Intestinal Motility Research Articles

Effect of chronic administration of magnesium supplement (magnesium glycinate) on male albino wistar rats’ intestinal (Ileum) motility, body weight changes, food and water intake

Recent researches suggests magnesium as an adjuvant medication for COVID 19 patients. Magnesium relaxes skeletal muscles, an effect when prolonged in intestinal smooth muscles can cause severe discomfort such as bloating, vomiting, constipation and nausea. The objectives of this study was to ascertain if magnesium will cause relaxation of the intestinal (ileum) smooth muscles as it does in skeletal muscles. Also, this research seeks to find out the receptor pathway through which magnesium will alter motility in the gut using acetylcholine, atropine and propranolol. Ten male albino wistar rats (100–150 g) were randomly assigned into two groups (control and magnesium treated) (n = 5). Animals were acclimatized for two weeks before treatment which lasted for 6 weeks. Magnesium treated animals received oral magnesium glycinate (1600 mg/70 kg) daily while control group receive normal saline of equal volume. All animals had free access to food and water ad libitum. Results were analyzed at statistical level of P < 0.05. Body weight changes, food and water intake were not statistically significant. Basal contractions of ileum in magnesium treated group were significantly lower compared to control group. Propranolol significantly increased the percentage relaxation in magnesium treated group compared to the control. Atropine significantly decrease the percentage relaxation in magnesium treated group compared to the control. Higher doses of acetylcholine (10−5 and 10−4) increased the contractions in magnesium treated group. Conclusively, magnesium decreases motility of the intestine through beta adrenergic receptor pathway. Intake of magnesium for long period should be closely monitored to avoid the discomforting symptoms earlier stated.

Intestinal expression patterns of transcription factors and markers for interstitial cells in the larval zebrafish.

For the digestion of food, it is important for the gut to be differentiated regionally and to have proper motor control. However, the number of transcription factors that regulate its development is still limited. Meanwhile, the interstitial cells of the gastrointestinal (GI) tract are necessary for intestinal motility in addition to the enteric nervous system. There are anoctamine1 (Ano1)-positive and platelet-derived growth factor receptor α (Pdgfra)-positive interstitial cells in mammal, but Pdgfra-positive cells have not been reported in the zebrafish. To identify new transcription factors involved in GI tract development, we used RNA sequencing comparing between larval and adult gut. We isolated 40 transcription factors that were more highly expressed in the larval gut. We demonstrated expression patterns of the 13 genes, 7 of which were newly found to be expressed in the zebrafish larval gut. Six of the 13 genes encode nuclear receptors. The osr2 is expressed in the anterior part, while foxP4 in its distal part. Also, we reported the expression pattern of pdgfra for the first time in the larval zebrafish gut. Our data provide fundamental knowledge for studying vertebrate gut regionalization and motility by live imaging using zebrafish.

Effect of cholecystokinin on small intestinal motility in suncus murinus

In a fasting gastrointestinal tract, a characteristic cyclical rhythmic migrating motor complex (MMC) occur that comprises of three phases: I, II, and III. Among these, phase III contractions propagate from the stomach to the lower intestine in mammals, including humans, dogs, and Suncus murinus (suncus). Apart from the phase III of MMC propagating from the stomach, during the gastric phase II, small intestine-originated strong contractions propagate to the lower small intestine; however, the mechanism of contractions originating in the small intestine has not been clarified. In this study, we aimed to elucidate the role of cholecystokinin (CCK) in small intestinal motility. Administration of sulfated CCK-8 in phase I induced phase II-like contractions in the small intestine, which lasted for approximately 10–20 min and then returned to the baseline, while no change was observed in the stomach. Contractions of small intestine induced by CCK-8 were abolished by lorglumide, a CCK1 receptor antagonist. Gastrin, a ligand for the CCK2 receptor, evoked strong contractions in the stomach, but did not induce contractions in the small intestine. To examine the effect of endogenous CCK on contractions of small intestinal origin, lorglumide was administered during phase II. However, there was no change in the duodenal motility pattern, and strong contractions of small intestinal origin were not abolished by treatment with lorglumide. These results suggest that exogenous CCK stimulates contractions of small intestine via CCK1 receptors, whereas endogenous CCK is not involved in the strong contractions of small intestinal origin.

