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๐Ÿ†•๐Ÿ”ฅ#PercutaneousElectricalNerveFieldStimulation improves weight & other anthropometric outcomes in #Children & #Adolescents with #FunctionalDyspepsia who restrict their oral intakeโ€ผ๏ธ
๐ŸŽฏ#PENFS can improve GI symptoms & #psychosocial outcomes #DGBIs๐Ÿ‘
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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๐Ÿ†•๐Ÿ”ฅAlternative Pathways of #Acetylcholine Release in Colon: Role of #HighAffinity Choline Transportersโ€ผ๏ธ
๐ŸŽฏHigh-affinity choline transporters provide a novel pathway for acetylcholine release originating from neuronal sources๐Ÿ‘
#ANMS #ESNM
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...

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๐Ÿ†•๐Ÿ”ฅAdolescent normative intervals for #BodySurfaceGastricMappingโ€ผ๏ธ
๐ŸŽฏBSGM normative reference intervals support test interpretation & allow specific phenotyping of gastric abnormalities & guide symptoms management๐Ÿ‘
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Key Points
โ€ข First-line therapies for functional dyspepsia, including proton pump inhibitors and Helicobacter pylori eradication, provide limited symptom relief in a substantial proportion of patients.
โ€ข Functional dyspepsia and gastroparesis share overlapping symptoms but differ in predominant pathophysiological mechanisms, requiring tailored therapeutic strategies.
โ€ข Predominantly central neuromodulators are most appropriate for epigastric pain syndrome, whereas predominantly peripheral neuromodulators are better suited for postprandial distress syndrome and gastroparesis-related nausea and vomiting.
โ€ข A pragmatic, symptom-oriented, and mechanism-based approach may facilitate individualized treatment selection and optimize clinical outcomes.

Key Points โ€ข First-line therapies for functional dyspepsia, including proton pump inhibitors and Helicobacter pylori eradication, provide limited symptom relief in a substantial proportion of patients. โ€ข Functional dyspepsia and gastroparesis share overlapping symptoms but differ in predominant pathophysiological mechanisms, requiring tailored therapeutic strategies. โ€ข Predominantly central neuromodulators are most appropriate for epigastric pain syndrome, whereas predominantly peripheral neuromodulators are better suited for postprandial distress syndrome and gastroparesis-related nausea and vomiting. โ€ข A pragmatic, symptom-oriented, and mechanism-based approach may facilitate individualized treatment selection and optimize clinical outcomes.

๐Ÿ†•๐Ÿ”ฅCentral & peripheral #Neuromodulators in #FD & #Gastroparesis: Symptom-Based #ClinicalReviewโ€ผ๏ธ
๐ŸŽฏA pragmatic, symptom-oriented & mechanism-based approach facilitate individualized treatment selection & optimize clinical outcomes
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #optandairport #airport #sweden #esnm #aviation #avgeek vl

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #optandairport #airport #sweden #esnm #aviation #avgeek vl

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1. POI is a common complication after abdominal sur-gery, prolonging the postoperative recovery time ofpatients.
2. POI will prolong the time for the intestines to empty,disrupt the intestinal flora balance, trigger related inflammatory responses, and cause disorder in the body's microenvironment.
3. Lactobacillus reuteri can alleviate intestinal metabolic disorders by promoting the expression of anti-inflammatory factors and inhibiting the expression of pro-inflammatory factors, thereby regulating the intestinal microbiota and facilitating the body's recovery.

Key points 1. POI is a common complication after abdominal sur-gery, prolonging the postoperative recovery time ofpatients. 2. POI will prolong the time for the intestines to empty,disrupt the intestinal flora balance, trigger related inflammatory responses, and cause disorder in the body's microenvironment. 3. Lactobacillus reuteri can alleviate intestinal metabolic disorders by promoting the expression of anti-inflammatory factors and inhibiting the expression of pro-inflammatory factors, thereby regulating the intestinal microbiota and facilitating the body's recovery.

