GI Motility Research Articles

S783 Exploring the Gender-Specific Impact of Hormonal Factors on GI Motility Disorders: A Comprehensive Population-Based Study

S783 Exploring the Gender-Specific Impact of Hormonal Factors on GI Motility Disorders: A Comprehensive Population-Based Study

Overweight/bowel dysmotility crosslinking and analogous laxative actions of two edible wild fruits in obese/constipated rats.

The prompt development of obesity/constipation is the most serious problem for both children and adults. Limited studies suggested an association between them but lacked preclinical studies. This study allows to evaluate their crosslink and to compare the aqueous extracts laxative actions of two edible wild fruits of Arbutus unedo (AUAE) and Crataegus monogyna (CMAE) in constipated high-fat diet (HFD) rats. Wistar rats were divided into experimental groups for 13 weeks: standard (SD) and HFD groups. SD-rats were randomly redivided into 2 groups: SD and SD + Loperamide (LOP, 3 mg/kg, b.w.). HFD-rats were randomly reseparated into HFD-group, (HFD + LOP)-group, [HFD + Yohimbine (YOH, 2 mg/kg, b.w.)]-group, [HFD+ LOP]-groups+ various doses of AUAE or CMAE (75, 150, and 300 mg/kg, b.w.). Diversified indicators were investigated to achieve the expected objectives, including; fecal parameters, gastrointestinal transit (GIT), gastric emptying (GE), oxidative stress-(OxS), blood biochemical analysis, and accompanied small/large bowel histological modification. The liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS) analysis of AUAE and CMAE allowed the identification of 11 and 6 phenolic compounds, respectively. In HFD-rats, the subsequent dysregulation of GI motility was markedly aggravated. More importantly, with the same way (CMAE and AUAE)-treated groups showed alleviated outcomes for the following: most stool parameters, GIT, and GE were remarkably recovered; a similar recovery pattern was observed in the histopathological structure, OxS, and blood biochemical indicators. Our results experimentally confirmed the crosslink between overweight and constipation and both fruits have potential as functional foods to reduce metabolic risk of the obesity associated with bowel dysmotility.

A Three-way Attack on the Gastrointestinal System- COVID-19, Ehler-Danlos Syndrome, and Anorexia Nervosa Leading to Severe Gastroparesis in a Young Female

A 28-year-old female with a past medical history of Major Depressive Disorder, Generalized Anxiety Disorder, Anorexia Nervosa, Chronic Pain Syndrome, and Gastro-esophageal Reflux presented to our clinic for establishing care in November 2022 with severe gastric dysmotility ever since contracting COVID-19 virus in December 2021. The patient’s symptoms were refractory to Erythromycin and metoclopramide therapy. A GI motility study in February 2022 showed delayed gastric emptying based on which the patient was diagnosed with Post COVID Gastroparesis. Based on an extensive clinical review of the patient’s past medical and surgical history, the patient was found to have cumulative symptoms of GERD, joint instability, abdominal hernia and chronic neuropathic pain, raising the suspicion of Ehler-Danlos syndrome- Hypermobility type. Given the failure of treatment with prokinetic agents and over 60 pounds of weight loss the patient underwent Percutaneous Endoscopic Gastrostomy-Jejunostomy in August 2022, the patient was started on Organic Tube Feeding Formula. To this date, the patient is using the PEG-J for feeding and remains nil per oral. Multiple trials of reintroducing oral feeding have been attempted but the patient still is unable to tolerate oral feeds completely and continues to complain of early satiety, nausea, and vomiting on reintroducing feeds.

MoPill a novel gastrointestinal positioning system (GPS): New technology to navigate the alimentary tract highway.