CPW partially attenuates DSS-induced ulcerative colitis in mice

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) of the gastrointestinal tract. The etiology is not fully understood, but environmental, microbial, and immunologic factors, as well as a genetic predisposition, play a role. UC is characterized by episodes of abdominal pain, diarrhea, bloody stools, weight loss, severe colonic inflammation, and ulceration. Despite the increase in the frequency of UC and the deterioration of the quality of life, there are still patients who do not respond well to available treatment options. Against this background, natural products such as polysaccharides are becoming increasingly important as they protect the intestinal mucosa, promote wound healing, relieve inflammation and pain, and restore intestinal motility. In this study, we investigated the effect of a polysaccharide isolated from the biomass of Campomanesia adamantium and Campomanesia pubescens (here referred to as CPW) in an experimental model of acute and chronic ulcerative colitis induced by dextran sulfate sodium (DSS). CPW reversed weight loss, increased disease activity index (DAI), bloody diarrhea, and colon shortening. In addition, CPW reduced visceral mechanical hypersensitivity, controlled oxidative stress and inflammation, and protected the mucosal barrier. CPW is not absorbed in the intestine, does not inhibit cytochrome P450 proteins, and does not exhibit AMES toxicity. These results suggest that CPW attenuates DSS-induced acute and chronic colitis in mice and may be a potential alternative treatment for UC.

Evaluation of Pacing Parameters to Induce Contractions in the Small Intestine.

Postoperative ileus and chronic intestinal pseudo-obstruction are intestinal motility disorders that can compromise bowel function resulting in a significant reduction in quality of life and prolonged hospital stays. While medication and nutritional support provides relief for some patients, a significant patient population remains untreated. Therefore, alternative treatment options are required. A novel framework that enables small intestine pacing and video mapping of the contractile response was developed. Pacing pulse parameters (pulse-period: 2.7, 10 s, pulse-width: 100, 400 ms, and pulse-amplitude: 4, 6, 8 mA) were systematically varied to investigate the effect of pacing on the small intestine contractility. The contractile response was quantified by computing the strain of the intestinal diameter at the pacing site. The framework was applied in vivo on porcine jejunal loops (n=4) where segmental contractions were induced in response to pacing pulses. Strain increased with increasing pulse-amplitude and pulse-width, while pacing at a period of 2.7 s elicited higher contractile strains compared to pacing at a period of 10 s at all settings (e.g., -0.18 ± 0.06 vs 0.12 ± 0.06 at 8 mA, 400 ms). For a pulse-width of 100 ms, the contractile strain continued to increase with increasing pulse-amplitude, while the induced strain was comparable for all pulse-amplitudes when paced with high pulse-width (400 ms). Therefore, pacing is an effective tool in modulating the intensity of segmental contractions.Clinical Relevance- Different pacing parameters can define contraction intensity and frequency in the small intestine. This is of therapeutic potential for treating motility disorders such as post-operative ileus and chronic intestinal pseudo-obstruction.

Houpo Paiqi Mixture Promotes Intestinal Motility in Constipated Rats by Modulating Gut Microbiota and Activating 5-HT-cAMP-PKA Signal Pathway.

Constipation is a common functional gastrointestinal disorder which needs more effective treatment approaches. Houpo Paiqi Mixture (HPPQM) is a type of Chinese patent medicine developed from a classical formula that has been widely applied to the treatment of intestinal motility disorder. Here we aim to assess the effectiveness of HPPQM in the treatment of constipation in rat models and its potential mechanism. UPLC-MS/MS was performed to investigate the chemical component of HPPQM. Rats were randomly divided into normal control, constipation model (CM), HPPQM (low, middle and high dose) and mosapride groups. Loperamide 8mg/kg was given orally to induce constipation model. The small intestine motility, colonic contraction, rectum propulsion and histological feature of the colon were significantly improved in HPPQM group, compared with CM group (P<0.05). Results of 16S rRNA sequencing revealed that HPPQM treatment strikingly restructured intestinal microbiota in constipated rats by increasing the relative abundances of Bacteroides and Akkermansia and decreasing the relative abundances of Prevotella and Lactobacillus. The levels of GPR43, 5-HT, 5-HT4R, cAMP, PKA were decreased while SERT was increased in constipated rats (P<0.05), which could be restored to normal levels by treatment with HPPQM (P<0.05). Differences in amplitude between experimental CLSMs (with HPPQM added) and control CLSMs were discovered, starting at the concentration of 40 nL/mL (P<0.05). It was found that GLPG0974 and GR113808 could significantly reduce this reactivity (P<0.05). HPPQM manifested a curative effect in constipated rats by promoting intestinal motility. The underlying mechanisms might be related to modulating gut microbiota and activating 5-HT-cAMP-PKA signal pathway.

