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Chronic gastrointestinal dysmotility

Rachel M McQuade, Vanesa Stojanovska, Raquel Abalo, Joel C Bornstein, Kulmira Nurgali
Gastrointestinal (GI) side-effects of chemotherapy are a debilitating and often overlooked clinical hurdle in cancer management. Chemotherapy-induced constipation (CIC) and Diarrhea (CID) present a constant challenge in the efficient and tolerable treatment of cancer and are amongst the primary contributors to dose reductions, delays and cessation of treatment. Although prevalence of CIC is hard to estimate, it is believed to affect approximately 16% of cancer patients, whilst incidence of CID has been estimated to be as high as 80%...
2016: Frontiers in Pharmacology
Rachel M McQuade, Simona E Carbone, Vanesa Stojanovska, Ahmed Rahman, Rachel M Gwynne, Ainsley M Robinson, Craig A Goodman, Joel C Bornstein, Kulmira Nurgali
BACKGROUND AND PURPOSE: Oxaliplatin is a platinum-based chemotherapeutic drug used as a first-line therapy for colorectal cancer. However, its use is associated with severe gastrointestinal side-effects resulting in dose limitations and/or cessation of treatment. In this study, we tested whether oxidative stress, caused by chronic oxaliplatin treatment, induces enteric neuronal damage and colonic dysmotility. EXPERIMENTAL APPROACH: Oxaliplatin (3 mg·kg(-1) per day) was administered in vivo to Balb/c mice intraperitoneally three times a week...
December 2016: British Journal of Pharmacology
Agostino Di Ciaula, Ignazio Grattagliano, Piero Portincasa
AIM: To perform a comprehensive study on gastrointestinal symptoms, motility and autonomic neuropathyin chronic alcoholics before and one year after abstinence. METHODS: Dyspeptic symptoms (questionnaires), fasting and postprandial gallbladder and gastric motility (ultrasonography), oro-cecal transit time (lactulose H2 -breath test), stool form score (indirect marker of colonic transit), and autonomic neuropathy (sweat spot test, R-R ratio) were assessed at baselinein 268subjects (136chronic alcoholics,132healthy controls)...
September 29, 2016: Journal of Digestive Diseases
G Di Nardo, C Di Lorenzo, A Lauro, V Stanghellini, N Thapar, T B Karunaratne, U Volta, R De Giorgio
BACKGROUND: Chronic intestinal pseudo-obstruction (CIPO) represents the most severe form of gastrointestinal dysmotility with debilitating and potentially lethal consequences. Symptoms can be non-specific, and result in this condition being diagnosed incorrectly or too late with consequences for morbidity and even mortality. PURPOSE: The present article aims to provide pediatric and adult gastroenterologists with an up to date review about clinical features, diagnosis and therapeutic options for CIPO...
January 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Valentina Rossi, Manuela Mosconi, Paolo Nozza, Daniele Murgia, Girolamo Mattioli, Isabella Ceccherini, Alessio Pini Prato
Chronic intestinal pseudo obstruction (CIPO) is a rare clinical entity characterized by symptoms and signs of intestinal obstruction without either recognizable anatomical abnormalities or intestinal aganglionosis. A Chinese female infant presented to our institution with a clinical diagnosis of CIPO. Aganglionosis was ruled out by full thickness colonic and ileal biopsies and by rectal suction biopsies. Unexpectedly, direct sequencing and PCR amplification of RET proto-oncogene from peripheral blood extracted DNA identified a RET R114H mutation...
September 2016: American Journal of Medical Genetics. Part A
Claire J Grant, Laura E Harrison, Caroline L Hoad, Luca Marciani, Penny A Gowland, Christopher W McIntyre
INTRODUCTION: Chronic kidney disease (CKD) affects gastrointestinal function and results in numerous adaptive and maladaptive responses. Disruption of the colonic microbiome and its attendant consequences - the loss of gut barrier integrity and increased generation of uremic toxins - has become well-recognized. However, less attention has been paid to characterizing the mechanisms behind dysfunction of the upper gastrointestinal (GI) tract, largely owing to the difficulty of studying small bowel function in vivo...
May 25, 2016: Journal of Gastroenterology and Hepatology
Filza Khalid, Hadiel Kaiyasah, Wafa Binfadil, Maiyasa Majid, Wessam Hazim, Yousif ElTayeb
INTRODUCTION: Pneumatosis intestinalis (PI) is not a disease but a radiological finding with a poorly understood pathogenesis. It can be divided into primary/idiopathic (15%) or secondary (85%) Kim et al. 2007, based on the factors thought to play a role in its development. Amongst the rare causes of secondary PI is gastrointestinal (GI) amyloidosis. PRESENTATION OF THE CASE: We report a case of a 46-year-old gentleman who presented with a one month history of acute on chronic abdominal pain, associated with one episode of melena...
