 2016 to 2020. Device tolerability was defined by successful utilization as a bridge to ambulatory pH monitoring and/or antireflux procedure, or as permanent therapy. Incidence of rejection was analyzed before, during, and after device implementation. Twenty-six participants were issued devices (15 pathologic, 5 physiological, 6 unknown reflux status), none of whom developed acute rejection episodes or chronic lung allograft dysfunction while using the device. Thirteen adopted the device promptly after transplantation (mean 1.7 mo) and remained free of rejection episodes over a mean 24.7 months of follow-up. Among those with pathologic reflux, lag time to device adoption strongly correlated with the development of rejection (r=0.8, P=0.0006). There was no such correlation among those with physiological reflux. Five developed acute rejection after device return. The device was tolerated by a majority of LTx patients and appears feasible as a barrier measure in the prevention of rejection. Delayed treatment of laryngopharyngeal reflux may lead to early allograft failure; therefore, the UES assist device should be given important consideration in transplant protection.

Deciphering antidiarrheal effects of Meda pata (Litsea glutinosa (Lour.) C.B.Rob.) leaf extract in chemical-induced models of albino rats.

Diarrhea is one of the leading causes of preventable death in developing countries, mainly caused by bacterial infections and traditional therapies are very common in diarrheal incidences. Meda Pata (Litsea glutionsa) has a long history of use as traditional medicine for diarrhea, dysentery, and spasm in Bangladesh, India, and some other Asian countries. This research reports the antidiarrheal effects of Meda Pata (Litsea glutinosa leaf extract, LGLEx) in animal models. The work has been supported by in silico molecular docking study to verify the effects. The antidiarrheal effect of LGLEx was investigated in castor oil-induced diarrhea, magnesium sulfate-induced diarrhea, and gastrointestinal motility test models. Antidiarrheal effects were supported by a molecular docking study through an interaction between LGLEx's GC-MS analyzed imidazole-containing compounds and muscarinic acetylcholine receptor (PDB: 4U14) and 5-HT3 receptor (PDB: 5AIN). LGLEx potentially reduced the diarrheal incidences in in vivo assays reducing gastrointestinal motility. The maximum diarrheal inhibition was obtained in the castor oil-induced model (62.63%) and and BaSO4-induced model (73.14%), which were statistically significant (P<0.05) when compared to the reference drug loperamide. In the castor-oil and BaSO4-induced models, peristaltic movement was reduced by 25.96% and 32.17%, respectively. Biochemical markers particularly IgE, C-reactive proteins, and serum electrolytes were significantly (P<0.0) restored in treated groups. A Molecular docking analysis revealed that two compounds (1-Ethyl-2-hydroxymethylimidazole and 1,6-Anhydro-beta-D-glucofuranose demonstrated the highest binding affinity with target receptors muscarinic acetylcholine receptor (PDB: 4U14) and 5-HT3 receptor (PDB: 5AIN) confirming their drug likeliness. The findings indicate a high potential antidiarrheal impact that warrants further investigation for its therapeutic application.

Evaluation of Antidiarrheal Activity of Aqueous Extract of Cucurbita moschata (Pumpkin) Leaf in Castor Oil Induced Diarrhea Wistar Rats

Background: Diarrhea is one of the major health problems in developing countries leading to mortality and morbidity among children under 5 years of age. This study evaluated the antidiarrheal activities of Cucurbita moschata on castor oil-induced diarrheal wistar rats.&#x0D; Methods: Thirty (30) wistar rats were divided into six groups of five rats each. All rats except group 1 received 1mL castor oil to induce diarrhea. Groups I and II served as the normal and negative control. Group III received the standard drug (loperamide), groups IV-VI were treated with 100, 200 and 300 mg/kg b.wt of aqueous leaf extract of Cucurbita moschata respectively. Stool inhibition, castor oil-induced enteropooling, and gastrointestinal motility test were determined to evaluate the antidiarrheal effect of the extract.&#x0D; Results: Percentage stool inhibition significantly (p &lt; 0.05) increased with increase in the dose of the extract. The percentage distance travelled by the charcoal of the groups treated with the plant extract significantly decreased when compared to the negative control. This decrease was comparable with the group administered loperamide. Administration of aqueous extract of Cucurbita moschata leaf significantly decreased the volume of the intestinal fluid when compared with the volume of intestinal fluid of the negative control and the group administered loperamide. &#x0D; Conclusion: Aqueous leaf extract of Cucurbita moschata possess antidiarrheal activity against castor oil-induced diarrhea.