Evaluation of gut motility in clinical practice is currently limited. A novel medical system (MoPill™) consisting of a capsule that wirelessly transmits radiofrequency signals to assess motility via 3D location, was used to conduct this study. The objectives were to: (1) confirm the safety of the MoPill™ system; (2) compare the 3D location transmitted by the capsule to its location captured by abdominal x-rays; 3 determine gastric emptying (GE), whole gut transit time (WGTT) and segmental transit times. The MoPill™ system consists of an electronic capsule (2 × 1.2 cm), eight color-coded adhesive sensors (6 × 5.5 cm), a recorder (15 × 11 × 2 cm), and software on a laptop. Four sensors were applied to the abdomen and four to the back. Healthy subjects who had fasted overnight ingested a 250-calorie protein bar, 17 oz. of water, followed by an activated capsule. No further caloric contents were permitted for the next 5 h. At 1, 5, and 24 h (if the capsule had not been expelled), upright abdominal X-rays (AP and lateral) were obtained to assess the location of the capsule, which was compared to the gastrointestinal positioning system (GPS) location determined by the MoPill™ system. Identification of the capsule's anatomical location by the MoPill™ system was based on (1) the 3D (x, y, z) location; (2) time; (3) trajectory (e.g., going up the right side of the body signified ascending colon); (4) frequency of contractions (e.g., 3 cycles/min for the stomach); and (5) milestone relationship (e.g., pyloric passage must follow the end of gastric contractions). GE was determined first by the end of the 3 cycles/min rhythmic movement of the stomach and then again by pyloric expulsion on 3D location. Small intestine transit was taken as the duration from pyloric expulsion to arrival in the cecum. Colon transit time was determined by calculating the duration from 3D arrival in the cecum to passage of the capsule out of the body (i.e., loss of signal accompanying a bowel movement). Ten healthy subjects (five women; mean age 34; mean BMI 24) were enrolled, and nine provided reliable data. The variation between the x-ray and the estimated (i.e., identified by the MoPill™ system) location of the capsule was within an average of 3.5 cm (range 0.9-9.4 cm). The mean GE was 3.1 h. The small intestine's mean transit time was 4.3 h. The mean colonic transit time was 17.6 h. There were no adverse events recorded during the study. MoPill™ is a novel gastrointestinal positional system that accurately identifies the location of a capsule compared to an X-ray. MoPill™ system also recognizes GE, small bowel, colonic, and WGTT as well as segmental gut location and movement characteristics. MoPill™ offers the potential for new insights into GI motility disorders not attainable by current modalities.

Insights into the current state of knowledge, practice, and attitudes of physicians regarding gastrointestinal motility disorders in Egypt

BackgroundGastrointestinal (GI) motility disorders are common in clinical settings, but physicians still lack sufficient understanding and effective management of these conditions.MethodsThis research assessed Egyptian physicians’ knowledge, practices, and attitudes towards GI motility disorders. A cross-sectional survey employing a self-administered questionnaire was carried out among physicians in Egypt. The questionnaire addressed various aspects of physicians’ understanding, practices, and attitudes regarding GI motility disorders. Data analysis was conducted using descriptive statistics and presented as frequencies and percentages.ResultsA total of 462 physicians took part in the study. Although nearly two-thirds of them knew about GI motility studies, a notable proportion lacked adequate knowledge about GI motility disorders. Notably, 84.2% correctly identified dysphagia as a critical symptom suggestive of an upper GI motility disorder. However, 13.4% incorrectly linked hematemesis with an upper GI motility disorder, and 16.7% expressed uncertainty. In terms of practice, around half of the participants encountered a small number of patients with GI motility disorders (less than 5 per week or even fewer). Only 29.7% felt confident in managing patients with motility disorders. Most participating physicians expressed a willingness to participate in training programs focused on motility disorders.ConclusionsThis study underscores a knowledge gap among Egyptian physicians concerning GI motility disorders. It suggests the necessity of tailored education and training programs to improve their competency and practice in this domain.

Circadian rhythm and whole gut transit in mice.

