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Abdominal Massage and Moxibustion in Elderly Constipation: Clinical Benefits With Uncertain Mechanisms. 腹部按摩和艾灸治疗老年便秘:临床疗效机制不确定。
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 DOI: 10.1111/nmo.70235
Tae Hee Lee
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引用次数: 0
Authors' Response to: Do not forget recommendations for transition to the adult world in esophageal atresia patients! 作者的回应:不要忘记食道闭锁患者向成人世界过渡的建议!
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2024-09-30 DOI: 10.1111/nmo.14922
Mohsin F Butt, Marc A Benninga, Maura Corsetti
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引用次数: 0
Protective Effects of Spondias mombin L. Juice Alone or in Combination With Lactobacillus acidophilus in 5-Fluorouracil-Induced Experimental Intestinal Mucositis. 单用或联用嗜酸乳杆菌对5-氟尿嘧啶诱导的实验性肠黏膜炎的保护作用
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2024-12-31 DOI: 10.1111/nmo.14970
Stphannie Jamyla de Araújo Barbosa, Maisie Mitchele Barbosa Oliveira, Susana Barbosa Ribeiro, Rafaela Alcindo Silva, Caroline Addison Carvalho Xavier de Medeiros, Gerlane Coelho Bernardo Guerra, Raimundo Fernandes de Araújo Júnior, Francisco Canindé de Sousa Junior, Agnes Andrade Martins, Leandro De Santis Ferreira, Francisco Ayrton Senna Domingos Pinheiro, Conceição S Martins Rebouças, Gerly Anne de Castro Brito, Renata Ferreira Carvalho Leitao, Raphael Victor Silva Andrade, Valkleidson Santos de Araujo, Aurigena Antunes de Araújo

Background: Evaluate the impact of Spondias mombin L. juice (SM), alone and in combination with Lactobacillus acidophilus, in an experimental model of intestinal mucositis.

Methods: Swiss mice were orally administered with saline, SM, or SM combined with L. acidophilus NRRL B-4495 at 1 × 109 colony-forming unit (CFU/mL) for 15 days before the induction of intestinal mucositis by a single intraperitoneal injection of 5-fluorouracil (5-FU) at 450 mg/kg. On the 18th day, following euthanasia, tissue samples were collected for histopathological examination. Jejunum tissues were analyzed for MUC-2 immunoexpression, concentrations of interleukin-1-beta (IL-1β), interleukin 6 (IL-6) and tumor necrosis factor (TNF)-α, and invertase activity.

Key results: 5-FU induced intestinal damage in all intestinal segments, and this damage involved villus blunting, flattened and vacuolated cells, crypt necrosis, inflammatory cell infiltration, and mucosa and submucosal edema compared to the control group. In contrast, SM or SM with L. acidophilus prevented these morphological alterations in all intestinal segments (p < 0.05). Both treatments reduced the intestinal concentration of IL-1 beta (p < 0.05), IL-6 (p < 0.05), and TNF-alpha (p < 0.05). Notably, the combination of SM and L. acidophilus, but not SM alone, prevented the 5-FU-induced decrease in invertase activity and mucin expression (p < 0.05). Furthermore, SM combined with L. acidophilus resulted in an increased population of lactic acid bacteria in feces on the 7th and 18th days. Combining SM with L. acidophilus also decreased fecal excretion of γ-Ergostenol and γ-sitosterol.

Conclusions and inferences: SM, alone and combined with Lactobacillus acidophilus demonstrated significant protective effects against 5-FU-induced intestinal mucositis, reducing inflammatory markers.