Evaluations of the in vivo laxative effects of aqueous root extracts of Euclea racemosa L. in mice

BackgroundManagement of constipation with currently available modern medicines is costly and chances of side effects are high. This limits their clinical usefulness and remain to be solved, and calls for investigations of new and better compounds. The experimental plant, Euclea racemosa L. (E. racemosa L) is among plants, which are used for management of constipation traditionally but its effect is not yet experimentally validated. Therefore, the aim of the present study is to investigate the laxative effects of this plant. MethodsThe laxative effects of aqueous root extracts of E. racemosa L. were evaluated using gastrointestinal motility, laxative activity, and gastrointestinal secretion tests. ResultsIn the laxative test, the 200 and 400 mg/kg doses of plant extract showed a significant increase in percent fecal water content. The plant extract also significantly accelerated the charcoal meal in gastrointestinal motility test of loperamide-constipated mice. Moreover, the experimental plant produced significant Gastrointestinal (GI) transit ratio at all doses but failed to produce a significantly higher fluid accumulation except 400 mg/kg doses of extract in gastrointestinal secretion test. The observed effect of the aqueous root extract might be due to the presence of secondary metabolites. The aqueous root extract of E. racemosa L. revealed the presence of terpenes, saponins, flavonoids and phenols when it was subjected to phytochemical screening. ConclusionThe investigation obtained from this study suggested that E. racemosa L. has a beneficial effect in producing laxative effect and this substantiate the traditional use of the plant for its claimed indication.

Anti-Diarrheal Activities of Hydromethanolic Crude Extract and Solvent Fractions of Acacia seyal (Fabaceae) Roots in Mice.

Traditionally, the root of Acacia seyal is used for the treatment of diarrhea. However, its efficacy has not been scientifically evaluated. Thus, this study aimed to validate the antidiarrheal activities using hydromethanolic crude extract and solvent fractions of Acacia seyal roots in mice. In each model, mice were divided into five groups of six mice at random. Group I mice (negative controls) were given 1mL/100 g distilled water for hydromethanolic crude extract tests as well as n-hexane, ethyl acetate and aqueous fractions, while groups II, III, and IV were given 100 mg/kg, 200 mg/kg, and 400 mg/kg of hydromethanolic crude extract or solvent fractions. Group V mice (positive control) were given 3 mg/kg Loperamide for the castor oil-induced diarrhea and enteropooling test. All of the doses were taken orally. However, Atropine sulfate, 5 mg/kg, was given intraperitoneally for the gastrointestinal motility test. Statistical Package for the Social Sciences (SPSS) version 26 was used to examine the statistical significance of differences in the number and weight of wet and total feces, distance traveled by a charcoal meal, and intestinal fluid accumulation across groups. When compared to the vehicle-treated group, the crude extract and n-hexane fraction notably delayed the onset of diarrhea, reduced the weight and volume of intestinal contents, and hindered the intestinal transit at all tested doses (P < 0.001). The ethyl acetate fraction also significantly (P < 0.001) decreased the weight of intestinal content at all doses examined. Only at 400 mg/kg did the aqueous fraction statistically (P < 0.01) prolonged the onset of diarrhea and impeded gastrointestinal motility. According to this study, the hydromethanolic crude extract and solvent fractions of Acacia seyal roots have promising antidiarrheal effects.

Neuropharmacological and Antidiarrheal Potentials of Duabanga grandiflora (DC.) Walp. Stem Bark and Prospective Ligand-Receptor Interactions of Its Bioactive Lead Molecules.

