- Bioelectronics for mapping gut activity. [Journal Article]
- BRBrain Res 2018 Aug 15; 1693(Pt B):169-173
- Gastric peristalsis is initiated and coordinated by an underlying bioelectrical activity, termed slow waves. High-resolution (HR) mapping of the slow waves has become a fundamental tool for accuratel...
Gastric peristalsis is initiated and coordinated by an underlying bioelectrical activity, termed slow waves. High-resolution (HR) mapping of the slow waves has become a fundamental tool for accurately defining electrophysiological properties in gastroenterology, including dysrhythmias in gastric disorders such as gastroparesis and functional dyspepsia. Currently, HR mapping is achieved via acquisition of slow waves taken directly from the serosa of fasted subjects undergoing invasive abdominal surgery. Recently, a minimally invasive retractable catheter and electrode has been developed for HR mapping that can only be used in short-term studies in subjects undergoing laparoscopy. Noninvasive mapping has also emerged from multichannel cutaneous electrogastrography; however, it lacks sufficient resolution and is prone to artifacts. Bioelectronics that can map slow waves in conscious subjects, postprandially and long-term, are in high demand. Due to the low signal-to-noise ratio of cutaneous electrogastrography, electrodes for HR mapping of gut activity have to acquire slow waves directly from the gut; hence, development of novel device implantation methods has inevitably accompanied development of the devices themselves. Initial efforts that have paved the way toward achieving these goals have included development of miniature wireless systems with a limited number of acquisition channels using commercially available off-the-shelf electronic components, flexible HR electrodes, and endoscopic methods for minimally invasive device implantation. To further increase the spatial resolution of HR mapping, and to minimize the size and power consumption of the implant for long-term studies, application-specific integrated circuitry, wireless power transfer, and stretchable electronics technologies have had to be integrated into a single system.
- Evaluation of gastric motility through surface electrogastrography in critically ill septic patients. Comparison of metoclopramide and domperidone effects: A pilot randomized clinical trial. [Journal Article]
- RGRev Gastroenterol Mex 2018 Jun 11
- CONCLUSIONS: Both metoclopramide and domperidone similarly increased the DF of gastric pacemaker activity and improved gastric motility by restoring a normogastric pattern. Gastric dysmotility is frequent in septic patients.
- Peroral endoscopic pyloromyotomy is efficacious and safe for refractory gastroparesis: prospective trial with assessment of pyloric function. [Clinical Trial]
- EEndoscopy 2018 Jun 12
- CONCLUSIONS: G-POEM was efficacious and safe for treating refractory gastroparesis, especially in patients with low pyloric distensibility.
- The Challenges of Gastroparesis: Changing Study Design to Improve Clinical Care. [Journal Article]
- AJAm J Gastroenterol 2018 Jun 07
- Glass half empty? Lessons learned about gastroparesis. [Review]
- FF1000Res 2018; 7
- Gastroparesis is defined as a combination of chronic dyspeptic symptoms and delayed emptying of a solid test meal. It remains a difficult-to-treat disorder with a significant impact on quality of lif...
Gastroparesis is defined as a combination of chronic dyspeptic symptoms and delayed emptying of a solid test meal. It remains a difficult-to-treat disorder with a significant impact on quality of life. Although gastroparesis is defined by delayed emptying, several important studies did not find a correlation between this biomarker and symptom severity or treatment success. Thus, some of the more recent trials explored strategies that ranged from antiemetics to antidepressants. Although dietary management showed benefit, most of the other interventions were barely superior to placebo or were not superior at all. Placebo responses were often quite high and this complicates the assessment of active agents. While it complicates the design and interpretation of clinical trials, high response rates for active and sham interventions indicate that we can achieve symptom relief in many patients and thus give them some reassurance. If indeed most therapies are only marginally better than placebo, the differences in adverse effects should be weighed more strongly, a point that is especially important in view of the controversy surrounding metoclopramide. Mechanistic studies introduced the network of macrophages as another potentially important player in the development of gastroparesis. Results are too preliminary and are largely based on preclinical data but show up- and downregulation of cellular elements controlling gastric function. Thus, future developments may teach us how they interfere with some of these mechanisms in clinical settings, potentially making gastroparesis a reversible process.
- Association between delayed gastric emptying and upper gastrointestinal symptoms: a systematic review and meta-analysis. [Journal Article]
- GutGut 2018 Jun 02
- CONCLUSIONS: The systematic review and meta-analysis supports an association between optimally measured delayed gastric emptying and UGI Sx.
- G-POEM for Gastroparesis: Is There Pressure to Go with the Flow? [Editorial]
- DDDig Dis Sci 2018 May 31
- Nuclear Scintigraphy in Practice: Gastrointestinal Motility. [Journal Article]
- AAAJR Am J Roentgenol 2018 May 29; :1-7
- CONCLUSIONS: Radionuclide gastrointestinal motility studies are noninvasive, quantitative, and physiologic diagnostic tools for evaluating patients with gastrointestinal complaints.
- Rome IV Diagnostic Questionnaire Complements Patient Assessment of Gastrointestinal Symptoms for Patients with Gastroparesis Symptoms. [Journal Article]
- DDDig Dis Sci 2018 May 28
- CONCLUSIONS: In this study, Gp patients were characterized using the PAGI-SYM and R4DQ. DGp had more severe retching and vomiting, while PSGp had more severe upper abdominal pain. PDS and CNVS were the most prevalent Rome IV diagnoses. The combination of PDS and CNVS was typically seen in patients with Gp. R4DQ can be helpful to characterize Gp patients.
New Search Next
- Lung transplantation and esophageal dysfunction. [Journal Article]
- RERev Esp Enferm Dig 2018; 110(6):339-341
- Lung transplants belong in the group of organ transplants with poorer outcomes, with acute rejection and bronchiolitis obliterans being cited as major causes of this. Poor allograft evolution has bee...
Lung transplants belong in the group of organ transplants with poorer outcomes, with acute rejection and bronchiolitis obliterans being cited as major causes of this. Poor allograft evolution has been associated with multiple factors, including those related to esophagogastric disease. In patients with end-stage pulmonary conditions eligible for a lung transplant gastroesophageal reflux (GER), esophageal dysmotily, and gastroparesis are highly prevalent and worsen upon transplantation, which may compromise transplant viability. High-resolution impedance manometry and long-term impedance pH-metry studies provide a new perspective where reflux and dysmotility share the limelight with changes in the diagnostic approach and in potential therapies.