Sesquiterpene lactones improve secretory diarrhea symptoms by inhibiting intestinal Ca2+-activated Cl– channel activities directly and indirectly

Secretory diarrhea caused by bacteria and viruses is usually accompanied by activation of the cystic fibrosis transmembrane conductance regulator (CFTR) and calcium-activated Cl– channels (CaCCs) in the intestinal epithelium. Inhibition of CFTR and CaCCs activities significantly reduces fluid losses and intestinal motility in diarrheal diseases. For this reason, CFTR and CaCCs are potential targets of therapeutic drug screening. Here, we reported that the sesquiterpene lactones, alantolactone (AL) and isoalantolactone (iAL), significantly inhibited ATP and Eact-induced short-circuit currents in T84, HT-29 and Fischer rat thyroid (FRT) cells expressing transmembrane protein 16A (TMEM16A) in a concentration-dependent manner. AL and iAL also inhibited the CaCC-mediated short-circuit currents induced by carbachol in the mouse colons. Both compounds inhibited forskolin-induced currents in T84 cells but did not significantly affect mouse colons. In vivo studies indicated that AL and iAL attenuated gastrointestinal motility and decreased watery diarrhea in rotavirus-infected neonatal mice. Preliminary mechanism studies showed that AL and iAL inhibited CaCCs at least partially by inhibiting Ca2+ release and basolateral membrane K+ channels activity. These findings suggest a new pharmacological activity of sesquiterpene lactone compounds that might lead to the development of treatments for rotaviral secretory diarrhea.

Quantitative analysis of the distribution of the myenteric plexus in the rabbit large intestine.

Rabbit large intestine has a segment-specific morphology and motility. However, the morphological features of the myenteric plexus, which controls intestinal motility, have not been characterized in each large intestinal segment. We investigated the myenteric plexus morphology in the rabbit large intestine using protein gene product 9.5 immunohistochemistry in whole-mount preparations. The tenial part of the first and second segments of the proximal colon had the most well developed myenteric plexus, while the caecum had the least. These findings suggest different neuronal control over the motility of each intestinal segment, thereby providing a fundamental understanding of the rabbit enteric nervous system.

Beyond the Digestive System: Understanding Gut-Brain-Microbiome Axis in Irritable Bowel Syndrome

IBS affects a significant number of people worldwide, particularly those under the age of 50, with women being twice as likely to be affected than men. Although the underlying pathophysiology of IBS is not yet fully comprehended, current research indicates that it could be related to the Gut-Brain Axis (GBA). This communication is vital to the intricate balance of the gastrointestinal system. Through this axis intestinal motility, secretion, and sensation are harmoniously regulated, resulting in efficient digestion and optimal nutrient absorption. Disturbance in the Gut-Brain Axis is linked to a broad spectrum of psychiatric and gastrointestinal disorders, including IBS. Managing IBS effectively requires a multidisciplinary approach, including dietary modifications, stress management techniques, medications, and psychological therapies. Proper management of IBS can lead to a healthy and fulfilling life for individuals affected by the disorder. Further studies are required to clarify the causes and development of most effective treatments for IBS

The effectiveness of preventive use of partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFibre®) in patients with benign prostatic hyperplasia and chronic functional constipation