๐Ÿ†•๐Ÿ”ฅ #Lactobacillus reuteri DSM 17938 improves #IntestinalMotility in ๐Ÿญ with #PostoperativeIleus by modulating #GutMicrobiota & #Macrophageโ€ผ๏ธ
๐ŸŽฏL. reuteri DSM 17938 is a promising probiotic for the prevention of #POI๐Ÿ‘
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Summary
โ€ข Guidelines recommend doubling the proton pump inhibitor (PPI) dosage for persistent nocturnal reflux symptoms, while wedge pillows are suggested as anon-pharmacological option. However, their efficacy compared with twice-daily PPI remains unstudied.
โ€ข A wedge pillow combined with a morning PPI was non-inferior to twice-daily PPI in alleviating nocturnal reflux symptoms and was associated with greater improvements in sleep quality, despite no significant changes in reflux parameters, suggesting that the observed benefit may be mediated by sleep-related factors.
โ€ข A wedge pillow can complement PPI therapy for man-aging nocturnal reflux symptoms, offering relief from night time symptoms and improving sleep quality inpatients not responding to morning PPI therapy.

Summary โ€ข Guidelines recommend doubling the proton pump inhibitor (PPI) dosage for persistent nocturnal reflux symptoms, while wedge pillows are suggested as anon-pharmacological option. However, their efficacy compared with twice-daily PPI remains unstudied. โ€ข A wedge pillow combined with a morning PPI was non-inferior to twice-daily PPI in alleviating nocturnal reflux symptoms and was associated with greater improvements in sleep quality, despite no significant changes in reflux parameters, suggesting that the observed benefit may be mediated by sleep-related factors. โ€ข A wedge pillow can complement PPI therapy for man-aging nocturnal reflux symptoms, offering relief from night time symptoms and improving sleep quality inpatients not responding to morning PPI therapy.

๐Ÿ†•๐Ÿ”ฅ#WedgePillow vs. evening #ProtonPumpInhibitor for #NocturnalReflux symptomsโ€ผ๏ธ
๐ŸŽฏAdding a wedge pillow was not inferior to evening PPI for nocturnal reflux symptoms โฉGreater improvements in #sleep quality๐Ÿ‘
๐Ÿ‘‰https://onlinelibrary.wiley.com/doi/10.1111/nmo.70256
#ANMS #ESNM #GERD #PPI

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Key Points:
Twenty percent of patients with systemic sclerosis met diagnostic criteria for irritable bowel syndrome or functional dyspepsia, the two most common disorders of gutโ€“brain interaction.
The presence of symptoms consistent with disorders of gutโ€“brain interaction is associated with more severe systemic sclerosis gastrointestinal disease and poorer quality of life.
Effective management strategies have been used to treat disorders of gut brain interaction that could be tested in those patients with systemic sclerosis and co-morbid disorders of gut brain interaction to reduce symptom burden and improve quality of life.

Key Points: Twenty percent of patients with systemic sclerosis met diagnostic criteria for irritable bowel syndrome or functional dyspepsia, the two most common disorders of gutโ€“brain interaction. The presence of symptoms consistent with disorders of gutโ€“brain interaction is associated with more severe systemic sclerosis gastrointestinal disease and poorer quality of life. Effective management strategies have been used to treat disorders of gut brain interaction that could be tested in those patients with systemic sclerosis and co-morbid disorders of gut brain interaction to reduce symptom burden and improve quality of life.

๐Ÿ†•๐Ÿ”ฅQuantifying the Prevalence of #DisordersofGutBrainInteraction in #SystemicSclerosisโ€ผ๏ธ
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
๐ŸŽฏ20% of patients with systemic sclerosis met diagnostic criteria for #IrritableBowelSyndrome or #FunctionalDyspepsia๐Ÿ‘
#ANMS #ESNM

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Keypoints:
Muscularis macrophages express high levels of ApoE after intestinal manipulation, but macrophage-specific deletion of ApoE does not impair gut motility or tissue morphology.
While global ApoE deficiency mildly affects intestinal transit and promotes inflammation, macrophage-derived ApoE is dispensable for maintaining normal and postoperative gut motility.