背景:评价mombin L.果汁(SM)单独使用和与嗜酸乳杆菌联合使用对肠黏膜炎实验模型的影响。方法:在单次腹腔注射450 mg/kg 5-氟尿嘧啶(5-FU)诱导肠黏膜炎前,以生理盐水、SM或SM联合嗜酸乳杆菌NRRL B-4495以1 × 109菌落形成单位(CFU/mL)口服给药15 d。安乐死后第18天,取组织标本进行组织病理学检查。分析空肠组织muc2免疫表达、白细胞介素-1- β (IL-1β)、白细胞介素6 (IL-6)、肿瘤坏死因子(TNF)-α浓度及转化酶活性。关键结果:与对照组相比,5-FU诱导的肠各节段损伤包括绒毛变钝、变平和空泡化细胞、隐窝坏死、炎症细胞浸润、粘膜和粘膜下水肿。相比之下,SM或SM联合嗜酸乳杆菌可阻止所有肠段的这些形态学改变(p)。结论和推论:SM单独或联合嗜酸乳杆菌对5- fu诱导的肠黏膜炎具有显著的保护作用,可降低炎症标志物。
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引用次数: 0
Clinical Efficacy of Abdominal Massage Combined With Moxibustion for Treatment of Chronic Constipation in Elderly Patients. 腹部按摩配合艾灸治疗老年慢性便秘的临床疗效观察。
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-11-15 DOI: 10.1111/nmo.70207
Yanan Li, Xiaowei Li, Jingpeng Zang, Lili Hao, Yawei Gao, Ying Liao

Objective: To observe the clinical efficacy of abdominal massage combined with moxibustion in alleviating chronic constipation in elderly patients.

Methods: A total of 74 elderly patients with constipation who visited Shijiazhuang People's Hospital between October 2022 and January 2024 were selected and randomly assigned into two groups: the abdominal massage + moxibustion (AM + M) group and the control group. The control group received usual bowel care (UBC), whereas the AM + M group received abdominal massage and moxibustion in addition to UBC, with five sessions per week for 4 weeks. Clinical efficacy was compared between the two groups following treatment. Statistical analysis was performed using GraphPad Prism, with p < 0.05 considered statistically significant.

Results: The total effective rate in the AM + M group (71.05%) was significantly higher than that in the control group (36.11%) (p < 0.05). Following treatment, both groups showed improvements in constipation symptoms (stool frequency and consistency), Constipation Severity Instrument (CSI) score, Patient Assessment of Constipation-Quality of Life (PAC-QOL) score and levels of nitric oxide (NO) and vasoactive intestinal peptide (VIP), with greater improvements in the AM + M group (CSI: p < 0.001; PAC-QOL: p < 0.001; NO: p < 0.01; VIP: p < 0.01). Additionally, the level of substance P increased significantly in the AM + M group compared with the control group (p < 0.01).

Conclusion: Four weeks of abdominal massage combined with moxibustion significantly improved stool characteristics, reduced defecation interval and duration, regulated intestinal neurotransmitter levels and enhanced quality of life in elderly patients with chronic constipation.

目的:观察腹部按摩配合艾灸治疗老年慢性便秘的临床疗效。方法:选择2022年10月至2024年1月在石家庄市人民医院就诊的老年便秘患者74例,随机分为腹部按摩+艾灸(AM + M)组和对照组。对照组接受常规肠道护理(UBC),而AM + M组在UBC之外还接受腹部按摩和艾灸,每周5次,持续4周。比较两组治疗后的临床疗效。结果:AM + M组总有效率(71.05%)显著高于对照组(36.11%)(p)。结论:4周腹部按摩联合艾灸可显著改善老年慢性便秘患者的大便特征,缩短排便间隔和排便时间,调节肠道神经递质水平,提高生活质量。
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引用次数: 0
Evacuation Dysfunction Does Not Impact Breath Test Results. 呼吸功能障碍不影响呼吸测试结果。
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-12-12 DOI: 10.1111/nmo.70211
Céline Soetaert, Mohamad Itani, George Triadafilopoulos, Sean Spencer, Linda Nguyen, Leila Neshatian

Background: Evacuation dysfunction affects gastrointestinal motility, yet its effect on small bowel microbiota is unknown. We aimed to compare the glucose breath test (GBT) and lactulose breath test (LBT) outcomes in patients with or without evacuation dysfunction based on high-resolution anorectal manometry (HR-ARM) and balloon expulsion test (BET).

Methods: We conducted a retrospective review of patients who received a HR-ARM and either a GBT or LBT from 2018 to 2024.