Anatomical proximity of the prostate gland and colon, common innervation, blood and lymph circulation create prerequisites for the involvement of the intestine in the pathological process in prostate diseases.&#x0D; Aim To evaluate the effectiveness of preventive treatment of chronic constipation (CC) with the use of partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®) in patients with benign prostatic hyperplasia (BPH) who are shown to have a prostate tour and its effect on the course of the postoperative period.&#x0D; Materials and methods. We examined 60 patients with BPH who were referred for surgical treatment (transurethral resection of the prostate), who had chronic functional constipation. By random sampling, the patients were divided into two groups of 30 people. In group 1, standard preparation for surgical treatment was carried out for 1 month. In group 2, patients, in combination with standard preparation for surgical treatment, took partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®) with food for the first 3 days – 1 sachet (5 g) per day, from the 4th to the 6th day – 2 sachets per day. From day 7, patients in group 2 were divided into two subgroups. In subgroup 2a, patients whose bowel function returned to normal continued taking the drug at a dose of 2 sachets per day. Those patients in whom the effect of restoring the regularity of bowel function was not satisfactory, took 3 sachets a day from the 7th day and were assigned to subgroup 2b. In the preoperative period, patients were examined on the 1st day (visit 1), 15th day (visit 2) and 30th day (visit 3) of observation. The average number of acts of defecation during the previous week, the severity and dynamics of clinical manifestations of constipation were evaluated on the basis of the Patient Assessment of Constipation Symptoms (PAC-SYM questionnaire), according to the totality of symptoms in points, as well as for each criterion separately. Evaluation of the effectiveness of treatment in the postoperative period was carried out on the basis of dynamic observation for 5–7 days.&#x0D; Results. Initially, all patients in the two groups had signs characteristic of BPH and chronic functional constipation, the groups were homogeneous. According to the results obtained in group 1 for 30 days of follow-up before surgery, none of the studied parameters significantly changed (p0.05). In group 2, after 15 days of follow-up, a significant (p0.05) positive dynamics was revealed for all the studied indicators, both in comparison with group 1 and in comparison with the results obtained at visit 1. By visit 3, despite the absence of statistically significant dynamics in the indicators of both group 1 and group 2, in comparison with visit 2, significant (p0.05) differences remained between the groups. During the study, subgroup 2a included 19 patients who took 2 sachets of OptiFiber® per day, and subgroup 2b included 11 men who took 3 sachets per day from the 7th day of observation. Restoration of intestinal motility in patients taking dietary fiber occurred at an earlier time, while the differences were also statistically significant (p0.05). In group 1, 14 cases of early postoperative complications were registered, and in group 2–9 cases, which is 35.7% less. The number of cases of antibiotic-associated diarrhea in group 1 was 3, while in group 2 there was 1 such case, which is 66.7% less. When analyzing the results obtained, there were no significant differences in the studied parameters in the postoperative period between subgroups 2a and 2b. All 30 (100%) patients of group 2 gave a positive review of partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®), and plan to continue taking them after completing participation in the study.&#x0D; Conclusion. Thus, according to the results of the study, we consider it appropriate to use partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®) in the treatment of CC in patients with BPH who are shown to have a prostate tour as a means to effectively eliminate the manifestations of CC, improve the results of surgical treatment and improve the quality of life of this category of patients.

Ligand-Modified Gold Nanoparticles as Mitochondrial Modulators: Regulation of Intestinal Barrier and Therapy for Constipation.

Intestinal metabolism-related diseases, such as constipation, inflammatory bowel disease, irritable bowel syndrome, and colorectal cancer, could be associated with the dysfunction of intestinal mitochondria. The mitochondria of intestinal epithelial cells are of great significance for promoting intestinal motility and maintaining intestinal metabolism. It is necessary for the prophylaxis and therapy of intestinal metabolism-related diseases to improve mitochondrial function. We investigated the effect of 4,6-diamino-2-pyrimidinethiol-modified gold nanoparticles (D-Au NPs) on intestinal mitochondria and studied the regulatory role of D-Au NPs on mitochondria metabolism-related disease. D-Au NPs improved the antioxidation capability of mitochondria, regulated the mitochondrial metabolism, and maintained intestinal cellular homeostasis via the activation of AMPK and regulation of PGC-1α with its downstream signaling (UCP2 and DRP1), enhancing the intestinal mechanical barrier. D-Au NPs improved the intestinal mitochondrial function to intervene in the emergence of constipation, which could help develop drugs to treat and prevent mitochondrial metabolism-related diseases. Our findings provided an in-depth understanding of the mitochondrial effects of Au NPs for improving human intestinal barriers.

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.

Electroacupuncture in the treatment of IBS in rats: Investigation of the mechanisms of CRH+ neurons in the paraventricular nucleus.

