Esophageal dysmotility patterns are associated with distinct clinical phenotypes and prognosis in patients with systemic sclerosis.

Objectives: Esophageal dysmotility is a common manifestation of SSc, contributing to substantial morbidity. We sought to determine whether esophageal dysmotility patterns, by high-resolution esophageal manometry were associated with distinct SSc clinical phenotypes and different outcomes.

Methods: We analyzed a cohort of SSc patients with detailed clinical and immunological data.

Gastrointestinal manifestations of systemic sclerosis: current approaches and emerging therapies.

Purpose Of Review: This review highlights recent advances in the understanding and management of gastrointestinal manifestations in systemic sclerosis (SSc). It is intended for clinicians and researchers aiming to improve diagnostic accuracy and therapeutic strategies in managing SSc-related gastrointestinal disease.

Recent Findings: Gastrointestinal involvement in SSc is highly variable in terms of clinical presentation, symptom severity, progression, timing of onset, and response to treatment.

Avoidant or Restrictive Food Intake Disorder Symptoms in Adults With Systemic Sclerosis: A Nationwide Study in Spain.

Objective: Patients with systemic sclerosis (SSc) may restrict food intake to manage their symptoms (particularly gastrointestinal [GI]). Whether some patients may develop nutritional and/or quality-of-life impairments indicative of an eating disorder, avoidant or restrictive food intake disorder (ARFID), is unknown. We aimed to (1) identify the prevalence and characteristics of ARFID symptoms in patients with SSc and (2) explore the relationship among ARFID symptoms, GI symptom burden, and health-related quality of life.

Effect of propinox and pinaverium bromide on colonic motor patterns and their synergistic effect with hyoscine butyl bromide.

Background: Antispasmodic agents are used to treat abdominal pain. The mode of action of pinaverium bromide and propinox in the colonic tissue has never been characterized. This study aimed to explore whether HBB can complement the antispasmodic effects of these drugs.

Practical Validation of the COuGH RefluX Score: A Multicenter Study in Patients From Hispano-America.

Background: Laryngopharyngeal reflux symptoms (LPS) are often attributed to gastroesophageal reflux disease (GERD), yet objective testing confirms GERD in only a small subset of patients. The COuGH RefluX score, previously validated in North American and Taiwanese populations, offers a non-invasive method to stratify GERD likelihood in patients with LPS. This study aimed to evaluate its performance in a real-world Hispano-American cohort.

The role of prokinetics in managing gastrointestinal involvement in SSc: a systematic literature review.

Objectives: Gastrointestinal involvement (GI) in SSc is frequent and heterogeneous, manifesting with different degrees of dysmotility. This systematic literature review aimed to summarize evidence on prokinetics for treating SSc-related GI dysmotility.

Methods: Studies investigating the effects of prokinetic agents on GI function and/or GI symptoms in patients with SSc were systematically identified on PubMed and Embase.

Updated document on the management of functional dyspepsia by the Asociación Española de Neurogastroenterologia y Motilidad (ASENEM) and Sociedad Española de Medicina Familiar y Comunitaria (semFYC).

Functional dyspepsia (FD) is a gut-brain axis disorder characterized by postprandial fullness, early satiety, bloating and/or epigastric pain, which are presumed to originate in the gastroduodenal tract. While the international recommendations in the Rome IV consensus require endoscopy to rule out an organic condition before establishing a diagnosis of FD, international guidelines recommend that, in the absence of risk factors, patient management be initiated at the primary care level by establishing Helicobacter pylori infection status, with eradication when positive, followed by empiric therapy with proton pump inhibitors and/or prokinetics, and that endoscopy be reserved for patients refractory to said measures. Second-line therapy includes neuromodulating agents, among which tricyclic antidepressants and atypical antipsychotics such as levosulpiride stand out.

European Guideline on Chronic Nausea and Vomiting-A UEG and ESNM Consensus for Clinical Management.

Introduction: Chronic nausea and vomiting are symptoms of a wide range of gastrointestinal and non-gastrointestinal conditions. Diagnosis can be challenging and requires a systematic and well-structured approach. If the initial investigation for structural, toxic and metabolic disorders is negative, digestive motility and gut-brain interaction disorders should be assessed.

Evaluation of Perceived Competence and Satisfaction in Neurogastroenterology and Motility Training During the Gastroenterology Fellowship in Spain.

Introduction: We evaluated the level of achievement of the published recommendations of the European and American neurogastroenterology and motility (NGM) Societies, on the competence in managing NGM disorders in a European Country with regulated gastroenterology training program.

Methods: We conducted a nationwide survey to gastroenterologists in Spain. Information regarding demographics, training center characteristics, NGM training, self-reported interest, satisfaction with the Tier 1 skills recommended by the ANMS-ESNM, and perceived competence in the diagnosis and management of diseases in the spectrum of NGM was obtained.