Key results: We studied 344 patients who underwent GBT and 144 who underwent LBT. Clinical characteristics between the two groups were comparable. Abnormal BET was observed in 53% of patients. Rates of abnormal breath tests were comparable among patients with or without abnormal BET. Patients with positive vs. negative breath tests had similar anorectal pressures, rectal sensory function, and BET results. There were significantly more negative breath tests in GBT (64%) versus LBT (35%), with higher rates of small intestinal bacterial overgrowth (SIBO) in LBT versus GBT (SIBO only: 20.1% vs. 7.6%; SIBO+IMO: 21.5% vs. 5.5%; p < 0.001).

Conclusions and inferences: The presence of evacuation dysfunction does not impact the results of the breath test. HR-ARM and BET demonstrate a high diagnostic yield in identifying the etiology of abdominal bloating in patients with chronic constipation or IBS without diarrhea, whereas hydrogen breath tests have a low diagnostic yield in this context. The specificity and sensitivity of LBT in this patient population remain less certain.

背景:排空功能障碍影响胃肠运动,但其对小肠微生物群的影响尚不清楚。我们的目的是比较基于高分辨率肛肠测压(HR-ARM)和球囊排出试验(BET)的有或无排空功能障碍患者的葡萄糖呼气试验(GBT)和乳果糖呼气试验(LBT)结果。方法:我们对2018年至2024年接受HR-ARM和GBT或LBT的患者进行了回顾性分析。主要结果:我们研究了344例接受GBT的患者和144例接受LBT的患者。两组患者的临床特征具有可比性。53%的患者出现BET异常。在有或没有异常BET的患者中,异常呼吸试验的比率具有可比性。呼气试验阳性与阴性患者的肛肠压力、直肠感觉功能和BET结果相似。GBT组呼气测试阴性(64%)明显多于LBT组(35%),LBT组的小肠细菌过度生长(SIBO)率高于GBT组(SIBO: 20.1% vs. 7.6%; SIBO+IMO: 21.5% vs. 5.5%) p结论和推断:排空功能障碍的存在不影响呼气测试结果。HR-ARM和BET在确定慢性便秘或无腹泻IBS患者腹胀的病因方面具有较高的诊断率,而氢呼气试验在这种情况下的诊断率较低。LBT在该患者群体中的特异性和敏感性仍不太确定。
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引用次数: 0
Socio-Economic Determinants and Regional Prevalence of Disorders of Gut-Brain Interaction in the Netherlands: Results From the Rome Foundation Global Epidemiology Study. 荷兰肠脑相互作用疾病的社会经济决定因素和区域患病率:来自罗马基金会全球流行病学研究的结果
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-10-16 DOI: 10.1111/nmo.70181
F Veldman, F Innocenti, M A Benninga, A D Sperber, O S Palsson, S I Bangdiwala, D Keszthelyi

Background: Disorders of gut-brain interaction (DGBI) impose significant burdens worldwide, yet reliable regional prevalence estimates are lacking, limiting insight into potential geographic variation. Socio-economic status (SES) may contribute but remains underexplored.

Methods: Data were obtained from the Dutch cohort of the Rome Foundation Global Epidemiology Study, including the Rome IV Adult Diagnostic Questionnaire, sociodemographic items, and SES indicators. The Netherlands was divided into three regions (Region 1: South; Region 2: West; Region 3: North-East). Regional prevalence was calculated for any DGBI, groups, and subtypes. Associations with SES were examined using logistic regression.

Key results: 2008 participants (50% female; age: 48 years [IQR: 31]; BMI: 25.25 kg/m2 [IQR: 5.98]) were included. Overall DGBI prevalence was 30.63% (95% CI: 28.65-32.68), with no significant regional differences (Region 1: 30.40%, 95% CI [26.61-34.47]; Region 2: 30.19%, 95% CI [27.19-33.36]; Region 3: 31.45%, 95% CI [27.96-35.16]; p = 1.000). No regional variation was found across DGBI groups or subtypes (all p > 0.05). Younger age (OR = 0.98, 95% CI [0.98-0.99]), female sex (OR = 2.10, 95% CI [1.70-2.59]), underweight (OR = 2.53, 95% CI [1.36-4.73]), and obesity (OR = 1.59, 95% CI [1.19-2.13]) were associated with higher odds of DGBI. In models adjusted for age, sex, and BMI, limited/no healthcare access (OR = 2.47, 95% CI [1.62-3.77], p < 0.0001) was associated with higher DGBI odds, whereas employment showed lower odds (OR = 0.65, 95% CI [0.52-0.81], p < 0.001). Other SES indicators were not associated.