Electroacupuncture (EA) is well documented to treat irritable bowel syndrome (IBS). However, the mechanism of the central nervous system related to IBS and acupuncture stimulation is still not well known. In this study, a rat model of IBS was established by cold-restraint comprehensive stresses for 15 days, and it was found that the levels of corticotropin-releasing hormone (CRH), corticosterone (CORT), and adrenocorticotropic hormone (ACTH) in the peripheral serum were increased; the visceral sensitivity was enhanced; and the intestinal motility was accelerated, specifically, there was an enhancement in the discharge frequency of neurons in the paraventricular nucleus (PVN). EA treatment for 3 days, 20 min/day, alleviated the increase in the levels of CRH, CORT, and ACTH in the peripheral serum of rats, reduced the visceral sensitivity of IBS rats, and inhibited colon movement and discharge frequency of the neurons in the PVN. Additionally, EA could reduce the excitability of CRH neurons and the expression of CRHR1 and CRHR2 in PVN. At the same time, the expression of CRH, CRHR1, and CRHR2 in the peripheral colon was decreased. Taken together, EA appears to regulate intestinal functional activity through the central CRH nervous system, revealing the central regulation mechanism of EA in IBS rats, and providing a scientific research basis for the correlation among the meridians, viscera, and brain.

Radiographic and histopathological study of gastrointestinal dysmotility in lipopolysaccharide-induced sepsis in the rat.

Sepsis is a highly incident condition in which a cascade of proinflammatory cytokines is involved. One of its most frequent consequences is ileus, which can increase mortality. Animal models such as that induced by systemic administration of lipopolysaccharide (LPS) are useful to deeply evaluate this condition. The effects of sepsis on the gastrointestinal (GI) tract have been explored but, to our knowledge, in vivo studies showing the motor and histopathological consequences of endotoxemia in an integrated way are lacking. Our aim was to study in rats the effects of sepsis on GI motility, using radiographic methods, and to assess histological damage in several organs. Male rats were intraperitoneally injected with saline or E. coli LPS at 0.1, 1, or 5 mg kg-1 . Barium sulfate was intragastrically administered, and X-rays were performed 0-24 h afterwards. Several organs were collected for organography, histopathology, and immunohistochemistry studies. All LPS doses caused gastroparesia, whereas changes in intestinal motility were dose-and time-dependent, with an initial phase of hypermotility followed by paralytic ileus. Lung, liver, stomach, ileum, and colon (but not spleen or kidneys) were damaged, and density of neutrophils and activated M2 macrophages and expression of cyclooxygenase 2 were increased in the colon 24 h after LPS 5 mg kg-1 . Using radiographic, noninvasive methods for the first time, we show that systemic LPS causes dose-, time-, and organ-dependent GI motor effects. Sepsis-induced GI dysmotility is a complex condition whose management needs to take its time-dependent changes into account.

Evaluation of the effect of Prithvi Mahabhuta (earth element) on intestinal transit time in Swiss albino mice

Background: Pugaphala (fruit of Areca catechu Linn.) and Udumbara Twaka (bark of Ficus glomerata Roxb.) are popular for their medicinal properties. Both drugs are used in a variety of compound formulations in Ayurveda. On the basis of their Rasa Panchaka (five factors of substance), pharmacognostical, and pharmaceutical research, Pugaphala and Udumbara Twaka were chosen as Prithvi Mahabhuta (earth element) dominant drugs in the current study. Aim: The aim of this study was to assess the impact of Prithvi Mahabhuta-dominating Dravya, Pugaphala, and Udumbara Twaka on intestinal transit time in Swiss albino mice. Materials and methods: A total of 18 Swiss albino mice were divided into three groups of six in each. Pugaphala and Udumbara Twaka were administered in mice in doses of 260 mg/kg and 520 mg/kg, respectively. Results: The result shows that both the drugs significantly reduce intestinal motility due to their Guna (properties) as Ruksha (dry), Vishada (nonslimy), Sthira (stable), Sheeta (cold), and Kashaya Rasa (astringent taste) of Prithvi Mahabhuta; however, Udumbara sample is found to be more efficient. Conclusion: The dominance of Prithvi Mahabhuta is thus confirmed by pharmacological studies in both Pugaphala and Udumbara Twaka, and it is also confirmed that Udumbara Twaka has more Parthiva dominancy than Pugaphala Churna. The Stambhana effect of Prithvi Mahabhuta on intestinal motility can be assessed by latency of onset of white-colored fecal matter in mice.

