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Neurogastroenterol Motil 2021 Apr 8:e14154. Epub 2021 Apr 8.

Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Mayo Clinic, Rochester, MN, USA.

Aims: Gastric emptying is of limited utility for predicting the severity of symptoms in patients with diabetes mellitus and gastrointestinal symptoms. We evaluated the extent to which symptoms recorded during a C-spirulina-based gastric emptying breath test (GEBT) or scintigraphy predicting the severity of daily symptoms in diabetes mellitus.

Methods: Gastric emptying, symptoms during a gastric emptying study, either scintigraphy (n = 38) or GEBT (n = 111), and daily gastrointestinal symptoms were evaluated in 149 patients with diabetes mellitus and variably severe gastrointestinal symptoms. Read More

J Tradit Chin Med 2021 04;41(2):326-330

Department of Acupuncture-Moxibustion and Tuina, Qilu Hospital of Shandong University, Jinan 250012, China.

Objective: To evaluate the effect of electroacupuncture on rapid gastric emptying by comparing the effectiveness of electroacupuncture at both Zusanli (ST36) and Zhongwan (CV12) (He-Mu acupoints) versus electroacupuncture at Zhongwan (CV12) alone.

Methods: Sixty-five patients were randomly divided into two groups; 33 patients in the He-Mu acupoints group received electroacupuncture at both Zusanli (ST36) and Zhongwan (CV12), while 32 patients in the single acupoint group received electroacupuncture only at Zhongwan (CV12). Both groups were treated once daily for 30 min, five times per week for 3 weeks. Read More

Langenbecks Arch Surg 2021 Apr 6. Epub 2021 Apr 6.

The Nutrition Department, Suining Central Hospital, Sichuan, China.

Purpose: Although laparoscopic Nissen fundoplication (LNF) is a kind of minimally invasive surgery, some transition time may still be required to allow the fundoplicated stomach to adapt to the new anatomical position. We observed transient delayed gastric emptying (DGE) post-LNF in our preliminary study. This study aimed to investigate the occurrence rate and development of transient DGE post-LNF. Read More

Surg Endosc 2021 Apr 6. Epub 2021 Apr 6.

Department of High-Tech and Endoscopic Surgery, Moscow Clinical Scientific Center Named After A.C.Loginov, Entusiastov shosse, 86, Moscow, Russia, 111123.

Introduction: There are limited numbers of high-volume centers performing minimally invasive pancreatoduodenectomy (MIPD) routinely. Several approaches to MIPD have been described. Aim of this analysis was to show the learning curve of three different approaches to MIPD. Read More

Eur J Pharmacol 2021 Apr 3:174072. Epub 2021 Apr 3.

Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology College, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, China; Department of Physiology and Pathophysiology, Xi'an Jiaotong University Health Science Center, 76 West Yan Ta Road, Xi'an, Shaanxi, 710061, China. Electronic address:

Glucagon-like peptide-2 (GLP-2) is secreted from enteroendocrine L-type cells of the gut and also released from preproglucagonergic (PPG) neurons in the nucleus tractus solitarius (NTS) and adjacent medial reticular nucleus of the brain stem. The neurons in the NTS express GLP-2, and the neurons send extensive projections to the hypothalamus. Recent studies show that the intracerebroventricular administration of GLP-2 significantly suppresses food intake in animals and some evidence suggest that the melanocortin receptor-4 (MC4-R) signaling in the hypothalamus is required for intracerebroventricular GLP-2-mediated inhibition of feeding. Read More

Curr Med Res Opin 2021 Apr 5:1-10. Epub 2021 Apr 5.

Medical Department, UPSA S.A.S, Rueil Malmaison, France.

Objective: Paracetamol has an established place in the management of mild-to-moderate pain, but has certain limitations, including varying bioavailability, and potential hepatotoxicity if taken in overdose. Effervescent formulations may help to overcome these limitations.

Methods: Pubmed searches, with no limits on date or language, were conducted in February 2020. Read More

Front Pediatr 2021 18;9:646395. Epub 2021 Mar 18.

Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.