Keypoints: Muscularis macrophages express high levels of ApoE after intestinal manipulation, but macrophage-specific deletion of ApoE does not impair gut motility or tissue morphology. While global ApoE deficiency mildly affects intestinal transit and promotes inflammation, macrophage-derived ApoE is dispensable for maintaining normal and postoperative gut motility.

๐Ÿ†•๐Ÿ”ฅ#MuscularisMacrophage-derived #ApoE is dispensable for maintaining #GutMotility ๐Ÿญโ€ผ๏ธ
๐ŸŽฏGlobal ApoE deficiency delays gut transit & promotes inflammation, while macrophage-specific ApoE deletion does not impair motility #POI๐Ÿ‘
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Key Points:
Calculating the CARS endoscopic score and performing FLIP panometry during endoscopy can assess the likelihood of an esophageal motility disorder and potentially expedite its diagnosis.
A CARS score >โ€‰4 combined with FLIP-REO is highly predictive (100% specificity/100% positive predictive value) of an EGJ obstruction diagnosis (achalasia or confirmed EGJOO) on HRM.

Key Points: Calculating the CARS endoscopic score and performing FLIP panometry during endoscopy can assess the likelihood of an esophageal motility disorder and potentially expedite its diagnosis. A CARS score >โ€‰4 combined with FLIP-REO is highly predictive (100% specificity/100% positive predictive value) of an EGJ obstruction diagnosis (achalasia or confirmed EGJOO) on HRM.

๐Ÿ†•๐Ÿ”ฅCombined utility of #CARS endoscopic score & #FLIP based on realโ€time assessmentsโ€ผ๏ธ
๐ŸŽฏCombination of CARS score โ‰ฅ 4 & reduced #EGJ opening on FLIP is highly predictive of an EGJ obstruction diagnosis #Achalasia #EGJOO๐Ÿ‘
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Key Points:
Validated options for assessing gastric emptying in patients with dietary restrictions that preclude eating the standard egg meal.
We developed and tested a vegan and allergy friendly meal using a vegan egg product for gastric emptying scintigraphy in 10 healthy volunteers after confirming in vitro stability/performance.
The tested vegan egg meal appears to be a suitable alternative to the standard egg meal for patients who are not able to eat eggs, though additional studies with larger sample sizes are needed for further validation.

Key Points: Validated options for assessing gastric emptying in patients with dietary restrictions that preclude eating the standard egg meal. We developed and tested a vegan and allergy friendly meal using a vegan egg product for gastric emptying scintigraphy in 10 healthy volunteers after confirming in vitro stability/performance. The tested vegan egg meal appears to be a suitable alternative to the standard egg meal for patients who are not able to eat eggs, though additional studies with larger sample sizes are needed for further validation.

๐Ÿ†•๐Ÿ”ฅPilot validation study of๐ŸŒฑplantโ€based & allergyโ€friendly alternative for testing #GastricEmptying #HealthyParticipantsโ€ผ๏ธ
๐ŸŽฏTested #vegan egg meal appears to be a suitable alternative to standard egg meal for patients who are not able to eat eggs
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Key Points:
This study reports the first documented case of myofilament loss in gastrointestinal smooth muscle cells in MELAS-associated chronic intestinal pseudo-obstruction (CIPO). Electron microscopic analysis demonstrated marked reduction of myofilaments accompanied by abundant abnormal mitochondria throughout the digestive tract, revealing that mitochondrial dysfunction may directly impair the smooth muscle contractile apparatus independent of previously described enteric nervous system abnormalities.
These findings suggest that apparent superior mesenteric artery syndrome in MELAS patients may represent underlying CIPO with inherent intestinal structural vulnerability, supporting early implementation of enteral nutrition strategies that bypass affected gastrointestinal segments. Future research should focus on quantitative assessment of contractile protein abnormalities and development of therapeutic interventions targeting smooth muscle function in mitochondrial disorders.