Duabanga grandiflora (DC.) Walp. is an ethnomedicinally significant plant used to treat various illnesses, but there is little scientific evidence to support its use. This study explored the pharmacological activities of methanol extract of D. grandiflora stem barks (MEDG) through in vivo approaches in Swiss albino mice and a computer-aided molecular approach. The forced swimming test (FST), tail suspension test (TST), elevated plus maze (EPM), and hole board test (HBT) were used to determine anti-depressant and anxiolytic activity in experimental mice. In addition, anti-diarrheal studies were performed using castor oil-induced diarrhea, castor oil-induced enter pooling, and the charcoal-induced gastrointestinal motility test. MEDG showed substantial depletions in the immobility times in both FST and TST after treatment with the MEDG extract, whereas moderate anxiolytic activity was manifested at a higher dose (400 mg/kg) compared with the control. Correspondingly, MEDG extract revealed a significant reduction in wet feces and decreased the small intestinal transit of charcoal meal in castor oil-induced diarrhea and charcoal-induced gastrointestinal motility test. In the computer-aided molecular approaches, vanillin displayed a promising binding score for both anxiolytic and anti-diarrheal activities, while duabanganal C showed a promising score for the anti-depressant activity. The present experimental findings along with a computer-aided model conclude that MEDG could be a possible Phyto therapeutic agent with potential anti-depressant, anxiolytic and anti-diarrheal activity.

Antidiarrheal and Antisecretory Effect of 80% Hydromethanolic Leaf Extract of Moringa stenopetala Baker f. in Mice.

Introduction In Ethiopia, different medicinal plants have been claimed and used to treat diarrheal diseases. However, these claimed effects for most medicinal plants have not been scientifically verified. One of such plants in Ethiopian folkloric medicine is Moringa stenopetala, which is usually consumed as a vegetable in southern Ethiopia. Thus, this study aimed to evaluate the antidiarrheal and antisecretory effects of 80% methanolic leaf extract of Moringa stenopetala in different mice models. Method Using Swiss albino mice, castor oil-induced diarrhea, charcoal meal-based gastrointestinal motility, and castor oil-induced secretion models were employed to assess antidiarrheal activity. In all of the test models, animals were randomly assigned into five groups consisting of six animals in each group. Group I received 0.5 ml of the vehicle (2% tween-80), while group II was treated with standard drug (3 mg/kg loperamide) in the respective models, whereas groups III to V received 150, 300, and 450 mg/kg of the methanolic leaf extracts of Moringa stenopetala. Onset, frequency, consistency, and weight of stool (diarrhea) were recorded, and different parameters and percentage proportions were calculated. Data were analyzed using one-way ANOVA followed by Tukey's test, and p < 0.05 was considered statistically significant at 95% confidence of interval. Result In the castor oil-induced diarrheal model, the percentage inhibition of diarrhea was 48.5, 58.6, and 60% for the respective doses of 150, 300, and 450 mg/kg of the extract. And, the extract showed a 36.8, 54.4, and 55.9% reduction of peristalsis in charcoal meal-based gastrointestinal motility test compared to the negative control group. Moreover, in the antisecretory assay, the 150, 300, and 450 mg/kg doses of MEMS inhibited fluid contents of the stool by 11.5, 54.54, and 61.82%, respectively, relative to the vehicle-treated group. Conclusion The findings revealed that the 80% methanolic leaf extract of Moringa stenopetala extract has shown antidiarrheal activity.

Antidiarrheal Effect of 80% Methanol Extract and Fractions of Clerodendrum myricoides (Hochst.) Vatke (Lamiaceae) Leaf in Swiss Albino Mice.