2016: International Journal of Surgery Case Reports
J E Dalziel, W Young, P Bercik, N J Spencer, L J Ryan, K E Dunstan, C M Lloyd-West, P K Gopal, N W Haggarty, N C Roy
BACKGROUND: Dysmotility in the gastrointestinal (GI) tract often leads to impaired transit of luminal contents leading to symptoms of diarrhea or constipation. The aim of this research was to develop a technique using high resolution X-ray imaging to study pharmacologically induced aged rat models of chronic GI dysmotility that mimic accelerated transit (diarrhea) or constipation. The 5-hydroxytryptamine type 4 (5-HT4 ) receptor agonist prucalopride was used to accelerate transit, and the opioid agonist loperamide was used to delay transit...
August 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Richard J Saad
The wireless motility and pH capsule (WMC) provides an office-based test to simultaneously assess both regional and whole gut transit. Ingestion of this non-digestible capsule capable of measuring temperature, pH, and the pressure of its immediate surroundings allows for the measurement of gastric, small bowel, and colonic transit times in an ambulatory setting. Approved by the US Food and Drug Administration for the evaluation of suspected conditions of delayed gastric emptying and the evaluation of colonic transit in chronic idiopathic constipation, WMC should be considered in suspected gastrointestinal motility disorders as it provides a single study capable of simultaneously assessing for regional, multiregional, or generalized motility disorders...
March 2016: Current Gastroenterology Reports
Sophie Fromhold-Treu, Georg Lamprecht
This review describes the gasterointestinal entities, their pathophysiology, clinical presentation, diagnostic workup and therapy that typically involve weight loss as the major presenting symptom. The differentiation of malassimilation into maldigestion and malabsorption is clinically mostly not helpful. Instead primary malasssimilation can be distinguished from secondary due to another disease. Celiac disease, lambliasis, small bowel CD, CVIDS and Whipple's disease result in loss of absorptive surface. Chronic intestinal pseudobstruction leads to weight loss through dysmotility and postprandial pain...
February 2016: Deutsche Medizinische Wochenschrift
Ping Lu, Hesheng Luo, Xiaojing Quan, Han Fan, Qincai Tang, Guang Yu, Wei Chen, Hong Xia
BACKGROUND: The mechanism underlying chronic stress-induced gastrointestinal (GI) dysmotility has not been fully elucidated and GI hormones have been indicated playing a role in mediating stress-induced changes in GI motor function. AIMS: Our objective was to study the possible role of substance P (SP) in the colonic hypermotility induced by repeated water avoidance stress (WAS) which mimics irritable bowel syndrome. METHODS: Male Wistar rats were submitted to WAS or sham WAS (SWAS) (1h/day) for up to 10 consecutive days...
April 2016: Neuropeptides
Varsha M Asrani, Harry D Yoon, Robin D Megill, John A Windsor, Maxim S Petrov
Gastrointestinal (GI) dysmotility is a common complication in acute, critically ill, postoperative, and chronic patients that may lead to impaired nutrient delivery, poor clinical, and patient-reported outcomes. Several pharmacological and nonpharmacological interventions to treat GI dysmotility were investigated in dozens of clinical studies. However, they often yielded conflicting results, at least in part, because various (nonstandardized) definitions of GI dysmotility were used and methodological quality of studies was poor...
February 2016: Medicine (Baltimore)
Berkeley N Limketkai, Alyssa M Parian, Neha D Shah, Jean-Frédéric Colombel
Crohn's disease is a chronic and progressive inflammatory disorder of the gastrointestinal tract. Despite the availability of powerful immunosuppressants, many patients with Crohn's disease still require one or more intestinal resections throughout the course of their disease. Multiple resections and a progressive reduction in bowel length can lead to the development of short bowel syndrome, a form of intestinal failure that compromises fluid, electrolyte, and nutrient absorption. The pathophysiology of short bowel syndrome involves a reduction in intestinal surface area, alteration in the enteric hormonal feedback, dysmotility, and related comorbidities...