There is limited information on therapeutic benefits and tube-related complications of pediatric nasoenteric (NE) tube feeding. We viewed, from different clinical aspects, NE tube feeding in children who are under intolerable conditions. A 10-years retrospective study enrolled 77 pediatric patients who underwent an endoscopic-guided placement of the NE tube for enteral nutrition. Read More

Indian J Surg Oncol 2021 Mar 27;12(1):22-30. Epub 2020 Aug 27.

Department of Surgical Gastroenterology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh 226010 India.

Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Read More

Mayo Clin Proc 2021 Apr;96(4):1071-1089

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. Electronic address:

Functional gastrointestinal (GI) disorders (FGIDs) result from central and peripheral mechanisms, cause chronic remitting-relapsing symptoms, and are associated with comorbid conditions and impaired quality of life. This article reviews sex- and gender-based differences in the prevalence, pathophysiologic factors, clinical characteristics, and management of functional dyspepsia (FD) and irritable bowel syndrome (IBS) that together affect approximately 1 in 4 people in the United States. These conditions are more common in women. Read More

Aliment Pharmacol Ther 2021 Apr 3. Epub 2021 Apr 3.

Temple University School of Medicine, Philadelphia, PA, USA.

Background: Gastroparesis is a serious gastrointestinal (GI) condition characterised by delayed gastric emptying (GE). Velusetrag-a potent, selective, pan-gastrointestinal 5-hydroxytryptamine type 4 receptor agonist-is under investigation for treatment of GI motility disorders including gastroparesis.

Aims: To assess the efficacy and safety of velusetrag for accelerating GE in subjects with diabetic or idiopathic gastroparesis. Read More

Updates Surg 2021 Apr 3. Epub 2021 Apr 3.

Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, West Bengal, 700020, India.

The aim of the present study is to report the overall perioperative outcome of Whipple's procedure (WP) with particular attention to the impact of preoperative biliary drainage (PBD) on postoperative clinical outcome. All the patients who underwent WP at our institution between August 2007 and December 2019 were retrospectively reviewed. Impact of PBD and the stent-surgery interval on the postoperative clinical outcome of WP were analyzed. Read More

Nutrients 2021 Mar 30;13(4). Epub 2021 Mar 30.

Laboratory of Evidence-Based Practice, Universidade Estadual de Mato Grosso do Sul, Campo Grande 79804970, MS, Brazil.

Background: Brain injury has several consequences throughout life, its increased incidence has caused great public concern. The aim was identifying the main nutritional therapies recommended for children with brain injuries.

Methods: A systematic review was carried out using the terms in the search strategy: "Brain Injuries", "Nutrition Therapy", and "Child" and their synonyms, from database inception up to August 2020. Read More

J Clin Med 2021 Mar 23;10(6). Epub 2021 Mar 23.

Unit of Gastroenterology, Molinette Hospital, 10126 Turin, Italy.

Diabetes mellitus is a widespread disease, and represents an important public health burden worldwide. Together with cardiovascular, renal and neurological complications, many patients with diabetes present with gastrointestinal symptoms, which configure the so-called diabetic enteropathy. In this review, we will focus on upper gastrointestinal symptoms in patients with diabetes, with particular attention to dyspepsia and diabetic gastroparesis (DG). Read More

Nutrients 2021 Mar 11;13(3). Epub 2021 Mar 11.

Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, PA 17033, USA.

The regulation of energy balance requires the complex integration of homeostatic and hedonic pathways, but sensory inputs from the gastrointestinal (GI) tract are increasingly recognized as playing critical roles. The stomach and small intestine relay sensory information to the central nervous system (CNS) via the sensory afferent vagus nerve. This vast volume of complex sensory information is received by neurons of the nucleus of the tractus solitarius (NTS) and is integrated with responses to circulating factors as well as descending inputs from the brainstem, midbrain, and forebrain nuclei involved in autonomic regulation. Read More

Neurogastroenterol Motil 2021 Apr 2:e14146. Epub 2021 Apr 2.

Department of Radiology, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.