Background Diarrhea is one of the tempting symptoms of diseases in the world. In Ethiopian traditional medicine practices, Clerodendrum myricoides is utilized for the treatment of diarrhea without scientific evidence. Objective This study was aimed to evaluate the antidiarrheal activity of 80% methanol extract and fractions of the leaf of Clerodendrum myricoides in mice. Methods The crude extract was prepared by maceration in 80% methanol and then fractionated using hexane, chloroform, and distilled water. Antidiarrheal activity was assessed by castor oil-induced diarrhea, enteropooling, and gastrointestinal motility models using onset of diarrhea, number and weight of feces, volume and weight of intestinal contents, and distance travelled by charcoal meal as main parameters. Negative controls received either distilled water or 2% Tween 80 (10 ml/kg), positive controls received 3 mg/kg loperamide or 1 mg/kg atropine, and the test groups received 100, 200, and 400 mg/kg doses of the extract. Results The crude extract and chloroform fraction significantly prolonged the onset of diarrhea at 200 and 400 mg/kg and decreased the number of wet, total, and weight of fresh feces at all tested doses. Hexane fraction has a significant antidiarrheal effect on the onset, number, and weight of feces at 400 mg/kg. The crude extract and chloroform fraction at all tested doses, as well as aqueous fraction at 200 mg/kg and 100 mg/kg, produced significant reduction in volume and weight of intestinal contents. Additionally, hexane fraction showed significant reduction of volume and weight of the intestinal content at 400 mg/kg. In the gastrointestinal motility test model, both chloroform fraction and crude extract at all tested doses and aqueous fraction at 200 mg/kg and 400 mg/kg showed a significant antidiarrheal effect as compared to the negative control. Conclusion The leaf of Clerodendrum myricoides showed antidiarrheal activity which supports the traditional use.

Antidiarrhoeal Potential of various Solvent Extracts of Achyranthes aspera against three diverse diarrhoeal animal models

Diarrhoea is a condition characterized by a variation in the bowel movement. It is one of the major health issues in developing countries. Its severity is more in children’s. Diarrhoea causes severe dehydration and some time it may lead to death. Globally, over 5 million children’s are dying each year because of diarrhoea. In the present scenario, herbal medicines are used by the people in a wider range because of its safety as compared to synthetic drugs. So it is very crucial to identify and investigate available natural drugs for treating diarrhoea. Hence, the present study endeavor the evaluation of antidiarrhoeal activity of Achyranthus aspera. The anti-diarrhoeal activity was performed by using different animal models like castor oil-induced diarrhoea, prostaglandin-E2 induced enteropooling and gastrointestinal motility test. All the extracts of Achyranthus aspera showed considerable antidiarrhoeal activity in all the three animal models by reducing diarrhoeal episodes. The findings of the present investigation revealed the significant antidiarrhoeal property of Achyranthes aspera. Hence this plant can be used in the suitable form as an alternative to available synthetic antidiarrhoeal medicines which are not completely safe. Thus the adverse effects of synthetic drugs can be minimized by reducing its use.

IN VIVO AND IN VITRO EVALUATION OF PHARMACOLOGICAL ACTIVITIES OF Hedychium coccineum RHIZOMES EXTRACT

The study reports the in vivo antidiarrheal and in vitro anthelmintic, cytotoxic, and thrombolytic activity of methanol extract of Hedychium coccineum rhizomes (MEHC). The antidiarrheal activity was determined using Castor oil-induced diarrhea and Gastrointestinal motility test in mice at the doses of 200 and 400 mg/kg body weight, whereas an aquarium worm, Tubifex tubifex, was used to determine the anthelmintic activity. The cytotoxic and thrombolytic activity of MEHC was performed by Brine shrimp lethality bioassay and clot lysis method respectively. In antidiarrheal, castor oil-induced diarrhea and gastrointestinal motility exhibited a significant reduction in diarrhea and defecation and an extremely significant inhibition in intestinal motility and peristalsis index by 200 and 400 mg/kg of MEHC. The MEHC (5, 10, and 20 mg/mL) showed a significant dose-dependent manner paralysis time and times to death in multiple comparisons to the different levamisole concentrations (0.5, 0.8, and 1 mg/mL) at in vitro anthelmintic activity. The brine shrimp lethality bioassay exhibited a weak LC50 (681.95 µg/mL; R² = 0.951) while in thrombolytic a significant percentage of clot lysis (32.70%, P &lt; 0.05) demonstrated. The findings demonstrate that H. coccineum rhizomes could be potential sources for biological activity.

Systemic Disease Associations with Disorders of Gut-Brain Interaction and Gastrointestinal Transit: A Review.

Functional gastrointestinal disorders (FGID) are now classified within the Rome IV framework as disorders of gut–brain interaction (DGBI). Disorders of gastrointestinal transit (as defined by abnormalities on contemporary gastrointestinal motility testing) frequently are associated with symptoms that are also characteristic of DGBIs. In this narrative review, we outline a non-inclusive set of systemic diseases or risk factors that have been classically associated with DGBIs and disorders of gastrointestinal transit; these include diabetes mellitus, paraneoplastic syndromes, surgery, Parkinson’s disease, systemic sclerosis, endocrinopathies, polypharmacy, and post-infectious syndromes.