Conclusion and inferences: DGBI affect nearly one-third of adults in the Netherlands, with no regional variation in prevalence. Putative risk factors include limited/no healthcare access and unemployment, supporting consideration of socioeconomic determinants in DGBI care, although further research is warranted.

背景:肠脑相互作用疾病(DGBI)在世界范围内造成了重大负担,但缺乏可靠的区域患病率估计,限制了对潜在地理差异的了解。社会经济地位(SES)可能有所贡献,但仍未得到充分探讨。方法:数据来自罗马基金会全球流行病学研究的荷兰队列,包括罗马IV成人诊断问卷、社会人口学项目和SES指标。荷兰被分为三个地区(1区:南部;2区:西部;3区:东北部)。计算任何DGBI、组和亚型的区域患病率。使用逻辑回归检验与SES的关联。关键结果:纳入2008名参与者(50%为女性,年龄48岁[IQR: 31], BMI: 25.25 kg/m2 [IQR: 5.98])。DGBI总体患病率为30.63% (95% CI: 28.65 ~ 32.68),地区差异无统计学意义(1区:30.40%,95% CI[26.61 ~ 34.47]; 2区:30.19%,95% CI[27.19 ~ 33.36]; 3区:31.45%,95% CI [27.96 ~ 35.16]; p = 1.000)。DGBI组或亚型间无区域差异(均p < 0.05)。年龄较小(OR = 0.98, 95% CI[0.98-0.99])、女性(OR = 2.10, 95% CI[1.70-2.59])、体重过轻(OR = 2.53, 95% CI[1.36-4.73])和肥胖(OR = 1.59, 95% CI[1.19-2.13])与DGBI的高发生率相关。在调整了年龄、性别和BMI的模型中,有限/没有医疗保健机会(OR = 2.47, 95% CI [1.62-3.77], p)。结论和推论:DGBI影响了荷兰近三分之一的成年人,患病率没有地区差异。假定的风险因素包括有限/没有医疗保健机会和失业,支持在DGBI护理中考虑社会经济决定因素,尽管需要进一步研究。
{"title":"Socio-Economic Determinants and Regional Prevalence of Disorders of Gut-Brain Interaction in the Netherlands: Results From the Rome Foundation Global Epidemiology Study.","authors":"F Veldman, F Innocenti, M A Benninga, A D Sperber, O S Palsson, S I Bangdiwala, D Keszthelyi","doi":"10.1111/nmo.70181","DOIUrl":"10.1111/nmo.70181","url":null,"abstract":"<p><strong>Background: </strong>Disorders of gut-brain interaction (DGBI) impose significant burdens worldwide, yet reliable regional prevalence estimates are lacking, limiting insight into potential geographic variation. Socio-economic status (SES) may contribute but remains underexplored.</p><p><strong>Methods: </strong>Data were obtained from the Dutch cohort of the Rome Foundation Global Epidemiology Study, including the Rome IV Adult Diagnostic Questionnaire, sociodemographic items, and SES indicators. The Netherlands was divided into three regions (Region 1: South; Region 2: West; Region 3: North-East). Regional prevalence was calculated for any DGBI, groups, and subtypes. Associations with SES were examined using logistic regression.</p><p><strong>Key results: </strong>2008 participants (50% female; age: 48 years [IQR: 31]; BMI: 25.25 kg/m<sup>2</sup> [IQR: 5.98]) were included. Overall DGBI prevalence was 30.63% (95% CI: 28.65-32.68), with no significant regional differences (Region 1: 30.40%, 95% CI [26.61-34.47]; Region 2: 30.19%, 95% CI [27.19-33.36]; Region 3: 31.45%, 95% CI [27.96-35.16]; p = 1.000). No regional variation was found across DGBI groups or subtypes (all p > 0.05). Younger age (OR = 0.98, 95% CI [0.98-0.99]), female sex (OR = 2.10, 95% CI [1.70-2.59]), underweight (OR = 2.53, 95% CI [1.36-4.73]), and obesity (OR = 1.59, 95% CI [1.19-2.13]) were associated with higher odds of DGBI. In models adjusted for age, sex, and BMI, limited/no healthcare access (OR = 2.47, 95% CI [1.62-3.77], p < 0.0001) was associated with higher DGBI odds, whereas employment showed lower odds (OR = 0.65, 95% CI [0.52-0.81], p < 0.001). Other SES indicators were not associated.</p><p><strong>Conclusion and inferences: </strong>DGBI affect nearly one-third of adults in the Netherlands, with no regional variation in prevalence. Putative risk factors include limited/no healthcare access and unemployment, supporting consideration of socioeconomic determinants in DGBI care, although further research is warranted.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70181"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12814999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the editor: Do not forget recommendations for transition to the adult world in esophageal atresia patients! 致编辑的信:不要忘记食道闭锁患者向成人世界过渡的建议!
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2024-09-20 DOI: 10.1111/nmo.14923
Christophe Faure, Usha Krishnan
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引用次数: 0
Can Esophageal Anatomy Help to Choose Between Functional Luminal Imaging Probe (FLIP) and Barium Esophagogram in Achalasia? 食道解剖能帮助贲门失弛缓症患者选择功能性腔内成像探针(FLIP)和食管钡剂造影吗?
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 DOI: 10.1111/nmo.70229
N Mattio, E Boissier, F Mion, S Roman