Background: Assessment of gastric function in humans has relied on modalities with varying degrees of invasiveness, which are usually limited to the evaluation of single aspects of gastric function, thus requiring patients to undergo a number of often invasive tests for a full clinical understanding. Therefore, the development of a non-invasive tool able to concurrently assess multiple aspects of gastric function is highly desirable for both research and clinical assessments of gastrointestinal (GI) function. Recently, technological advances in magnetic resonance imaging (MRI) have provided new tools for dynamic (or "cine") body imaging. Read More

J Neurogastroenterol Motil 2021 Apr;27(2):265-278

Department of Physiology, Marmara University School of Medicine, Istanbul, Turkey.

Background/aims: Gastrointestinal motility changes contribute to development and maintenance of obesity. Nesfatin-1 (NES-1) is involved in central appetite control. The aim is to elucidate effects of NES-1 and high-fat diet (HFD) on gastrointestinal motility and to explore myenteric neuron expressions of tyrosine hydroxylase (TH), vasoactive intestinal peptide (VIP), and neuronal nitric oxide synthase (nNOS) in HFDinduced oxidative injury. Read More

Headache 2021 Apr 1. Epub 2021 Apr 1.

Department of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA.

Background: Migraine is a complex, multifaceted, and disabling headache disease that is often complicated by gastrointestinal (GI) conditions, such as gastroparesis, functional dyspepsia, and cyclic vomiting syndrome (CVS). Functional dyspepsia and CVS are part of a spectrum of disorders newly classified as disorders of gut-brain interaction (DGBI). Gastroparesis and functional dyspepsia are both associated with delayed gastric emptying, while nausea and vomiting are prominent in CVS, which are also symptoms that commonly occur with migraine attacks. Read More

J Pharm Pharmacol 2021 Mar;73(2):247-262

School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Objectives: To explore the intervention mechanism of combining Polygala tenuifolia (PT) with Magnolia officinalis (MO) on gastrointestinal motility disorders caused by PT.

Methods: Urine and faeces of rats were collected; the effects of PT and MO on the gastric emptying and small intestine advancing rates in mice were analysed via ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) to determine the potential metabolites. Changes in the metabolic profiles of the urine and faeces were revealed by untargeted metabolomics, followed by multivariate statistical analysis. Read More

PLoS Comput Biol 2021 Mar 31;17(3):e1008852. Epub 2021 Mar 31.

Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.

Plasma glucose and insulin responses following an oral glucose challenge are representative of glucose tolerance and insulin resistance, key indicators of type 2 diabetes mellitus pathophysiology. A large heterogeneity in individuals' challenge test responses has been shown to underlie the effectiveness of lifestyle intervention. Currently, this heterogeneity is overlooked due to a lack of methods to quantify the interconnected dynamics in the glucose and insulin time-courses. Read More

Obes Surg 2021 Mar 30. Epub 2021 Mar 30.

Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSP, Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, 05403-010, Brazil.

Intragastric balloon (IGB) is a minimally invasive and reversible therapy for weight loss with a good efficacy and safety profile. Introduced in the 1980s, IGBs have significantly evolved in the last couple of decades. They mechanically act by decreasing the volume of the stomach and its reservoir capacity, delaying gastric emptying, and increasing satiety leading to a subsequent weight loss. Read More

Surg Today 2021 Mar 30. Epub 2021 Mar 30.

Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.

Purpose: We sometimes experienced prolonged delayed gastric emptying (DGE) in neurologically impaired patients undergoing laparoscopic fundoplication and gastrostomy. We explored the difference in the DGE rate according to the preoperative stomach position.

Methods: Thirty-two neurological impaired patients who underwent laparoscopic fundoplication and gastrostomy between 2015 and 2019 were classified into two groups based on stomach position: non-elevated stomach position (NESP) and elevated stomach position (ESP). Read More

J Clin Gastroenterol 2021 Feb 2. Epub 2021 Feb 2.

*Division of Digestive and Liver Diseases §Division of Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX †Department of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA ‡Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.

Goal: The goal of this study was to evaluate the relationship between pretransplant delayed gastric emptying (DGE) and posttransplant acute cellular rejection (ACR) in lung transplant recipients.

Background: DGE is very prevalent (23% to 91%) after lung transplantation but pretransplant prevalence has not been well studied. DGE may lead to poor posttransplant outcomes by predisposing to microaspiration. Read More

Front Surg 2021 12;8:583671. Epub 2021 Mar 12.