In preclinical studies whole gut transit (WGT) in mice is a gold-standard "leading-edge" approach that measures the time between orogastric gavage of carmine red and defecation of the first carmine red pellet. Transit studies in humans are performed during the active day because GI motility and transit are suppressed during the night. Since mice are nocturnal, WGT studies traditionally done during the day occur during their rest phase. How circadian rhythm affects WGT in mice is not known. We used an automated approach for high temporal resolution uninterrupted testing of mouse WGT and activity. We housed wild-type Bl6/C57 mice under the standard 12 h light-dark cycles. At 8 weeks, we performed carmine red orogastric gavage and assessed WGT during Light (rest) conditions. Then, we exposed mice to a reverse 12 h light-dark cycle for 2 weeks and tested them in the Dark (active) under red light conditions. Timelapse videos were analyzed to quantify activity and to timestamp all pellets, and multiple parameters were analyzed. When complementary light cycle reversal experiments were performed, we found a significant increase in mouse activity when mice were tested during their Dark (active) phase, compared to their Light (rest) phase. In mice tested in the Active phase compared to the Rest phase, we found a significant acceleration in WGT, increased rate and total number of pellets produced, and more pellet clustering. These data show that the mice tested in the Active phase have important differences in activity that correlate with multiple alterations in gastrointestinal transit. During the Active phase mice have faster WGT, produce more pellets, and cluster their output compared to testing in the Rest phase. Like in humans, circadian rhythm is an important consideration for transit studies in mice, and a simple reverse light cycle approach facilitates further studies on the role of circadian rhythm in GI motility.

571 - Moving forward: long-term outcomes of gastric emptying in diabetic gastroparesis patients managed medically at a GI motility center

571 - Moving forward: long-term outcomes of gastric emptying in diabetic gastroparesis patients managed medically at a GI motility center

Этапы становления микробиоты желудочно‑кишечного тракта и роль пробиотиков в коррекции кишечной колики у детей первых месяцев жизни

The physiologic microbiota of the GI tract performs many important functions that coordinate various processes, such as trophic, protective, anti-inflammatory, and immune functions. Transient enzymatic immaturity and immaturity of neuroendocrine regulation of GI motility in newborns creates prerequisites for gastrointestinal dysfunctions that increase with imbalance of the intestinal microbiome, represented by intestinal colic, increased gas formation, gastroesophageal and duodenogastric regurgitation. The objective of the study was to analyze the effectiveness of Probielle® Baby probiotic in the correction of intestinal colic and associated functional GI disorders in children of the first months of life. Patients and methods. The study included 88 children of the first 3 months of life, divided into 3 groups – two main groups receiving Probielle® Baby probiotic and a control group, in which only symptomatic therapy of intestinal colic was performed. The parameters of efficacy assessment included: daily monitoring of crying duration, assessment of stool frequency and consistency, severity of flatulence, frequency and nature of regurgitation, dynamics of intestinal microbiota composition. In order to determine the severity of the intestinal colic syndrome, a score was used. Results. In association with Probielle® Baby, the regression of intestinal colic was more pronounced, and fewer episodes of flatulence and proximal gastroesophageal regurgitation were also noted. Thus, the use of probiotics will significantly increase the effectiveness of complex therapy of gastrointestinal dysfunctions in newborns and children of the first months of life. Key words: microbiota, newborns, immunity, intestinal colic, Probielle Baby

The many faces of gastrointestinal dysfunction in stiff person syndrome spectrum disorders.