Background: Functional luminal imaging probe (FLIP) and barium esophagogram (BE) are complementary to high-resolution manometry in achalasia. Anatomical changes and achalasia treatment could alter their interpretation. Our objective was to compare FLIP and BE for achalasia diagnosis and follow up and to evaluate the impact of anatomical changes.

Methods: One hundred and thirty patients who underwent FLIP were included. The indication of FLIP was a suspicion of achalasia (naive group, n = 68 patients) or symptoms after achalasia treatment (treated group, n = 62 patients). Esophago-gastric junction distensibility index (EGJ-DI) was considered low when < 3 mm2/mmHg for a 50 mL distension plateau. BE were reviewed for the presence of esophageal stasis and anatomical changes. FLIP and BE results were compared.

Key results: EGJ-DI was significantly lower in the naive group than in the treated group (2.7 mm2/mmHg vs. 5.6, p < 0.01). BE revealed abnormalities more frequently in the treated group than in the naive group (esophageal stasis 61% vs. 37%, p < 0.01; esophageal dilation 63% vs. 39%, p < 0.01; blown out myotomy 26% vs. 3%, p < 0.01). EGJ-DI was lower in patients with stasis on BE compared to those without in the naive group but not in the treated group. Intrabag pressure tended to be lower in treated patients with stasis or blown out myotomy compared to those without.

Conclusions & inferences: FLIP is complementary to BE and should be interpreted with caution, notably after achalasia treatment. Further studies should determine the respective place of BE and FLIP in patients' work up.

