Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
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Neurogastroenterol. Motil. · Oct 2011
Preferential activation of the vagal nodose nociceptive subtype by TRPA1 agonists in the guinea pig esophagus.
The TRPA1 receptor is directly activated by a wide range of chemicals including many endogenous molecules relevant for esophageal pathophysiology. We addressed the hypothesis that the TRPA1 agonists differentially activate esophageal nociceptive subtypes depending on their embryological source (neural crest or epibranchial placodes). ⋯ We conclude that the TRPA1 agonists are substantially more effective activators of the placodes-derived than the neural crest-derived esophageal nociceptors. Our data predict that in esophageal diseases the presence of endogenous TRPA1 activators will be preferentially signaled by the vagal nodose nociceptors.
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Neurogastroenterol. Motil. · Sep 2011
Inter-observer reproducibility and analysis of gastric volume measurements and gastric emptying assessed with magnetic resonance imaging.
Magnetic resonance (MR) imaging provides direct, non-invasive measurements of gastric function and emptying. The inter-observer variability (IOV) of MR volume measurements and the most appropriate analysis of MR data have not been established. To assess IOV of total gastric volume (TGV) and gastric content volume (GCV) measurements from MR images and the ability of standard power exponential (PowExp), and a novel linear exponential (LinExp) model to describe MR data. ⋯ Gastric MR provides quantitative measurements of postprandial volume change with low IOV, unless the stomach is nearly empty. The novel LinExp model describes the dynamic volume changes in the early postprandial period more accurately than the PowExp model used in existing gastric emptying studies.
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Neurogastroenterol. Motil. · Aug 2011
ReviewDiagnosis and treatment of chronic constipation--a European perspective.
Although constipation can be a chronic and severe problem, it is largely treated empirically. Evidence for the efficacy of some of the older laxatives from well-designed trials is limited. Patients often report high levels of dissatisfaction with their treatment, which is attributed to a lack of efficacy or unpleasant side-effects. Management guidelines and recommendations are limited and are not sufficiently current to include treatments that became available more recently, such as prokinetic agents in Europe. ⋯ We present an overview of the pathophysiology, diagnosis, current management and available guidelines for the treatment of chronic constipation, and include recent data on the efficacy and potential clinical use of the more newly available therapeutic agents. Based on published algorithms and guidelines on the management of chronic constipation, secondary pathologies and causes are first excluded and then diet, lifestyle, and, if available, behavioral measures adopted. If these fail, bulk-forming, osmotic, and stimulant laxatives can be used. If symptoms are not satisfactorily resolved, a prokinetic agent such as prucalopride can be prescribed. Biofeedback is recommended as a treatment for chronic constipation in patients with disordered defecation. Surgery should only be considered once all other treatment options have been exhausted.
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Neurogastroenterol. Motil. · Jul 2011
Clinical TrialControl of esophageal distension-induced secondary peristalsis by the GABA(B) agonist baclofen in humans.
Secondary peristalsis is important for the clearance of retained food bolus or refluxate from the esophagus. The effects of the gamma aminobutyric acid receptor type B (GABA(B) ) agonist on secondary peristalsis remain unclear in humans. We aimed to investigate the effect of a GABA(B) agonist baclofen on esophageal secondary peristalsis. ⋯ This study provides an evidence for inhibitory modulation of esophageal secondary peristalsis by the GABA(B) agonist baclofen. Activation of secondary peristalsis is probably modulated by GABA(B) receptors; however, baclofen does not lead to any motility change in secondary peristalsis.
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Neurogastroenterol. Motil. · Jul 2011
Comparative StudyVariation of symptoms during the menstrual cycle in female patients with gastroparesis.
Gastroparesis, a chronic gastric motility disorder with symptoms of nausea, vomiting, early satiety, postprandial fullness and bloating, predominantly affects women. Some studies suggest that gastric emptying may be slower in females especially during the luteal phase of the menstrual cycle when estrogen and progesterone levels are elevated. In females with irritable bowel syndrome, symptoms may worsen during the luteal phase. The aim of this study was to determine if symptoms of gastroparesis vary along the menstrual cycle and to determine the effect of oral contraceptive agents (OCPs) on symptoms. ⋯ Increased symptoms, particularly nausea and early satiety, occurred in the luteal phase of the menstrual cycle in female patients with gastroparesis. A variation in symptoms was not seen in gastroparesis female patients on hormonal contraception.