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https://www.readbyqxmd.com/read/28535580/gastroparesis-updates-on-pathogenesis-and-management
#1
REVIEW
Nanlong Liu, Thomas Abell
Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of early satiety, bloating, nausea, vomiting, and abdominal pain. Along with these symptoms, an objective finding of delayed gastric emptying, along with a documented absence of gastric outlet obstruction, are required for diagnosis. This article focuses on updates in the pathogenesis and management of Gp. Recent studies on full thickness biopsies of Gp patients have shed light on the complex interactions of the central, autonomic, and enteric nervous systems, which all play key roles in maintaining normal gut motility...
May 25, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28531392/a-randomised-controlled-feasibility-and-proof-of-concept-trial-in-delayed%C3%A2-gastric-emptying-when-metoclopramide-fails-we-should-revisit%C3%A2-nasointestinal-feeding-versus-dual-prokinetic-treatment-achieving-goal-nutrition-in-critical-illness-and-delayed-gastric
#2
Stephen J Taylor, Kaylee Allan, Helen McWilliam, Alex Manara, Jules Brown, Rosemary Greenwood, Deirdre Toher
BACKGROUND & AIMS: Delayed gastric emptying (DGE) commonly limits the use of enteral nutrition (EN) and may increase ventilator-associated pneumonia. Nasointestinal feeding has not been tested against dual prokinetic treatment (Metoclopramide and Erythromycin) in DGE refractory to metoclopramide. This trial tests the feasibility of recruiting this 'treatment-failed' population and the proof of concept that nasointestinal (NI) feeding can increase the amount of feed tolerated (% goal) when compared to nasogastric (NG) feeding plus metoclopramide and erythromycin treatment...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28529530/chai-qin-cheng-qi-decoction-and-carbachol-improve-intestinal-motility-by-regulating-protein-kinase-c-mediated-ca-2-release-in-colonic-smooth-muscle-cells-in-rats-with-acute-necrotising-pancreatitis
#3
Chen-Long Zhang, Zi-Qi Lin, Rui-Jie Luo, Xiao-Xin Zhang, Jia Guo, Wei Wu, Na Shi, Li-Hui Deng, Wei-Wei Chen, Xiao-Ying Zhang, Shameena Bharucha, Wei Huang, Robert Sutton, John A Windsor, Ping Xue, Qing Xia
Chai-Qin-Cheng-Qi decoction (CQCQD) improves intestinal motility in acute pancreatitis (AP), but the mechanism(s) require elucidation. We investigated the effects of CQCQD and carbachol, a prokinetic agent, on colonic smooth muscle cells (SMCs) in L-arginine-induced necrotising AP model in rats. In treatment groups, intragastric CQCQD (20 g/kg, 2 hourly × 3 doses) or intraperitoneal carbachol (60 μg/kg) was given 24 hours after induction of AP. Both CQCQD and carbachol decreased the severity of pancreatic and colonic histopathology (all P < 0...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28526488/-targeting-the-gut-liver-axis-in-liver-disease
#4
REVIEW
Reiner Wiest, Agustin Albillos, Michael Trauner, Jashmohan Bajaj, Rajiv Jalan
The gut is open to the outer environment, harbours the microbiome containing several fold more genetic material than the human genome and produces a myriad of metabolites as well as hormones/peptides. The liver is at the nexus between this vast source of nutrients, toxins and hormones and the remaining human body. Not surprisingly, this liver-gut-axis has hence, been demonstrated in experimental models and in-vitro systems to contribute to the pathogenesis of most liver diseases such as alcoholic and non-alcoholic fatty liver disease (NAFLD), -steatohepatitis (NASH), cholestatic liver diseases, hepatocellular carcinoma, acute-on-chronic liver failure, progression to fibrosis/cirrhosis and complications of cirrhosis...
May 16, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28516373/class-side-effects-decreased-pressure-in-the-lower-oesophageal-and-the-pyloric-sphincters-after-the-administration-of-dopamine-antagonists-neuroleptics-anti-emetics-l-name-pentadecapeptide-bpc-157-and-l-arginine
#5
Zeljka Belosic Halle, Josipa Vlainic, Domagoj Drmic, Dean Strinic, Kresimir Luetic, Mario Sucic, Maria Medvidovic-Grubisic, Tatjana Pavelic Turudic, Igor Petrovic, Sven Seiwerth, Predrag Sikiric
The ulcerogenic potential of dopamine antagonists and L-NAME in rats provides unresolved issues of anti-emetic neuroleptic application in both patients and experimental studies. Therefore, in a 1-week study, we examined the pressures within the lower oesophageal and the pyloric sphincters in rats [assessed manometrically (cm H2O)] after dopamine neuroleptics/prokinetics, L-NAME, L-arginine and stable gastric pentadecapeptide BPC 157 were administered alone and/or in combination. Medication (/kg) was given once daily intraperitoneally throughout the 7 days, with the last dose at 24 h before pressure assessment...