背景:功能性腔内成像探针(FLIP)和钡食管造影(BE)是贲门失弛缓症高分辨率测压术的补充。解剖改变和失弛缓症的治疗可能改变其解释。我们的目的是比较FLIP和BE对贲门失弛缓症的诊断和随访,并评估解剖改变的影响。方法:纳入130例行FLIP手术的患者。FLIP的适应症是怀疑失弛缓症(初治组,n = 68例)或失弛缓症治疗后出现症状(治疗组,n = 62例)。食管胃交界膨胀性指数(EGJ-DI)在2/mmHg为50 mL膨胀平台时被认为是低的。检查是否有食管停滞和解剖改变。FLIP和BE结果比较。关键结果:初始组EGJ-DI显著低于治疗组(2.7 mm2/mmHg vs. 5.6, p)。结论和推断:FLIP是BE的补充,应谨慎解释,特别是在失缓症治疗后。进一步的研究应该确定BE和FLIP在患者工作中的各自位置。
{"title":"Can Esophageal Anatomy Help to Choose Between Functional Luminal Imaging Probe (FLIP) and Barium Esophagogram in Achalasia?","authors":"N Mattio, E Boissier, F Mion, S Roman","doi":"10.1111/nmo.70229","DOIUrl":"https://doi.org/10.1111/nmo.70229","url":null,"abstract":"<p><strong>Background: </strong>Functional luminal imaging probe (FLIP) and barium esophagogram (BE) are complementary to high-resolution manometry in achalasia. Anatomical changes and achalasia treatment could alter their interpretation. Our objective was to compare FLIP and BE for achalasia diagnosis and follow up and to evaluate the impact of anatomical changes.</p><p><strong>Methods: </strong>One hundred and thirty patients who underwent FLIP were included. The indication of FLIP was a suspicion of achalasia (naive group, n = 68 patients) or symptoms after achalasia treatment (treated group, n = 62 patients). Esophago-gastric junction distensibility index (EGJ-DI) was considered low when < 3 mm<sup>2</sup>/mmHg for a 50 mL distension plateau. BE were reviewed for the presence of esophageal stasis and anatomical changes. FLIP and BE results were compared.</p><p><strong>Key results: </strong>EGJ-DI was significantly lower in the naive group than in the treated group (2.7 mm<sup>2</sup>/mmHg vs. 5.6, p < 0.01). BE revealed abnormalities more frequently in the treated group than in the naive group (esophageal stasis 61% vs. 37%, p < 0.01; esophageal dilation 63% vs. 39%, p < 0.01; blown out myotomy 26% vs. 3%, p < 0.01). EGJ-DI was lower in patients with stasis on BE compared to those without in the naive group but not in the treated group. Intrabag pressure tended to be lower in treated patients with stasis or blown out myotomy compared to those without.</p><p><strong>Conclusions & inferences: </strong>FLIP is complementary to BE and should be interpreted with caution, notably after achalasia treatment. Further studies should determine the respective place of BE and FLIP in patients' work up.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 1","pages":"e70229"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146065606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychological Symptoms and Adverse Childhood Experiences Negatively Impact Coexisting Obstructed Defecation and Fecal Incontinence Symptoms. 心理症状和不良童年经历负向影响并存的排便障碍和大便失禁症状。
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 DOI: 10.1111/nmo.70243
Elisa Karhu, Brooke Gurland, Meredith R Craven, Dany Lamothe, Leila Neshatian

Introduction: Many patients with obstructed defecation report concurrent fecal incontinence. However, the impact of psychological factors on coexisting symptoms remains unclear. We aimed to investigate the association between history of adverse childhood experiences (ACEs) and psychological symptoms on the severity of coexisting obstructed defecation and fecal incontinence.

Methods: Retrospective analysis of a prospective IRB registry of patients with primary complaint of obstructed evacuation symptoms who completed validated surveys for assessment of psychological symptoms using the Hospital Anxiety and Depression Scale (HADS), the Adverse Childhood Experiences (ACE) questionnaire, and clinical characteristics including symptom severity.

Results: A total of 128 patients with obstructed defecation and fecal incontinence (110 women), average (SD) age 55 (16) years, were included; mean Renzi Obstructed Defecation Syndrome (ODS) score of 9.75 (3.97) and mean Cleveland Clinic Fecal Incontinence (CCFI) score of 9.38 (5.54). ACEs were reported by 60 (47%) and HADS anxiety and depression ≥ 8 by 63 (49%) and 36 (28%) of the cohort, respectively. Patients with ACEs had more severe ODS (not CCFI) scores which correlated with higher HADS anxiety and depression scores. There were no correlations between CCFI and HADS anxiety and depression scores (p > 0.05). Younger patients were more likely to report ACEs, higher HADS, ODS and lower CCFI scores. After adjusting for age, higher depression scores correlated significantly with the severity of both CCFI and ODS scores.

Conclusions: The observed differences in the impact of ACEs and psychological symptoms on coexisting obstructed defecation and fecal incontinence symptoms suggest distinct pathophysiological mechanisms, which could guide targeted treatment strategies across different age groups.