Key Points: This study reports the first documented case of myofilament loss in gastrointestinal smooth muscle cells in MELAS-associated chronic intestinal pseudo-obstruction (CIPO). Electron microscopic analysis demonstrated marked reduction of myofilaments accompanied by abundant abnormal mitochondria throughout the digestive tract, revealing that mitochondrial dysfunction may directly impair the smooth muscle contractile apparatus independent of previously described enteric nervous system abnormalities. These findings suggest that apparent superior mesenteric artery syndrome in MELAS patients may represent underlying CIPO with inherent intestinal structural vulnerability, supporting early implementation of enteral nutrition strategies that bypass affected gastrointestinal segments. Future research should focus on quantitative assessment of contractile protein abnormalities and development of therapeutic interventions targeting smooth muscle function in mitochondrial disorders.

๐Ÿ†•๐Ÿ”ฅLoss of #Myofilaments in gastrointestinal smooth muscle represents a novel pathological mechanism in MELAS-associated chronic intestinal Pseudo-obstruction #CIPOโ€ผ๏ธ
๐ŸŽฏ #Mitochondrial dysfunction directly impairs smooth muscle contractile apparatus
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Key Points
Patients with rectal prolapse only at defecation present a distinct, younger phenotype with more severe obstructive defecation symptoms, higher intrarectal push pressures, and better-preserved anal sphincter function. In contrast patients with spontaneous rectal prolapse are older and have higher fecal incontinence severity associated with lower resting anal tone and less sustained squeeze pressures.
MRI defecography shows greater pelvic floor laxity in spontaneous prolapse (larger levator hiatus length/width, bowl volume, and wider resting anorectal angle), whereas defecation-only prolapse demonstrates more preserved hiatus anatomy and less patulous anal canal.
Defecation-only prolapse may represent an early stage of disease. Identifying the phenotype of rectal prolapse can inform timing and type of intervention though surgical recurrence rates were similar between groups.

Key Points Patients with rectal prolapse only at defecation present a distinct, younger phenotype with more severe obstructive defecation symptoms, higher intrarectal push pressures, and better-preserved anal sphincter function. In contrast patients with spontaneous rectal prolapse are older and have higher fecal incontinence severity associated with lower resting anal tone and less sustained squeeze pressures. MRI defecography shows greater pelvic floor laxity in spontaneous prolapse (larger levator hiatus length/width, bowl volume, and wider resting anorectal angle), whereas defecation-only prolapse demonstrates more preserved hiatus anatomy and less patulous anal canal. Defecation-only prolapse may represent an early stage of disease. Identifying the phenotype of rectal prolapse can inform timing and type of intervention though surgical recurrence rates were similar between groups.

๐Ÿ†•๐Ÿ”ฅDistinct Phenotypes of #RectalProlapse #RP in Womenโ€ผ๏ธ
๐ŸŽฏ#Defecation-only RP represents an early stage of disease #preserved #AnalSphincter function โฌ‡๏ธ#PelvicFloorLaxity๐Ÿ‘
๐ŸŽฏPatients with #Spontaneous RP are older & haveโฌ†๏ธ fecal incontinence severity
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Key Points
โ€ข We employed Atmo Capsules to measure the frequency and amplitude of stomach contractions using a method called accelerometry which detects changes in capsule orientation and acceleration.
โ€ข Stomach contractions occurring at a frequency of 3 cycles per minute were found which were lower in amplitude in patients with delayed gastric emptying compared to healthy controls and individuals with normal gastric emptying.
โ€ข This technical assessment provides support for the Atmo Capsule accelerometer to characterize normal and abnormal stomach contractile profiles in patients with suspected motility disorders.

Key Points โ€ข We employed Atmo Capsules to measure the frequency and amplitude of stomach contractions using a method called accelerometry which detects changes in capsule orientation and acceleration. โ€ข Stomach contractions occurring at a frequency of 3 cycles per minute were found which were lower in amplitude in patients with delayed gastric emptying compared to healthy controls and individuals with normal gastric emptying. โ€ข This technical assessment provides support for the Atmo Capsule accelerometer to characterize normal and abnormal stomach contractile profiles in patients with suspected motility disorders.