Resolution of dysphagia due to secondary achalasia with neuropathic chronic intestinal pseudo-obstruction by peroral endoscopic myotomy.

Chronic intestinal pseudo-obstruction (CIPO) is a rare condition affecting the motility of the lower gastrointestinal tract, while achalasia is an uncommon esophageal motility disorder. The coexistence of both conditions is extremely rare. We present the case of a patient who had both pathologies, admitted for dysphagia and oral intolerance, the symptoms finally resolved by performing a POEM.

Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study.

Background: Systemic sclerosis (SSc) is a chronic autoimmune disease characterised by microvascular damage and fibrosis. Mortality in patients with SSc has significantly decreased. Consequently, patients with SSc have longer life expectancy, and health-related quality of life (HrQoL) has become more relevant in the comprehensive management of the disease.

Evaluation of the mechanism of action of paracetamol, drotaverine, and peppermint oil and their effects in combination with hyoscine butylbromide on colonic motility: human study.

Introduction: Drotaverine, paracetamol, and peppermint oil are often prescribed for the treatment of gastrointestinal spasm and pain. This study aimed to evaluate the effect of these drugs alone and combined with the well-known antispasmodic hyoscine butylbromide on the human colon.

Methods: Colon samples were obtained from macroscopically normal regions of 68 patients undergoing surgery and studied in muscle bath.

Common questions and rationale answers about the intestinal bacterial overgrowth syndrome (SIBO).

The recognition and treatment of intestinal bacterial overgrowth syndrome are matters of controversy. The symptoms that have guided the search for the disorder suffer from lack of specificity, especially in the absence of well-defined predisposing factors. The accuracy of diagnostic procedures has been questioned and the proposed therapies achieve generally low effectiveness figures, with large differences between available studies.

New insights into the characterization of the mechanism of action of hyoscine butylbromide in the human colon ex vivo.

Introduction: Hyoscine butylbromide (HBB) is one of the most used antispasmodics in clinical practice. Recent translational consensus has demonstrated a similarity between human colonic motor patterns studied ex vivo and in vivo, suggesting ex vivo can predict in vivo results. It is unclear whether the mechanism of action of antispasmodics can predict different use in clinical practice.

Distinctive gastrointestinal motor dysfunction in patients with MNGIE.

Background: Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare mitochondrial disease caused by mutations in TYMP, encoding thymidine phosphorylase. Clinically it is characterized by severe gastrointestinal dysmotility associated with cachexia and a demyelinating sensorimotor polyneuropathy. Even though digestive manifestations are progressive and invariably lead to death, the features of gastrointestinal motor dysfunction have not been systematically evaluated.

Benefit of extending the protocol for high resolution manometry according to the version 4.0 of the Chicago criteria. A multicenter study.

Background: The last version of the Chicago Criteria for high resolution esophageal manometry proposes an expanded protocol including complementary maneuvers to improve the diagnostic yield of the exploration. Our aim was to determine the diagnostic gain of the CCv4.0 protocol compared to the CCv3.

Evaluation of abdominal gas by plain abdominal radiographs.

Background: Our aim was to determine the reliability of plain abdominal radiographs for the evaluation of abdominal gas content in patients with functional digestive symptoms.

Methods: Abdominal CT scan scout views, mimicking a conventional plain abdominal radiograph, were obtained from 30 patients both during episodes of abdominal distension and basal conditions. Physicians (n = 50) were instructed to rate the estimated volume of gas in the 60 images presented in random sequence using a scale graded from 0 to ≥600 ml.

Clinical significance of small bowel manometry patterns suggestive of intestinal obstruction.

Introduction: Minute rhythm and prolonged simultaneous contractions are patterns of postprandial small bowel contractile activity that historically have been considered as suggestive of mechanical intestinal obstruction; however, these patterns have been also encountered in patients with motility-like symptoms in the absence of bowel obstruction. The objective of this study was to determine the current diagnostic outcome of patients with these intestinal manometry patterns.

Methods: Retrospective study of patients with chronic digestive symptoms evaluated by intestinal manometry at our center between 2010 and 2018.

Effect of colonic distension on small bowel motility measured by jejunal high-resolution manometry.

Background: Abnormal motility patterns in the jejunum can be detected in patients with prominent colonic content, and these abnormalities may be due to either a primary jejunal dysfunction or a reflex distortion. The objective of the present study was to determine the effect of colonic distension on small bowel postprandial motility using high-resolution manometry.

Methods: Single center, controlled, parallel, randomized, single blind study in healthy subjects testing the effect of colonic filling vs sham infusion on the responses to a meal in 16 healthy subjects.