May 2016: Inflammatory Bowel Diseases
Sajneet K Khangura, Natasha Kamal, Nancy Ho, Martha Quezado, Xiongce Zhao, Beatriz Marciano, Jennifer Simpson, Christa Zerbe, Gulbu Uzel, Michael D Yao, Suk See DeRavin, Colleen Hadigan, Douglas B Kuhns, John I Gallin, Harry L Malech, Steven M Holland, Theo Heller
BACKGROUND & AIMS: Chronic granulomatous disease (CGD) is an inherited disorder of the reduced nicotinamide adenine dinucleotide phosphate oxidase complex within phagocytic cells that predisposes people to bacterial and fungal infections. Approximately 40% of patients with CGD have gastrointestinal involvement. We aimed to characterize the endoscopic features of gastrointestinal CGD and define the role of endoscopy in patients. METHODS: We created a database of all patients with CGD seen at the National Institutes of Health from 1990 through 2010...
March 2016: Clinical Gastroenterology and Hepatology
J Pfeifer
Patients with intractable chronic constipation should be evaluated with physiological tests after structural disorders and extracolonic causes have been excluded. Conservative treatment options should be tried unstintingly. It should be pointed out that especially new drugs such as prucalopride and linaclotide seem to be a big step forward in treating patients with chronic constipation. If surgery is indicated, for many years subtotal colectomy with IRA was the treatment of choice, although segmental resections were also a good option for isolated megasigmoid, sigmoidocele or recurrent sigmoid volvulus...
September 2015: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
G Parthasarathy, K Ravi, M Camilleri, C Andrews, L A Szarka, P A Low, A R Zinsmeister, A E Bharucha
BACKGROUND: Acetylcholinesterase inhibitors (ACIs), e.g., neostigmine, are known to increase upper and lower gastrointestinal (GI) motility and are used to treat acute colonic pseudoobstruction. However, their effects on gastroduodenal motility in humans are poorly understood. Our hypotheses were that, in patients with suspected GI motility disorders, neostigmine increases gastric and small intestinal motor activity, and these effects are greater in patients with cardiovagal neuropathy, reflecting denervation sensitivity...
December 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Andrea Maier, Vera Mannartz, Hermann Wasmuth, Christian Trautwein, Ulf-Peter Neumann, Joachim Weis, Joachim Grosse, Matthias Fuest, Max-J Hilz, Joerg B Schulz, Christina Haubrich
Chronic intestinal pseudoobstruction (CIP) can be a severe burden and even a life-threatening disorder. Typically, several years of uncertainty are passing before diagnosis. We are reporting the case of a young woman with a decade of severe, progressive gastrointestinal dysmotility. Unusually, she had also developed an autonomic neuropathy, and a stiff limb syndrome.In addition to achalasia and CIP the young woman also developed neuropathic symptoms: orthostatic intolerance, urinary retention, a Horner syndrome, and lower limb stiffness...
August 2015: Medicine (Baltimore)
Colin B Ligon, Laura K Hummers, Zsuzsanna H McMahan
OBJECTIVE: To increase awareness of oxalate nephropathy as a cause of acute kidney injury (AKI) among systemic sclerosis patients with small intestinal dysmotility and malabsorption, and to prompt consideration of dietary modification and early treatment of predisposing causes of oxalate nephropathy in this population. METHODS: Two cases of biopsy-proven oxalate nephropathy were identified among systemic sclerosis patients in the course of direct clinical care. Subsequently, a retrospective search of the Johns Hopkins Pathology databases identified a third patient with systemic sclerosis who developed oxalate nephropathy...
December 2015: Seminars in Arthritis and Rheumatism
Mira M Wouters, Maria Vicario, Javier Santos
Functional gastrointestinal disorders (FGIDs) are characterized by chronic complaints arising from disorganized brain-gut interactions leading to dysmotility and hypersensitivity. The two most prevalent FGIDs, affecting up to 16-26% of worldwide population, are functional dyspepsia and irritable bowel syndrome. Their etiopathogenic mechanisms remain unclear, however, recent observations reveal low-grade mucosal inflammation and immune activation, in association with impaired epithelial barrier function and aberrant neuronal sensitivity...
January 2016: Gut
María M Piskorz, Gerardo Rank, María Velázquez Espeche, Analisa García Cainzo, Andrea Pisarevsky, Juan A Sorda, Jorge Olmos
Scleroderma is a chronic autoimmune disease of unknown cause characterized by fibrotic skin and multiple organs involvement, including the gastrointestinal tract. It occurs mainly in women between 35 and 65 years of age. It is classified as limited or diffuse based on the extent of skin involvement. Gastrointestinal dysmotility is observed in up to 90% of patients with a diffuse and limited scleroderma. It may involve any segment of the gastrointestinal tract from the esophagus to the anus and is related to collagen deposition at the level of enteric and vascular smooth muscle...
March 2015: Acta Gastroenterologica Latinoamericana
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