The effect of stiff person syndrome spectrum disorders (SPSD) on the gastrointestinal tract (GIT) is unknown. This case series aims to characterize the prevalence and types of GI dysfunction in individuals with SPSD. A retrospective chart review included individuals diagnosed with SPSD with descriptors of GI symptoms in their medical records. SPSD phenotypes, type of motility test performed, and dysmotility pattern (upper, lower, or diffuse) were assessed. Descriptive statistics and univariate chi-square analyses were utilized. Of 240 individuals with SPSD, 32% reported GI symptoms, most were female (83.1%), and white (74%), with a median age at time of GI symptom onset of 50 ± 13 years. Most common symptoms reported were dysphagia (45%), constipation (40%), and nausea/vomiting (23%). Most individuals had classic SPS (47%) followed by SPS-plus (29%) and 82.9% were positive for serum antiGAD65 antibodies. Of 36 patients that underwent at least one GI motility test, 26 had evidence of upper, lower, or diffuse GI dysmotility (44.4%, 17%, and 4%, respectively). The group who did not undergo testing had a higher proportion of patients with DM. There is a high prevalence of GI symptoms and transit abnormalities in patients with SPSD. Future prospective, longitudinal studies are warranted to further assess GI symptoms in the context of SPSD and to determine if individuals with GI symptoms differ in prognosis or treatment response from those without GI symptoms. In the meantime, there should be a low threshold for motility testing in patients with SPSD.

S1557 Understanding the Impact of Liver Transplantation on GI Motility: Prevalence and Risk of GERD and Gastroparesis in Transplant Recipients

S1557 Understanding the Impact of Liver Transplantation on GI Motility: Prevalence and Risk of GERD and Gastroparesis in Transplant Recipients

S630 Gastroparesis Is Here to Stay: Long-Term Outcomes of Gastric Emptying and Symptoms in Gastroparesis Patients Treated at a GI Motility Center

S630 Gastroparesis Is Here to Stay: Long-Term Outcomes of Gastric Emptying and Symptoms in Gastroparesis Patients Treated at a GI Motility Center

Chronic Pain and Mood Disorders Are Not Barriers to Symptom Improvement Under Collaborative Co-managed Care (C3).

Patients with comorbid chronic pain and mood disorders have more severe gastrointestinal disease and higher healthcare expenses than their peers. We sought to determine whether management under our innovative Collaborative Co-Managed Care (C3) general gastroenterology care model improved outcomes. Patient questionnaires completed by outpatients at our GI Motility Center were analyzed alongside demographic information to determine predictors of response to treatment based on adequate relief of gastrointestinal symptoms and improvement in quality of life. These comorbidities did not significantly impair response and may be associated with improved response under our model. The C3 general gastroenterology care model anchors on setting expectations and team-based communication and improves outcomes of, and access to, care.

Geographical Distribution, Chemical Constituents, and Activity Profile of Magnolia

Many Asian countries use the bark of the Magnolia for medicinal purposes. Magnolia has many medical uses, including regulating GI motility, treating cough and asthma, preventing cardiovascular disease, and treating mental illness and brain disorders. To date, 118 magnolia species have been discovered. However, the International Union for Conservation of Nature has designated 231 species as vulnerable and critically endangered. Magnolia leaves yielded 20 isolated chemicals, including 16 lignans with 6 distinct structural types, such as honokiol, veraguensin, sitosterol, and magliflonenone. Magnolia species show pharmacological activities like Neuroprotective, anti-cancer, Anti-microbial, Antiplatelets, Anti-asthmatic, Gastrointestinal, and Hormone regulation. Magnolia bark extracts such as honokiol 2',6-di-(5-propenyl)-1,1'-biphenyl-2,2'-diol, have been demonstrated to benefit health. In recent in vitro and preclinical research, honokiol was found to have anti-inflammatory, anti-angiogenic, anti-oxidative, and anti-cancer activities. Honokiol and magnolol prevented the thromboxane B2 synthesis in response to thrombin, arachidonic acid, and collagen. So, soon, if we cultivate and save the endangered magnolia species through biotechnological means, it will be a boon for mankind.