Department of Hepatobiliary Surgery, Weihai Central Hospital Affiliated to Qingdao University, Weihai, China.

Laparoscopic pancreaticoduodenectomy has developed rapidly in recent years. Postoperative pancreatic fistula is still the most dangerous complication of laparoscopic pancreaticoduodenectomy. Baumgart pancreaticojejunostomy is considered one of the safest anastomosis procedures, with low rates of pancreatic fistula. Read More

Acta Pharm Sin B 2021 Mar 30;11(3):763-780. Epub 2020 Jul 30.

Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China.

Intestinal toxicity induced by chemotherapeutics has become an important reason for the interruption of therapy and withdrawal of approved agents. In this study, we demonstrated that chemotherapeutics-induced intestinal damage were commonly characterized by the sharp upregulation of tryptophan (Trp)-kynurenine (KYN)-kynurenic acid (KA) axis metabolism. Mechanistically, chemotherapy-induced intestinal damage triggered the formation of an interleukin-6 (IL-6)-indoleamine 2,3-dioxygenase 1 (IDO1)-aryl hydrocarbon receptor (AHR) positive feedback loop, which accelerated kynurenine pathway metabolism in gut. Read More

Int J Surg 2021 Mar 24;88:105923. Epub 2021 Mar 24.

Department of Hepato-Pancreato-Biliary Surgery, Manchester Royal Infirmary, Manchester, UK.

Background: Post-operative pancreatic fistula (POPF) and delayed gastric emptying (DGE) both remain problematic complications following pancreaticoduodenectomy. This systematic review and meta-analysis evaluates whether Roux-en-Y compared to a single loop reconstruction in pancreaticoduodenectomy significantly reduces rates of these complications.

Methods: A systematic review and meta-analysis was conducted according to the PRISMA guidelines by screening EMBASE, MEDLINE/PubMed, CENTRAL and bibliographic reference lists for comparative studies meeting the predetermined inclusion criteria. Read More

J Gastrointest Surg 2021 Mar 26. Epub 2021 Mar 26.

Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN, USA.

Background: The decision to routinely leave a nasogastric tube after pancreatoduodenectomy remains controversial. We sought to determine the impact of immediate nasogastric tube removal versus early nasogastric tube removal (<24 h) on postoperative outcomes.

Methods: A retrospective review of our institution's prospective ACS-NSQIP database identified patients that underwent pancreatoduodenectomy from 2015 to 2018. Read More

Gastrointest Endosc 2021 Mar 23. Epub 2021 Mar 23.

Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. Electronic address:

Surg Endosc 2021 Mar 26. Epub 2021 Mar 26.

Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming Chiao Tung University, 201 Section 2 Shipai Road, Taipei, 112, Taiwan.

Background: This study is to clarify the feasibility of and justification for robotic pancreaticoduodenectomy (RPD) in patients with pancreatic adenocarcinoma.

Methods: A 1-to-1 propensity score-matched comparison of RPD and open pancreaticoduodenectomy (OPD) was performed based on six covariates commonly used to predict the survival outcome for pancreatic adenocarcinoma.

Results: A total of 130 patients were enrolled, with 65 in each study group after propensity score matching. Read More

J Hepatobiliary Pancreat Sci 2021 Mar 26. Epub 2021 Mar 26.

Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Hepato-Pancreato-Biliary Division, Thailand.

Pancreatoduodenectomy (PD) is the standard treatment of periampullary tumors. However, the overall morbidity rate, including intra-abdominal collection, hemorrhage post-pancreatectomy, and delayed gastric emptying, are still high, with rates of approximately 65.9%-77. Read More

Eur J Drug Metab Pharmacokinet 2021 Mar 25. Epub 2021 Mar 25.

Laboratory of Biopharmaceutics, Pharmacokinetics, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784, Athens, Greece.

Background And Objectives: Losartan presents multiple peaks after single oral administration, which can be attributed to gastric emptying. The aim of this study was to describe the multiple peak phenomenon of losartan using a delay differential model and a model with sine function. The impact of gastric emptying on pharmacokinetic parameters was investigated by applying principal component analysis to the individual parameter estimates. Read More