May 17, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28514401/-differentiation-therapy-for-non-acidic-gastroesophageal-reflux-disease
#6
N B Lishchuk, V I Simanenkov, S V Tikhonov
AIM: To investigate the clinical and pathogenetic features of the non-acidic types of gastroesophageal reflux disease (GERD) and to evaluate the impact of combined therapy versus monotherapy on the course of this disease. SUBJECTS AND METHODS: The investigation enrolled 62 patients with non-acidic GERD. The follow-up period was 6 weeks. The patients were divided into 2 groups: 1) weakly acidic gastroesophageal refluxes (GER); 2) weakly alkaline GER. Then each group was distributed, thus making up 4 groups: 1) 19 patients with weakly acidic GER who received monotherapy with rabeprazole 20 mg/day; 2) 21 patients with weakly acidic GER had combined therapy with rabeprazole 20 mg and itopride; 3) 8 patients with weakly alkaline GER who received ursodeoxycholic acid (UDCA) monotherapy; and 4) 14 patients with weakly alkaline GER who had combined therapy with UDCA and itopride, The clinical symptoms of the disease, the endoscopic pattern of the upper gastrointestinal tract (GIT) mucosa, histological changes in the esophageal and gastric mucosa, and the results of 24-hour impedance pH monitoring were assessed over time...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28459037/levosulpiride-and-serum-prolactin-levels
#7
Mohammad Shafi Kuchay, Ambrish Mithal
Levosulpiride is the levorotatory enantiomer of sulpiride used in dyspeptic syndromes of various etiologies. The prokinetic effect of levosulpiride is mediated through the blockade of enteric inhibitory dopaminergic type 2 (D2) receptors. The antagonism of central D2 receptors leads to both therapeutic (e.g. antiemetic effect due to D2 receptor blockade in the chemoreceptor trigger zone) and adverse (including hyperprolactinemia) effects. Dopamine is the main endogenous inhibitor of prolactin synthesis and secretion in the anterior pituitary...
March 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28449422/the-effect-of-anti-reflux-therapy-on-patients-diagnosed-with-minor-disorders-of-peristalsis-in-high-resolution-manometry
#8
Joonho Jeong, Sung Eun Kim, Moo In Park, Seun Ja Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Youn Jung Choi, Jun Yeob Lee, Young Dal Lee
Background/Aims: Minor disorders of peristalsis are esophageal motility disorders categorized by the Chicago Classification (CC), version 3.0, which was announced in 2014. This study evaluated the efficacy of anti-reflux therapy in patients with minor peristaltic disorders. Methods: Patients with minor peristaltic disorders in accordance with CC v3.0 were included. We reviewed the medical records of patients with esophageal high-resolution manometry findings, and investigated the demographic and clinical information as well as the medical therapy...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28431454/da-9701-improves-colonic-transit-time-and-symptoms-in-patients-with-functional-constipation-a-prospective-study
#9
Su Young Kim, Hyun Sun Woo, Sung Han Choi, Dong Kyun Park, Kwang An Kwon, Jun-Won Chung, Yoon Jae Kim, Jung Ho Kim, Su Ji Kim, Kyoung Oh Kim
BACKGROUND AND AIM: DA-9701, a newly developed prokinetic agent formulated with Pharbitis Semen and Corydalis Tuber, has been shown to effectively treat functional dyspepsia. Recently, it has also been suspected to improve gastrointestinal motor function. The aims of this study were to assess the effect of DA-9701 on colonic transit time (CTT) and symptoms of functional constipation. METHODS: We prospectively enrolled 33 patients with functional constipation based on the Rome III criteria...