导读:许多有排便障碍的患者报告并发性大便失禁。然而,心理因素对共存症状的影响尚不清楚。我们的目的是调查儿童不良经历史(ace)与并存的排便障碍和大便失禁严重程度的心理症状之间的关系。方法:回顾性分析前瞻性IRB登记的主要主诉为疏散障碍症状的患者,这些患者完成了使用医院焦虑和抑郁量表(HADS)、不良童年经历(ACE)问卷和临床特征(包括症状严重程度)评估心理症状的有效调查。结果:共纳入排便障碍和大便失禁患者128例(女性110例),平均(SD)年龄55(16)岁;Renzi排便障碍综合征(ODS)平均评分为9.75分(3.97分),Cleveland Clinic Fecal Incontinence (CCFI)平均评分为9.38分(5.54分)。该队列中有60人(47%)报告了ace, 63人(49%)和36人(28%)分别报告了HADS焦虑和抑郁≥8。ace患者有更严重的ODS(非CCFI)评分,这与更高的HADS焦虑和抑郁评分相关。CCFI与HADS焦虑、抑郁评分无相关性(p < 0.05)。年轻患者更有可能报告ace,更高的HADS, ODS和较低的CCFI评分。在调整年龄后,较高的抑郁评分与CCFI和ODS评分的严重程度显著相关。结论:观察到ace与心理症状对并存的排便障碍和大便失禁症状影响的差异,提示不同的病理生理机制,可以指导不同年龄组的针对性治疗策略。
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引用次数: 0
Validation of the Leuven Epigastric Pain Syndrome Scale in Patients With Epigastric Pain. 鲁汶胃脘痛综合征量表在胃脘痛患者中的应用验证。
IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-01 DOI: 10.1111/nmo.70247
Bert Broeders, Lucas Wauters, Florencia Carbone, Cedric Van de Bruaene, Karen Van den Houte, Tim Vanuytsel, Michael Jones, Jan Tack

Background: Functional dyspepsia (FD) is a highly prevalent disorder of gut-brain interaction (DGBI) characterized by symptoms of postprandial distress or epigastric pain/burning. To measure symptom severity in FD, recently the Leuven postprandial distress scale (LPDS) was validated for postprandial distress symptoms. However, validated questionnaires for epigastric pain and burning, the cardinal symptoms of the epigastric pain syndrome (EPS), are currently lacking.

Aim: The aim of this study was to validate the Leuven Epigastric Pain Syndrome scale for epigastric pain and epigastric burning in FD.

Methods: We used baseline and therapy data from treatment studies in patients with FD from the University Hospital of UZ Leuven. Only patients fulfilling the Rome IV criteria for EPS or PDS-EPS overlap were selected. For the Leuven Epigastric Pain Syndrome (LEPS) scale, the mean of the epigastric burning and epigastric pain question of the diary (Likert scale, 0-4, absent to very severe) was used. The correlation of the difference in LEPS before and after treatment with validated anchor questionnaires, including Patient Assessment of Upper Gastrointestinal Disorders Symptoms Questionnaire (PAGI-SYM) total, PAGI-SYM upper abdominal pain, PAGI-SYM heartburn, overall symptom severity (OSS), and overall treatment evaluation (OTE), was evaluated. PAGI-SYM upper abdominal pain was used as an anchor to calculate the minimal clinically important difference (MCID) of the LEPS score. Data are shown as Pearson correlation coefficient with a significance level α = 0.05.

Results: The analysis used data from 27 patients with EPS and 38 with overlap EPS-PDS Delta LEPS correlated positively with delta PAGI-SYM total and with delta PAGI-SYM upper abdominal pain whereas no correlation was found for delta LEPS and delta PAGI-SYM heartburn, indicating good convergent validity. Known group validity was confirmed by higher scores in patients with high OSS scores compared with patients with low OSS scores. Analysis of steady state data showed good test-retest reliability of the LEPS score. The MCID of the LEPS score was established at -0.3 points on the LEPS scale.

Conclusion: The LEPS questionnaire is a sensitive and reliable outcome measure to record epigastric pain and burning symptoms in FD/EPS.