Awareness of Population Regarding GLP-1 (liraglutide and Semaglutide) Prescribing in PHCC in Abha City, KSA

Background: GLP-1 is a peptide hormone related to the glucagon superfamily and shares a significant amino acid sequence with glucagon. The glucagon superfamily peptides are secreted from the small intestine, pancreas, brain, and peripheral nerves. Furthermore, GLP-1 controls intestinal motility and decreases gastric motility. It also has an effect of satiety, which may be attributed to its effect on the gut, but it also has a direct effect on the hypothalamic feeding centers. Aim: This study aims to assess the population awareness level regarding GLP-1 prescribing in PHCC in Abha City. Methods: A descriptive cross-sectional web-based study was used. An online questionnaire was developed by the study researchers based on a literature review and after consultation of the field experts. The questionnaire of this study included participants’ demographic data, medical history, and GLP-1 use and satisfaction. Also, it covered participants’ awareness regarding GLP-1 and its effects. Results: A total of 160 participants who used GLP-1 completed the study survey. Participants’ ages ranged from 18 to more than 50 years with a mean age of 34.8 ± 13.9 years old. Exactly 89 (55.6%) participants were females. The most used GLP-1 were Saxenda (39.4%), Ozempic (37.5%), and Trulicity (14.4%) while 8.8% used a combination of them. Exactly 127 (79.4%) participants had an overall poor awareness level regarding GLP-1 while only 33 (20.6%) had a good awareness level. Conclusion: In conclusion, the current study revealed that a significant portion of diabetic and obese persons use GLP-1 for reducing weight and controlling blood glucose levels. On the other hand, their awareness level regarding the drugs was unsatisfactory. Keywords: GLP-1, diabetes, obesity, awareness, use, population, knowledge, Saudi Arabia

Возможности патогенетической терапии у больных с функциональной патологией органов пищеварения

INTRODUCTION: Functional diseases of the gastrointestinal tract presents a real problem to public health. The basis of effective therapy for irritable bowel syndrome (IBS) and functional dyspepsia (FD) is a combined use of symptom-reducing drugs. AIM: To assess the dynamics of the intensity of abdominal pain and changes in the motility of stomach and intestine after treatment of patients with IBS, and with IBS in combination with FD, with STW 5 preparation. MATERIALS AND METHODS: 28 patients with IBS, including patients with a combination of IBS and FD, were taking STW 5 orally, 20 drops 3 times daily before meals for 14 days, to relieve clinical symptoms. Before and after treatment, patients completed a survey using VAS and ‘7 × 7’ questionnaires and underwent peripheral electrogastroenterocolography (EGECG). RESULTS: The level of abdominal pain before treatment in patients with predominating constipation corresponded to a moderate degree of intensity, in patients with diarrhea to a mild degree of intensity. During treatment, 32.1% of patients noted relief of abdominal pain in the second week of treatment; bloating was less common and/or did not occur in 71.4% of patients; 42.9% of study participants noted normalization of stool frequency and/or stool shape. Improvement of clinical condition in terms of FD symptoms was observed in 76.9% of patients with IBS and FD. The use of STW 5 was associated with a 51.3% reduction of pain intensity (p &lt; 0.001) after a week of treatment. Mean changes in the colon coefficient rhythmicity (Crhythm) according to the results of EGECG after treatment in patients with constipation reliably differed from the level of change in Crhythm in patients with diarrhea (p = 0.047). CONCLUSION: The results of the study confirm the effectiveness of STW 5 in the treatment of patients with IBS, and with IBS in combination with FD.

Utility of Color Doppler Ultrasonography in Monitoring of a Free Jejunal Flap.

External color Doppler ultrasonography is reported to be a useful monitoring technique that is simple and noninvasive; however, details of imaging of the transferred free jejunal flap have not been reported. We reviewed our experience using external color Doppler ultrasonography to monitor a transferred free jejunal flap and examined its utility. Retrospective study. Subjects were 43 patients who underwent total pharyngolaryngectomy, reconstruction with a free jejunal flap, and color Doppler ultrasonography before, during, and after surgery between September 2017 and December 2021. During surgery, arterial thrombosis was detected up to 100% with the loss of continuous color signals in the entire circumference. After surgery, the positive predictive value was 100% for each of wiggling movement, dynamic intestinal movement, and continuous color signals in the entire circumference on color Doppler ultrasonography for detecting flap viability. Their negative predictive value was 100%, 7.1%, and 50%, respectively. During surgery, the continuous color signals in the entire circumference sign were useful with 100% negative predictive value for detecting the arterial thrombosis. After surgery, the wiggling movement sign very was useful with 100% positive and negative predictive values, enabling salvage surgery to be performed soon after detection of flap failure. 4 Laryngoscope, 133:3361-3369, 2023.