Activity of methanol root extract of Parquetina nigrescens (Afzel.) Bullock on castor oil-induced diarrhoea in mice

This study aimed at providing pharmacological rationale for the ethnomedicinal use of Parquetina nigrescens root in the treatment of diarrhoea. The antidiarrhoeal activity of methanol root extract of P. nigrescens(MPN) was determined using castor oil-induced diarrhoea (COD), castor oil-induced enteropooling (COE) and gastrointestinal motility (GIT) tests. In COD, MPN at all doses significantly (p≤0.01) delayed the onset of diarrhoea and significantly (p≤0.05) decreased the number of wet faeces (with percentage inhibition of 52.2; 53.33 and 71.13 at 25, 50 and 100 mg/kg) respectively. The frequency of defecation was significantly (p≤0.01) decreased at 50 and 100 mg/kg. In COE, MPN at all doses significantly (p≤0.01) reduced the volume of intestinal content with percentage inhibition of intestinal fluid accumulation of 79.36; 47.62; 68.25 at doses of 25, 50 and 100 mg/kg respectively against control. In the GIT test, MPN significantly (p≤0.01) decreased the distance travelled by charcoal with a percentage reduction of peristalsis index of 41.19; 47.26; 43.46 at doses of 25, 50 and 100 mg/kg respectively against control. The percentage inhibition of GIT at all doses of MPN was 50.48, 39.00 and 45.62 respectively. MPN possesses antidiarrhoeal activity thus, the credence for its ethnomedicinal use in the treatment of diarrhoea.&#x0D; Keywords: Diarrhoea, castor oil, enteropooling, gastrointestinal motility, Parquetina nigrescens

Questionnaire-Based Survey on Epidemiology of Functional Gastrointestinal Disorders and Current Status of Gastrointestinal Motility Testing in Asian Countries

Background/Aims: Functional gastrointestinal disorders (FGIDs) are diagnosed and classified using the latest Rome IV criteria, released in 2016. Epidemiology of FGID diagnosed by the Rome IV criteria and current clinical application of gastrointestinal motility testing in Asian countries are not well known. The aims of this survey are to elucidate the present situation of epidemiology and diagnostic tests of FGID in clinical practice in some East and Southeast Asian countries. Methods: The questionnaire focusing on current situation of FGID diagnosis and gastrointestinal motility testing was distributed to members of the International Gastroenterology Consensus Symposium study group and collected to be analyzed. Results: The prevalence rates of subtypes of both functional dyspepsia (FD) and irritable bowel syndrome (IBS) are relatively similar in all Asian countries. In these countries, most patients underwent both upper endoscopy and Helicobacter pylori test to diagnose FD. Colonoscopy was also frequently performed to diagnose IBS and chronic constipation. The frequency of gastrointestinal motility testing to examine gastric emptying and colonic transit time varied among Asian countries. Conclusions: This survey revealed epidemiology of FGIDs and current status of gastrointestinal motility testing in some East and Southeast Asian countries.

Anti-diarrhoeal Effects of Aqueous Extract of Vitex doniana Stem Bark in Castor Oil-induced Wistar Rats

Vitex doniana is a medicinal plant commonly used in traditional medicine for the treatment of diarrhoea-related disorders. In the present study, aqueous extract of Vitex doniana stem back was evaluated for anti-diarrhoeal effects. Thirty albino rats of average weight 124 ± 4.35 g were distributed into five groups. Groups 1, 2, 3, 4 and 5 were orally administered 2 mL of normal saline, 2.5 mg/kg bodyweight (bw) loperamide, 100, 200, 400 mg/kg bodyweight of aqueous extract of V. doniana stem back, respectively. The extract was evaluated using feacal characteristics, gastrointestinal motility and enteropooling test. Results for phytochemical screening revealed the presence of tannins, cardiac glycosides, phenols, steroids and saponins. Aqueous extract of Vitex doniana stem bark significantly (p &lt; 0.05) reduced total stool frequency (TSF). 100 mg/kg bw of the extract had the least TSF (4.80 ± 1.64) when compared with the reference drug (5.75 ± 2.98). 100 mg/kg bw and 400 mg/kg bw showed higher percentage inhibition of defecation than the standard drug. The extract also exhibited inhibition of wet stooling and intestinal secretion. It possesses anti-diarrhoeal effects and thus could be a potential source of new drug for the treatment of diarrhoea.&#x0D; Keywords: Diarrhoea; enteropooling gastrointestinal motility; phytochemicals; Vitex doniana

The Impact of COVID-19 on Gastrointestinal Motility Testing in Asia and Europe.