April 21, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28424994/modulation-of-gastrointestinal-motility-beyond-metoclopramide-and-domperidone-pharmacological-and-clinical-evidence-for-phytotherapy-in-functional-gastrointestinal-disorders
#10
Ahmed Madisch, Bettina R Vinson, Heba Abdel-Aziz, Olaf Kelber, Karen Nieber, Karin Kraft, Martin Storr
The prokinetic cisapride, an important therapeutic option in functional gastrointestinal (GI) disorders, was withdrawn from the market 15 years ago due to rare severe side effects. Likewise in 2014, the use of metoclopramide (MCP) and domperidone in functional GI disorders (FGID) was restricted, consequently leaving a therapeutic gap in clinical practice. A systematic review revealed that the herbal medicinal product (HMP) STW 5 presents a therapeutic option equivalent to MCP and cisapride. STW 5 is the only HMP for which efficacy has been shown in randomized controlled clinical trials (RCTs) in functional dyspepsia and irritable bowel syndrome, based on its multitarget effect on numerous etiological factors...
May 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28413079/mexican-consensus-on-dyspepsia
#11
R Carmona-Sánchez, O Gómez-Escudero, M Zavala-Solares, M V Bielsa-Fernández, E Coss-Adame, A I Hernández-Guerrero, F Huerta-Iga, M E Icaza-Chávez, M A Lira-Pedrín, J A Lizárraga-López, A López-Colombo, A Noble-Lugo, J Pérez-Manauta, R H Raña-Garibay, J M Remes-Troche, J L Tamayo, L F Uscanga, F Zamarripa-Dorsey, M A Valdovinos Díaz, J A Velarde-Ruiz Velasco
Since the publication of the 2007 dyspepsia guidelines of the Asociación Mexicana de Gastroenterología, there have been significant advances in the knowledge of this disease. A systematic search of the literature in PubMed (01/2007 to 06/2016) was carried out to review and update the 2007 guidelines and to provide new evidence-based recommendations. All high-quality articles in Spanish and English were included. Statements were formulated and voted upon using the Delphi method. The level of evidence and strength of recommendation of each statement were established according to the GRADE system...
April 13, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28366993/a-multicenter-randomized-trial-comparing-rabeprazole-and-itopride-in-patients-with-functional-dyspepsia-in-japan-the-nagoya-study
#12
Takeshi Kamiya, Michiko Shikano, Eiji Kubota, Tsutomu Mizoshita, Tsuneya Wada, Satoshi Tanida, Hiromi Kataoka, Hiroshi Adachi, Makoto Hirako, Noriaki Okuda, Takashi Joh
The aims of this study were to compare the therapeutic effects of a proton pump inhibitor (PPI), rabeprazole (RPZ), and a prokinetic agent, itopride (ITO), and to investigate the role of PPI in the treatment strategy for Japanese functional dyspepsia (FD) patients. We randomly assigned 134 patients diagnosed by Rome III criteria to 4 weeks treatment with RPZ 10 mg/day (n = 69) or ITO 150 mg/day (n = 65). Dyspeptic symptoms were evaluated using FD scores at baseline and after 1, 2 and 4 weeks of treatment...
March 2017: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/28356304/erythromycin-prophylaxis-against-recurrent-small-bowel-obstruction
#13
Emily Rea, Emma Husbands
We describe three cases where erythromycin suspension has been used successfully in preventing recurrence of small bowel obstruction in patients with terminal illness and for whom it proved more effective than standard preparations such as metoclopramide and domperidone. These patients also experienced a longer term benefit over some months. With recent alerts over longer term use of metoclopramide and domperidone, we demonstrate that erythromycin is a viable alternative prokinetic in patients with terminal illness at risk of small bowel obstruction instead of or alongside metoclopramide and domperidone...
March 29, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28340625/habit-training-versus-habit-training-with-direct-visual-biofeedback-in-adults-with-chronic-constipation-study-protocol-for-a-randomised-controlled-trial
#14
Christine Norton, Anton Emmanuel, Natasha Stevens, S Mark Scott, Ugo Grossi, Sybil Bannister, Sandra Eldridge, James M Mason, Charles H Knowles
BACKGROUND: Constipation affects up to 20% of adults. Chronic constipation (CC) affects 1-2% of adults. Patient dissatisfaction is high; nearly 80% feel that laxative therapy is unsatisfactory and symptoms have significant impact on quality of life. There is uncertainty about the value of specialist investigations and whether equipment-intensive therapies using biofeedback confer additional benefit when compared with specialist conservative advice. METHODS/DESIGN: A three-arm, parallel-group, multicentre randomised controlled trial...