Small Bowel Transit Scintigraphy in Children With Pediatric Intestinal Pseudo-Obstruction.

Objective evidence of small intestinal dysmotility is a key criterion for the diagnosis of pediatric intestinal pseudo-obstruction (PIPO). Small bowel scintigraphy (SBS) allows for objective measurement of small bowel transit (SBT), but limited data are available in children. We aimed to evaluate the utility of SBS in children suspected of gastrointestinal dysmotility. Patients undergoing gastric emptying studies for suspected foregut dysmotility, including PIPO, from 2016 to 2022 at 2 tertiary children's hospitals were recruited to an extended protocol of gastric emptying studies to allow for assessment of SBT. PIPO was classified based on antroduodenal manometry (ADM). SBT was compared between PIPO and non-PIPO patients. Scintigraphic parameters were assessed and correlated against ADM scores. Fifty-nine patients (16 PIPO and 43 non-PIPO diagnoses) were included. SBS was performed with liquid and solid meals in 40 and 26 patients, respectively. As compared to the non-PIPO group, PIPO patients had a significantly lower median percentage of colonic filling at 6 hours, with both liquid (48% vs 83%) and solid tests (5% vs 65%). SBT in PIPO patients with myopathic involvement was significantly slower than in patients with neuropathic PIPO, both for liquid and solid meal. A significant correlation was found between solid SBT and ADM scores (r = -0.638, P = 0.036). SBS provides a practically feasible assessment of small intestinal motility. It shows a potential utility to help diagnose and characterize PIPO. SBS seems most discriminative in PIPO patients with myopathic involvement. Studies in a larger pediatric population and across different ages are required.

BQ788 reveals glial ETB receptor modulation of neuronal cholinergic and nitrergic pathways to inhibit intestinal motility: Linked to postoperative ileus.

ET-1 signalling modulates intestinal motility and inflammation, but the role of ET-1/ETB receptor signalling is poorly understood. Enteric glia modulate normal motility and inflammation. We investigated whether glial ETB signalling regulates neural-motor pathways of intestinal motility and inflammation. We studied ETB signalling using: ETB drugs (ET-1, SaTX, BQ788), activity-dependent stimulation of neurons (high K+ -depolarization, EFS), gliotoxins, Tg (Ednrb-EGFP)EP59Gsat/Mmucd mice, cell-specific mRNA in Sox10CreERT2 ;Rpl22-HAflx or ChATCre ;Rpl22-HAflx mice, Sox10CreERT2 ::GCaMP5g-tdT, Wnt1Cre2 ::GCaMP5g-tdT mice, muscle tension recordings, fluid-induced peristalsis, ET-1 expression, qPCR, western blots, 3-D LSM-immunofluorescence co-labelling studies in LMMP-CM and a postoperative ileus (POI) model of intestinal inflammation. In the muscularis externa ETB receptor is expressed exclusively in glia. ET-1 is expressed in RiboTag (ChAT)-neurons, isolated ganglia and intra-ganglionic varicose-nerve fibres co-labelled with peripherin or SP. ET-1 release provides activity-dependent glial ETB receptor modulation of Ca2+ waves in neural evoked glial responses. BQ788 reveals amplification of glial and neuronal Ca2+ responses and excitatory cholinergic contractions, sensitive to L-NAME. Gliotoxins disrupt SaTX-induced glial-Ca2+ waves and prevent BQ788 amplification of contractions. The ETB receptor is linked to inhibition of contractions and peristalsis. Inflammation causes glial ETB up-regulation, SaTX-hypersensitivity and glial amplification of ETB signalling. In vivo BQ788 (i.p., 1mg·kg-1 ) attenuates intestinal inflammation in POI. Enteric glial ET-1/ETB signalling provides dual modulation of neural-motor circuits to inhibit motility. It inhibits excitatory cholinergic and stimulates inhibitory nitrergic motor pathways. Amplification of glial ETB receptors is linked to muscularis externa inflammation and possibly pathogenic mechanisms of POI.