背景:功能性消化不良(FD)是一种非常普遍的肠-脑相互作用(DGBI)疾病,其特征是餐后窘迫或胃脘痛/灼烧。为了测量FD的症状严重程度,最近鲁汶餐后痛苦量表(lpd)被验证用于餐后痛苦症状。然而,对于胃脘痛和灼烧这一胃脘痛综合征(EPS)的主要症状,目前缺乏有效的问卷调查。目的:本研究的目的是验证鲁汶胃脘痛综合征量表对FD患者胃脘痛和胃脘灼烧的评价。方法:我们使用鲁汶大学医院FD患者治疗研究的基线和治疗数据。只选择符合罗马IV标准的EPS或PDS-EPS重叠的患者。Leuven上腹疼痛综合征(LEPS)量表采用胃脘烧灼感和胃脘痛问题的平均值(李克特量表,0-4,无至非常严重)。评估治疗前后LEPS差异与有效锚定问卷(包括患者上消化道疾病症状评估问卷(PAGI-SYM)总分、PAGI-SYM上腹痛、PAGI-SYM胃灼热、总体症状严重程度(OSS)和总体治疗评价(OTE))的相关性。PAGI-SYM上腹痛作为锚点,计算LEPS评分的最小临床重要差异(MCID)。数据以Pearson相关系数表示,显著性水平α = 0.05。结果:分析使用了27例EPS患者和38例重叠EPS- pds患者的数据,Delta LEPS与Delta PAGI-SYM总量和Delta PAGI-SYM上腹痛呈正相关,而Delta LEPS与Delta PAGI-SYM烧心没有相关性,表明具有良好的收敛效度。已知的组效度通过高OSS评分的患者比低OSS评分的患者得分更高来证实。对稳态数据的分析表明,LEPS评分具有良好的重测信度。LEPS评分的MCID在LEPS量表上设定为-0.3分。结论:LEPS问卷是记录FD/EPS患者胃脘痛和灼烧症状的一种敏感、可靠的结果测量方法。
{"title":"Validation of the Leuven Epigastric Pain Syndrome Scale in Patients With Epigastric Pain.","authors":"Bert Broeders, Lucas Wauters, Florencia Carbone, Cedric Van de Bruaene, Karen Van den Houte, Tim Vanuytsel, Michael Jones, Jan Tack","doi":"10.1111/nmo.70247","DOIUrl":"https://doi.org/10.1111/nmo.70247","url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) is a highly prevalent disorder of gut-brain interaction (DGBI) characterized by symptoms of postprandial distress or epigastric pain/burning. To measure symptom severity in FD, recently the Leuven postprandial distress scale (LPDS) was validated for postprandial distress symptoms. However, validated questionnaires for epigastric pain and burning, the cardinal symptoms of the epigastric pain syndrome (EPS), are currently lacking.</p><p><strong>Aim: </strong>The aim of this study was to validate the Leuven Epigastric Pain Syndrome scale for epigastric pain and epigastric burning in FD.</p><p><strong>Methods: </strong>We used baseline and therapy data from treatment studies in patients with FD from the University Hospital of UZ Leuven. Only patients fulfilling the Rome IV criteria for EPS or PDS-EPS overlap were selected. For the Leuven Epigastric Pain Syndrome (LEPS) scale, the mean of the epigastric burning and epigastric pain question of the diary (Likert scale, 0-4, absent to very severe) was used. The correlation of the difference in LEPS before and after treatment with validated anchor questionnaires, including Patient Assessment of Upper Gastrointestinal Disorders Symptoms Questionnaire (PAGI-SYM) total, PAGI-SYM upper abdominal pain, PAGI-SYM heartburn, overall symptom severity (OSS), and overall treatment evaluation (OTE), was evaluated. PAGI-SYM upper abdominal pain was used as an anchor to calculate the minimal clinically important difference (MCID) of the LEPS score. Data are shown as Pearson correlation coefficient with a significance level α = 0.05.</p><p><strong>Results: </strong>The analysis used data from 27 patients with EPS and 38 with overlap EPS-PDS Delta LEPS correlated positively with delta PAGI-SYM total and with delta PAGI-SYM upper abdominal pain whereas no correlation was found for delta LEPS and delta PAGI-SYM heartburn, indicating good convergent validity. Known group validity was confirmed by higher scores in patients with high OSS scores compared with patients with low OSS scores. Analysis of steady state data showed good test-retest reliability of the LEPS score. The MCID of the LEPS score was established at -0.3 points on the LEPS scale.</p><p><strong>Conclusion: </strong>The LEPS questionnaire is a sensitive and reliable outcome measure to record epigastric pain and burning symptoms in FD/EPS.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":"38 1","pages":"e70247"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Neurogastroenterology and Motility
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