- Gastroparesis. [Review]
- NRNat Rev Dis Primers 2018 Nov 01; 4(1):41
- Gastroparesis is a disorder characterized by delayed gastric emptying of solid food in the absence of a mechanical obstruction of the stomach, resulting in the cardinal symptoms of early satiety, pos...
Gastroparesis is a disorder characterized by delayed gastric emptying of solid food in the absence of a mechanical obstruction of the stomach, resulting in the cardinal symptoms of early satiety, postprandial fullness, nausea, vomiting, belching and bloating. Gastroparesis is now recognized as part of a broader spectrum of gastric neuromuscular dysfunction that includes impaired gastric accommodation. The overlap between upper gastrointestinal symptoms makes the distinction between gastroparesis and other disorders, such as functional dyspepsia, challenging. Thus, a confirmed diagnosis of gastroparesis requires measurement of delayed gastric emptying via an appropriate test, such as gastric scintigraphy or breath testing. Gastroparesis can have idiopathic, diabetic, iatrogenic, post-surgical or post-viral aetiologies. The management of gastroparesis involves: correcting fluid, electrolyte and nutritional deficiencies; identifying and treating the cause of delayed gastric emptying (for example, diabetes mellitus); and suppressing or eliminating symptoms with pharmacological agents as first-line therapies. Several novel pharmacologic agents and interventions are currently in the pipeline and show promise to help tailor individualized therapy for patients with gastroparesis.
- Real-World, Non-Interventional, Observational Study to Evaluate Effectiveness and Tolerability of Acotiamide Hydrochloride Hydrate in Treatment of Functional Dyspepsia. [Journal Article]
- ATAdv Ther 2018; 35(11):1884-1893
- CONCLUSIONS: The current study demonstrates that treatment with acotiamide improves symptoms, QoL and is well tolerated in Indian patients with FD.
- Laparoscopic-thoracoscopic esophageal resection in the treatment of giant epiphrenic esophageal diverticulum (Ivor Lewis operation): Case report. [Journal Article]
- IJInt J Surg Case Rep 2018; 52:89-94
- CONCLUSIONS: The laparoscopic-thoracoscopic esophageal resection with gastric tube plasty (Ivor Lewis operation) might be the method of choice in cases of giant epiphrenic esophageal diverticula, when esophageal resection is connected with the high risk of anastomotic dehiscence due to esophageal wall necrosis.We have established that in case of necrobiotic changes in the esophageal wall in the area of the diverticulum, this tactic is completely justified because of the greater patient safety and the less risk of the stapler suture line dehiscence.
- PROLONGED GASTROESOPHAGEAL REFLUX MONITORING BY IMPEDANCE-PHMETRY: A REVIEW OF THE SUBJECT PONDERED WITH OUR EXPERIENCE WITH 1,200 CASES. [Journal Article]
- AGArq Gastroenterol 2018; 55Suppl 1(Suppl 1):76-84
- CONCLUSIONS: Impedance-pHmetry is a promising method, with great advantages over conventional pHmetry. The choice between these two types of monitoring should be very judicious. The authors suggest the importance of careful evaluation of each reflux episode by the physician responsible for the examination, necessary for the correct interpretation of the tracings.
- Prevalence and clinical characteristics of refractoriness to optimal proton pump inhibitor therapy in non-erosive reflux disease. [Journal Article]
- APAliment Pharmacol Ther 2018; 48(10):1074-1081
- CONCLUSIONS: True refractoriness in patients with GERD symptoms attending a secondary care setting is lower than previously reported. Following a careful history and optimal PPI dosing, the rate of refractoriness was 20%. True NERD constitutes only a third of the PPI-refractory group.
- Review: Precision nutrition of ruminants: approaches, challenges and potential gains. [Journal Article]
- AAnimal 2018; 12(s2):s246-s261
- A plethora of sensors and information technologies with applications to the precision nutrition of herbivores have been developed and continue to be developed. The nutritional processes start outside...