March 24, 2017: Trials
https://www.readbyqxmd.com/read/28322886/high-gamma-oscillations-in-the-motor-cortex-during-visuo-motor-coordination-a-tacs-interferential-study
#15
E Santarnecchi, A Biasella, E Tatti, A Rossi, D Prattichizzo, S Rossi
BACKGROUND: While the role of beta (∼20Hz), theta (∼5Hz) and alpha (∼10Hz) oscillations in the motor areas have been repeatedly associated with defined properties of motor performance, the investigation of gamma (∼40-90Hz) oscillatory activity is a more recent and still not fully understood component of motor control physiology, despite its potential clinical relevance for motor disorders. OBJECTIVE/HYPOTHESIS: We have implemented an online neuromodulation paradigm based on transcranial alternating current stimulation (tACS) of the dominant motor cortex during a visuo-motor coordination task...
March 18, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28321555/medical-treatment-of-gastroesophageal-reflux-disease
#16
Daniel A Kroch, Ryan D Madanick
Medical treatment is effective in the majority of patients with gastroesophageal reflux disease (GERD). Lifestyle modifications are often recommended for patients with GERD, although the data supporting lifestyle recommendations are limited. Antacids are often used to treat the symptoms of GERD, but their effect is short-lived. H2-receptor antagonists and proton-pump inhibitors provide more effective options for remission of GERD symptoms and healing of esophagitis. Prokinetic medications (e.g., metoclopramide) have not been proven to help in the control of symptoms...
March 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28320545/haloperidol-undermining-gastroparesis-symptoms-hugs-in-the-emergency-department
#17
Rene Ramirez, Philip Stalcup, Brandon Croft, Michael A Darracq
BACKGROUND: Gastroparesis associated nausea, vomiting & abdominal pain (GP N/V/AP) are common presentations to the emergency department (ED). Treatment is often limited to antiemetic, prokinetic, opioid, & nonopioid agents. Haloperidol (HP) has been shown to have analgesic & antiemetic properties. We sought to evaluate HP in the ED as an alternative treatment of GP N/V/AP. METHODS: Using an electronic medical record, 52 patients who presented to the ED w/GP N/V/AP secondary to diabetes mellitus and were treated w/HP were identified...
March 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28292527/enteral-nutrition-volume-is-not-correlated-with-lower-respiratory-tract-infection-in-patients-on-mechanical-ventilation
#18
A Colomar, B Guardiola, J A Llompart-Pou, I Ayestarán, J Rodríguez-Pilar, M Ferreruela, J M Raurich
OBJECTIVE: To evaluate the effect of enteral nutrition volume, gastrointestinal function and the type of acid suppressive drug upon the incidence of lower respiratory tract infections in critically ill patients on mechanical ventilation (MV). DESIGN: A retrospective secondary analysis was carried out. SETTING: The Intensive Care Unit of a University Hospital. PATIENTS OR PARTICIPANTS: Patients≥18-years-old expected to need MV for more than four days, and receiving enteral nutrition by nasogastric tube within 24h of starting MV...
March 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28279123/a-pioneering-study-oral-clarithromycin-treatment-for-feeding-intolerance-in-very-low-birth-weight-preterm-infants
#19
Selim Sancak, Tugba Gursoy, Abdulhamit Tuten, Didem Arman, Guner Karatekin, Fahri Ovali
PURPOSE: To examine the prokinetic effect of clarithromycin in very low birth weight (VLBW) preterm infants. MATERIALS AND METHODS: VLBW preterm infants who have not achieved half of the full enteral feeding in the second week of life were enrolled in the study. The infants enrolled in the study were randomized. 20 infants received oral clarithromycin (7.5 mg/kg, twice a day) and 20 control infants did not receive any treatment. RESULTS: Full enteral feeding was attained earlier in the clarithromycin group than in the control group [7 (6-9) vs 9 (9-11) days, respectively; p < 0...
March 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28276285/gastric-conduit-obstruction-due-to-gastroduodenal-compression-a-new-complication-post-ivor-lewis-oesophagectomy
#20
Victoria A Perkins, Samuel McFerran, Ali Kordzadeh, Elias Sdralis, Bruno Lorenzi, Alexandros Charalabopoulos
INTRODUCTION: Oesophagectomy for oesophageal carcinoma carries a high risk of significant morbidity and mortality. Delayed gastric emptying is a relatively common complication following this procedure. A variety of medical, surgical and endoscopic strategies have been described to manage it. The vast majority of cases are related to post-operative pyloric dysfunction and are amenable to conventional management strategies. PATIENTS AND METHODS: We present a new case of a patient with a duodenal hiatus hernia resulting in extrinsic gastroduodenal compression by the massively distended gastric conduit as a cause of gastric outlet obstruction following laparoscopic-assisted Ivor-Lewis oesophagectomy 2 years previously...
March 9, 2017: Acta Chirurgica Belgica
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