Background: The new coronavirus disease (COVID-19) has high infection and mortality rates, and has become a pandemic. The infection and mortality rates are lower in Asian countries than in European countries. This study aimed to conduct a survey on the effects of COVID-19 on the capacity to perform gastrointestinal motility tests in Asian countries compared with European countries. Methods: We used the questionnaire previously established by our team for researchers in European countries. The correlation between the decreased rate of gastrointestinal motility and function tests, and the infection/mortality rates of COVID-19 and stringency of a government’s interventions in each country was analysed and protective measures were assessed. Results: In total, 58 gastroenterologists/motility experts in Asian countries responded to this survey. The infection/mortality rates of COVID-19 and Stringency Index had a significant impact on the testing capacity of oesophageal manometry and catheter-based pH monitoring. In European countries, most facilities used filtering facepiece 2/3 (FFP2/3) masks during oesophageal motility studies. Meanwhile, in Asian countries, most facilities used surgical masks. Conclusion: The total infection and mortality rates of COVID-19 can affect the rate of gastrointestinal motility testing and the type of protective equipment that must be used.

Recommendations for the reopening and activity resumption of the neurogastroenterology units in the face of the COVID-19 pandemic. Position of the Sociedad Latinoamericana de Neurogastroenterología.

La pandemia por COVID-19 ha obligado a establecer medidas para evitar los contagios durante la realización de pruebas diagnósticas y terapéuticas en gastroenterología. Los estudios motores del tubo digestivo implican un riesgo elevado e intermedio de trasmisión de la infección por este virus. Dada su indicación electiva o no urgente en la mayoría de los casos, recomendamos diferir la realización de estas pruebas hasta que haya un control significativo de la tasa de infección en cada país, durante la pandemia. Cuando las autoridades sanitarias permitan el regreso a la normalidad y en ausencia de un tratamiento efectivo o una vacuna preventiva de la infección por COVID-19, recomendamos un protocolo estricto para clasificar a los pacientes de acuerdo a su estatus infecto-contagioso mediante el uso apropiado de pruebas para la detección del virus y su respuesta inmune, así como el uso de medidas de protección que deberá seguir el personal de la salud para evitar el contagio durante la realización de una prueba de motilidad gastrointestinal.

European Society for Neurogastroenterology and Motility recommendations for conducting gastrointestinal motility and function testing in the recovery phase of the COVID-19 pandemic.

BackgroundDuring the peak of the COronaVIrus Disease 2019 (COVID‐19) pandemic, care for patients with gastrointestinal motility and functional disorders was largely suspended. In the recovery phases of the pandemic, non‐urgent medical care is resumed, but there is a lack of guidance for restarting and safely conducting motility and function testing. Breath tests and insertion of manometry and pH‐monitoring probes carry a risk of SARS‐CoV‐2 spread through droplet formation.MethodsA panel of experts from the European Society for Neurogastroenterology and Motility (ESNM) evaluated emerging national and single‐center recommendations to provide the best current evidence and a pragmatic approach to ensure the safe conduct of motility and function testing for both healthcare professionals and patients.ResultsAt a general level, this involves evaluation of the urgency of the procedure, evaluation of the infectious risk associated with the patient, the investigation and the healthcare professional(s) involved, provision of the test planning and test units, education and training of staff, and use of personnel protection equipment. Additional guidance is provided for specific procedures such as esophageal manometry, pH monitoring, and breath tests.Conclusions and InferencesThe ESNM guidelines provide pragmatic and appropriate guidance for the safe conduct of motility and function testing in the COVID‐19 pandemic and early recovery phase.