A plethora of sensors and information technologies with applications to the precision nutrition of herbivores have been developed and continue to be developed. The nutritional processes start outside of the animal body with the available feed (quantity and quality) and continue inside it once the feed is consumed, degraded in the gastrointestinal tract and metabolised by organs and tissues. Finally, some nutrients are wasted via urination, defecation and gaseous emissions through breathing and belching whereas remaining nutrients ensure maintenance and production. Nowadays, several processes can be monitored in real-time using new technologies, but although these provide valuable data 'as is', further gains could be obtained using this information as inputs to nutrition simulation models to predict unmeasurable variables in real-time and to forecast outcomes of interest. Data provided by sensors can create synergies with simulation models and this approach has the potential to expand current applications. In addition, data provided by sensors could be used with advanced analytical techniques such as data fusion, optimisation techniques and machine learning to improve their value for applications in precision animal nutrition. The present paper reviews technologies that can monitor different nutritional processes relevant to animal production, profitability, environmental management and welfare. We discussed the model-data fusion approach in which data provided by sensor technologies can be used as input of nutrition simulation models in near-real time to produce more accurate, certain and timely predictions. We also discuss some examples that have taken this model-data fusion approach to complement the capabilities of both models and sensor data, and provided examples such as predicting feed intake and methane emissions. Challenges with automatising the nutritional management of individual animals include monitoring and predicting of the flow of nutrients including nutrient intake, quantity and composition of body growth and milk production, gestation, maintenance and physical activities at the individual animal level. We concluded that the livestock industries are already seeing benefits from the development of sensor and information technologies, and this benefit is expected to grow exponentially soon with the integration of nutrition simulation models and techniques for big data analysis. However, this approach may need re-evaluating or performing new empirical research in both fields of animal nutrition and simulation modelling to accommodate a new type of data provided by the sensor technologies.
- Utility of Esophageal High-Resolution Manometry in Clinical Practice: First, Do HRM. [Review]
- DDDig Dis Sci 2018; 63(12):3178-3186
- Esophageal high-resolution manometry (HRM) has advanced the understanding of esophageal motor function and the ability to diagnose and manage disorders of esophageal motility. In this review, we desc...
Esophageal high-resolution manometry (HRM) has advanced the understanding of esophageal motor function and the ability to diagnose and manage disorders of esophageal motility. In this review, we describe the indications for and the technical performance of HRM. The Chicago classification of esophageal motor function, now in its third iteration, streamlines and standardizes the nomenclature and basic interpretation of HRM data depicted as Clouse topographic plots. In clinical practice, HRM is an important diagnostic test for patients with dysphagia as well as patients with suspected gastroesophageal reflux disease (GERD), particularly in those patients with a suboptimal symptomatic response to antisecretory therapy. HRM can support diagnoses such as achalasia, as well as provide evidence for behavioral disorders such as rumination syndrome or supragastric belching with the assistance of postprandial HRM with impedance. Further, the GERD classification of motor function introduces a three-part hierarchical evaluation of esophageal motor function in GERD, highlighting the value of assessment of esophageal contractile reserve through provocative maneuvers during HRM such as multiple rapid swallows.
- New developments in the treatment of gastroparesis and functional dyspepsia. [Review]
- COCurr Opin Pharmacol 2018 Sep 20; 43:111-117
- Functional dyspepsia (FD) and gastroparesis are frequent causes of upper gastrointestinal symptoms such as postprandial fullness, early satiation, epigastric pain or burning, upper abdominal bloating...
Functional dyspepsia (FD) and gastroparesis are frequent causes of upper gastrointestinal symptoms such as postprandial fullness, early satiation, epigastric pain or burning, upper abdominal bloating, bothersome belching, nausea and vomiting. The underlying pathophysiological mechanisms are heterogeneous and involved mechanisms such as abnormal gastric motility (accommodation, emptying), visceral hypersensitivity, low grade mucosal inflammation and cellular changes in enteric nerves, muscle or interstitial cells of Cajal. Patient-reported outcomes for evaluating treatment efficacy in these conditions were recently developed and validated. Prokinetic agents, which enhance gastric motility, are used for treating both gastroparesis and FD. In FD, besides acid suppressive therapy and Helicobacter pylori eradication, neuromodulators and drugs that enhance gastric accommodation can be applied. In gastroparesis, anti-emetics may also provide symptom relief. Novel approaches under evaluation in these conditions are the fundus relaxing agents acotiamide and buspirone and the antidepressant mirtazapine in FD. For gastroparesis, recently studied agents include the prokinetic ghrelin agonist relamorelin, the prokinetic serotonergic agents velusetrag and prucalopride, the anti-emetic aprepitant and per-endoscopic pyloric myotomy procedures.
- A cross-sectional study of show English bulldogs in the United States: evaluating paw lesions, cytological findings, pruritic behaviours and gastrointestinal signs. [Journal Article]
- VDVet Dermatol 2018; 29(5):395-e130
- CONCLUSIONS: This study supports that show EBDs have frequent pedal lesions and history of dermatological disease, with over half receiving medication, as well as increased frequency of belching, flatulence and facial rubbing. Pedal cytological findings were not predictive of lesions, with the exception of white coloured exudation.
New Search Next
- Gastric gas dynamics in healthy humans. [Journal Article]
- NMNeurogastroenterol Motil 2018; 30(11):e13408
- CONCLUSIONS: An excellent balance between belching and distal gastric empting allows the stomach to adapt to great variations in gas intake. In general, most gastric gas is emptied to distal intestinal segments, but in some circumstances gastric gas induces belching, a mechanism that may improve gas tolerance.