Mini-review: Enteric glial cell reactions to inflammation and potential therapeutic implications for GI diseases, motility disorders, and abdominal pain

Enteric glial cells are emerging as critical players in the regulation of intestinal motility, secretion, epithelial barrier function, and gut homeostasis in health and disease. Enteric glia react to intestinal inflammation by converting to a ‘reactive glial phenotype’ and enteric gliosis, contributing to neuroinflammation, enteric neuropathy, bowel motor dysfunction and dysmotility, diarrhea or constipation, ‘leaky gut’, and visceral pain. The focus of the minireview is on the impact of inflammation on enteric glia reactivity in response to diverse insults such as intestinal surgery, ischemia, infections (C. difficile infection, HIV-Tat-induced diarrhea, endotoxemia and paralytic ileus), GI diseases (inflammatory bowel diseases, diverticular disease, necrotizing enterocolitis, colorectal cancer) and functional GI disorders (postoperative ileus, chronic intestinal pseudo-obstruction, constipation, irritable bowel syndrome). Significant progress has been made in recent years on molecular pathogenic mechanisms of glial reactivity and enteric gliosis, resulting in enteric neuropathy, disruption of motility, diarrhea, visceral hypersensitivity and abdominal pain. There is a growing number of glial molecular targets with therapeutic implications that includes receptors for interleukin-1 (IL-1R), purines (P2X2R, A2BR), PPARα, lysophosphatidic acid (LPAR1), Toll-like receptor 4 (TLR4R), estrogen-β receptor (ERβ) adrenergic α-2 (α-2R) and endothelin B (ETBR), connexin-43 / Colony-stimulating factor 1 signaling (Cx43/CSF1) and the S100β/RAGE signaling pathway. These exciting new developments are the subject of the minireview. Some of the findings in pre-clinical models may be translatable to humans, raising the possibility of designing future clinical trials to test therapeutic application(s). Overall, research on enteric glia has resulted in significant advances in our understanding of GI pathophysiology.

EPH83 Characteristics, Comorbid Gi Conditions, and Treatment Patterns Among Individuals Diagnosed with Rett Syndrome

rett syndrome (rtt) is a rare, neurodevelopmental disorder primarily affecting females1 often resulting in early loss of acquired skills including hand use, walking, and verbal communication. disorders of gastrointestinal (gi) motility such as gastroesophageal reflux disease (gerd) and constipation are common for individuals diagnosed with rtt. few studies have examined the characteristics, clinical sequalae, medication and healthcare service utilization in response to gi comorbidities associated with rtt.

WEO Newsletter.

WEO Newsletter.

Constipation-Predominant Irritable Bowel Syndrome (IBS-C): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. The pathogenesis of IBS is not completely clear, but it is known to be multifactorial and complex. Endogenous and exogenous factors such as abnormal GI motility, low-grade inflammation, increased epithelial permeability and visceral hypersensitivity, but diet and psychosocial aspects are also recognized as important actors. Furthermore, the interaction between diet and gut microbiota has gained interest as a potential contributor to the pathophysiology of IBS. To date, there is no specific diet for IBS with constipation (IBS-C); however, many studies show that fiber intake, especially soluble fiber such as inulin, could have a positive effect on symptoms. This review aims to evaluate the effects of some nutritional components such as fibers but also functional foods, prebiotics, probiotics and symbiotics on symptoms and microbiota in IBS-C subjects.

Pink1-/- Rats Demonstrate Swallowing and Gastrointestinal Dysfunction in a Model of Prodromal Parkinson Disease.