๐Ÿ†•๐Ÿ”ฅAccelerometric assessment of #Gastric Contractility using #Atmo Wireless Motility Capsuleโ€ผ๏ธ
๐ŸŽฏAtmo Capsule enables precise quantification of gastric contraction profiles, permitting differentiation of normal from pathological motor patterns๐Ÿ‘
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#NGM #ANMS #ESNM

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #optandairport #airport #sweden #esnm #aviation #avgeek vl

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KEY POINTS
โ€ข Enterochromaffin (EC) cells release signaling molecules which can activate nearby sensory nerves.Whether this occurs via a conventional synapse for-mation is unknown.
โ€ข EC cells rarely make contact with sensory nerves inthe upper gut but this frequency increases in the distal colon.
โ€ข Neurite-like protrusiton on EC cells, named by some as โ€œneuropodsโ€ are not a preferential site of contact with nerve fibres.

KEY POINTS โ€ข Enterochromaffin (EC) cells release signaling molecules which can activate nearby sensory nerves.Whether this occurs via a conventional synapse for-mation is unknown. โ€ข EC cells rarely make contact with sensory nerves inthe upper gut but this frequency increases in the distal colon. โ€ข Neurite-like protrusiton on EC cells, named by some as โ€œneuropodsโ€ are not a preferential site of contact with nerve fibres.

๐Ÿ†• #Neuroepithelial landscape of #Enterochromaffin cells varies across #GI locationโ€ผ๏ธ
โœ…EC cells rarely make contact with sensory nerves in upper gut but this frequency increases in distal colon๐Ÿ‘
๐ŸŽฏ #Neuropods are not a preferential site of contact๐Ÿ”ฅ
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/...
#ANMS #ESNM

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #optandairport #airport #sweden #esnm #aviation #avgeek vl

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #optandairport #airport #sweden #esnm #aviation #avgeek vl

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๐ŸšจThrilled to welcome the new #EditorialTeam at
#NGM led by our new Editor-in-Chief, Prof. Daniel Keszthelyi ๐ŸŽ‰
๐Ÿ”ŠWe look forward to great science & fascinating breakthroughs ahead in #Neurogastroenterology & #Motility #GutBrainScience #ANMS #ESNM

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #optandairport #airport #sweden #esnm #aviation #avgeek vl

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Prof. Edoardo Savarino takes us through the highlights of the updated #UEG and #ESNM #dysphagia guidelines and the difference they could make to patient outcomes.

Listen now ๐Ÿ”‰ buff.ly/CfJ9oay

#GastroSky

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #sweden #optandairport #esnm #airport #aviation #avgeek vl

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #sweden #optandairport #esnm #airport #aviation #avgeek vl

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #sweden #optandairport #esnm #airport #aviation #avgeek vii3

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #sweden #optandairport #esnm #airport #aviation #avgeek vl

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #sweden #optandairport #esnm #airport #aviation #avgeek vl

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways can you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #sweden #optandairport #esnm #airport #aviation #avgeek vl

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๐Ÿ†•๐Ÿ”ฅThe Path Forward: Assessing a Pilot Competency-Based Curriculum on #DGBIs for Gastroenterology Traineesโ€ผ๏ธ #NGMJournal
๐Ÿ‘‰ onlinelibrary.wiley.com/doi/10.1111/nmโ€ฆ
โœ…DGBI education curriculum
โœ…Pre-&Post-individual knowledge scores
๐ŸŽฏAttitudes in managing DGBIs๐Ÿ‘
#ANMSociety #ESNM

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Optand airport (Sweden) information ESNM General weather, closest aviation weather, Maps, hotels and aeronautical information for Optand airport (Sweden)

How many runways do you see for Optand airport (Sweden) ? : The answer is on https://www.bigorre.org/aero/meteo/esnm/en #sweden #optandairport #esnm #airport #aviation #avgeek vl

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