Early motor and non-motor signs of Parkinson disease (PD) include dysphagia, gastrointestinal dysmotility, and constipation. However, because these often manifest prior to formal diagnosis, the study of PD-related swallow and GI dysfunction in early stages is difficult. To overcome this limitation, we used the Pink1-/- rat, a well-established early-onset genetic rat model of PD to assay swallowing and GI motility deficits. Thirty male rats were tested at 4months (Pink1-/- = 15, wildtype (WT) control = 15) and 6months (Pink1-/- = 7, WT = 6) of age; analogous to early-stage PD in humans. Videofluoroscopy of rats ingesting a peanut-butter-barium mixture was used to measure mastication rate and oropharyngeal and pharyngoesophageal bolus speeds. Abnormal swallowing behaviors were also quantified. A second experiment tracked barium contents through the stomach, small intestine, caecum, and colon at hours 0-6 post-barium gavage. Number and weight of fecal emissions over 24h were also collected. Compared to WTs, Pink1-/- rats showed slower mastication rates, slower pharyngoesophageal bolus speeds, and more abnormal swallowing behaviors. Pink1-/- rats demonstrated significantly delayed motility through the caecum and colon. Pink1-/- rats also had significantly lower fecal pellet count and higher fecal pellet weight after 24h at 6months of age. Results demonstrate that swallowing dysfunction occurs early in Pink1-/- rats. Delayed transit to the colon and constipation-like signs are also evident in this model. The presence of these early swallowing and GI deficits in Pink1-/- rats are analogous to those observed in human PD.

An Engineered Living Intestinal Muscle Patch Produces Macroscopic Contractions that can Mix and Break Down Artificial Intestinal Contents.

The intestinal muscle layers execute various gut wall movements to achieve controlled propulsion and mixing of intestinal content. Engineering intestinal muscle layers with complex contractile function is critical for developing bioartificial intestinal tissue to treat patients with short bowel syndrome. Here, the first demonstration of a living intestinal muscle patch capable of generating three distinct motility patterns and displaying multiple digesta manipulationsis reported. Assessment of contractility, cellular morphology, and transcriptome profile reveals that successful generation of the contracting muscle patch relies on both biological factors in a serum-free medium and environmental cues from an elastic electrospun gelatin scaffold. By comparing gene-expression patterns among samples, it is shown that biological factors from the medium strongly affect ion-transport activities, while the scaffold unexpectedly regulates cell-cell communication. Analysis of ligandreceptor interactome identifies scaffold-driven changes in intercellular communication, and 78% of the upregulated ligand-receptor interactions are involved in the development and function of enteric neurons. The discoveries highlight the importance of combining biomolecular and biomaterial approaches for tissue engineering. The living intestinal muscle patch represents a pivotal advancement for building functional replacement intestinal tissue. It offers a more physiological model for studying GI motility and for preclinical drug discovery.

Esophageal Inlet Patch: A Clinically Significant Entity in Advanced Pulmonary Disease and Lung Transplant Rejection

Background: Esophageal inlet patch (IP) refers to heterotopic gastric mucosa in the cervical esophagus. Secretions from IP may produce symptoms of laryngopharyngeal reflux (LPR) and accelerate progression of lung disease. We aimed to characterize the significance of IP among patients with advanced pulmonary disease, including lung transplant (LTx) recipients, and to assess outcomes following IP ablation. Methods: We established and reviewed a prospective database of all patients with advanced pulmonary disease referred for GI motility evaluation for presence of IP over 7 years. Total IP size, results of pH testing, incidence of transplant rejection and mortality, and effects of IP ablation on symptoms were analyzed. Results: Twenty-seven (13 LTx recipients) of 440 pulmonary patients referred for upper endoscopy were found to have IPs, and 14 completed IP ablation (mean number of 1.7 sessions to ablate IP). Total IP size correlated with total acid exposure time ( P = .01) and symptoms of cough ( P < .00001), heartburn ( P = .0001), and globus ( P < .00001). Symptom severity of heartburn and dysphagia improved following IP ablation ( P = .04 and 0.008). Eight of 13 LTx patient with IP developed either acute or chronic rejection, with 3 cases of post-LTx mortality occurring in patients who did not undergo IP ablation. Conclusions: IP should be given careful consideration in patients with advanced pulmonary disease and lung transplant recipients, particularly if symptoms of cough, heartburn, or globus are present. Total IP size may be predictive of severity of LPR, and symptom recurrence should prompt re-examination for residual IP.