간행물

Journal of Neurogastroenterology and Motility update

  • : 대한소화기기능성질환·운동학회(구 대한소화관운동학회)
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCI,SCOPUS
  • : 연속간행물
  • : 계간
  • : 2093-0879
  • : 2093-0887
  • : 대한소화관운동학회지(~2009) → Journal of Neurogastroenterology and Motility(2010~)

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수록범위 : 1권1호(1994)~27권1호(2021) |수록논문 수 : 1,311
Journal of Neurogastroenterology and Motility
27권1호(2021년 01월) 수록논문
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KCI등재 SCI SCOPUS

4Achalasia During Pregnancy: Proposed Management Algorithm Based on a Thorough Literature Review

저자 : Sergei Vosko , Daniel L Cohen , Ortal Neeman , Shai Matalon , Efrat Broide , Haim Shirin

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 1호 발행 연도 : 2021 페이지 : pp. 8-18 (11 pages)

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Fewer than 40 cases of achalasia occurring in pregnant woman have been reported in the literature. Given the rarity of achalasia during pregnancy, and the numerous treatment options that are available for achalasia in general, no guidelines exist for the management of achalasia during pregnancy. Diagnosis of new cases may be difficult as symptoms and physiological changes that occur during pregnancy may obscure the clinical presentation of achalasia. The management of achalasia in pregnancy is also challenging. Treatment decisions should be individualized for each case, considering both the welfare of the mother and the fetus. Since pregnant women suffering from achalasia represent a diagnostic and therapeutic challenge with complex maternal-fetal aspects to consider, we have reviewed the available literature on the subject and summarized current diagnostic and therapeutic options. Additionally, we present a management algorithm as a means to guide treatment of future cases. We recommend that a conservative approach should be adopted with bridging therapies performed until after delivery when definitive treatment of achalasia can be more safely performed.
(J Neurogastroenterol Motil 2021;27:8-18)

KCI등재 SCI SCOPUS

5Gut Microbial Dysbiosis in the Pathogenesis of Gastrointestinal Dysmotility and Metabolic Disorders

저자 : Rajan Singh , Hannah Zogg , Lai Wei , Allison Bartlett , Uday C Ghoshal , Singh Rajender , Seungil Ro

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 1호 발행 연도 : 2021 페이지 : pp. 19-34 (16 pages)

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Of all microorganisms in the human body, the largest and most complex population resides in the gastrointestinal (GI) tract. The gut microbiota continuously adapts to the host environment and serves multiple critical functions for their hosts, including regulating host immunity, procuring energy from food, and preventing the colonization of pathogens. Mounting evidence has suggested gut microbial imbalance (dysbiosis) as a core pathophysiology in the development of GI motility and metabolic disorders, such as irritable bowel syndrome and diabetes. Current research has focused on discovering associations between these disorders and gut microbial dysbiosis; however, whether these associations are a consequence or cause is still mostly unexplored. State-of-the-art studies have investigated how gut microbes communicate with our body systems through microbiota-derived metabolites and how they are able to modulate host physiology. There is now mounting evidence that alterations in the composition of small intestinal microbes have an association with GI dysmotility and metabolic disorders. Although treatment options for gut microbial dysbiosis are currently limited, antibiotics, fecal microbiota transplantation, probiotics, and dietary interventions are currently the best options. However, treatment with broad-spectrum antibiotics has been viewed with skepticism due to the risk of developing antibiotic resistant bacteria. Studies are warranted to elucidate the cellular and molecular pathways underlying gut microbiota-host crosstalk and for the development of a powerful platform for future therapeutic approaches. Here, we review recent literature on gut microbial alterations and/or interactions involved in the pathophysiology of GI dysmotility and metabolic disorders.
(J Neurogastroenterol Motil 2021;27:19-34)

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Obesity is a global epidemic posing a significant burden on patients and healthcare systems. Gastroesophageal reflux disease is associated with obesity and its prevalence is also growing worldwide. Numerous bariatric surgeries and endoscopic procedures have arisen to assist with weight loss and management of obesity-related conditions. However, the effect of these interventions on reflux is variable and the evidence is often conflicting. To date, Roux-en-Y gastric bypass remains the gold-standard for attaining both reflux and weight loss management, however novel endoscopic techniques are quickly becoming more prevalent as an alternative to surgery. This review aims to summarize currently available endoscopic and surgical weight loss procedures and their impact on reflux symptoms while emphasizing areas requiring additional investigation.
(J Neurogastroenterol Motil 2021;27:35-45)

KCI등재 SCI SCOPUS

7Knowledge, Attitude, and Practice Survey of Gastroparesis in Asia by Asian Neurogastroenterology and Motility Association

저자 : Tadayuki Oshima , Kewin T H Siah , Yong Sung Kim , Tanisa Patcharatrakul , Chien-lin Chen , Sanjiv Mahadeva , Hyojin Park , Min-hu Chen , Ching-liang Lu , Xiaohua Hou , Duc T Quach , Ari F Syam , M Masudur

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 1호 발행 연도 : 2021 페이지 : pp. 46-54 (9 pages)

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Background/Aims
Gastroparesis is identified as a subject that is understudied in Asia. The scientific committee of the Asian Neurogastroenterology and Motility Association performed a Knowledge, Attitude, and Practices survey on gastroparesis among doctors in Asia.
Methods
The questionnaire was created and developed through a literature review of current gastroparesis works of literature by the scientific committee of Asian Neurogastroenterology and Motility Association.
Results
A total of 490 doctors from across Asia (including Bangladesh, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, the Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam) participated in the survey. Gastroparesis is a significant gastrointestinal condition. However, a substantial proportion of respondents was unable to give the correct definition and accurate diagnostic test. The main reason for lack of interest in diagnosing gastroparesis was “the lack of reliable diagnostic tests” (46.8%) or “a lack of effective treatment” (41.5%). Only 41.7% of respondents had access to gastric emptying scintigraphy. Most doctors had never diagnosed gastroparesis at all (25.2%) or diagnosed fewer than 5 patients a year (52.1%).
Conclusions
Gastroparesis can be challenging to diagnose due to the lack of instrument, standardized method, and paucity of research data on normative value, risk factors, and treatment studies in Asian patients. Future strategies should concentrate on how to disseminate the latest knowledge of gastroparesis in Asia. In particular, there is an urgent need to estimate the magnitude of the problems in high risk and idiopathic patients as well as a standardized diagnostic procedure in Asia.
(J Neurogastroenterol Motil 2021;27:46-54)

KCI등재 SCI SCOPUS

8Acid Exposure Time > 6% Might Not Improve the Therapeutic Outcome in Chinese Gastroesophageal Reflux Disease Patients

저자 : Yuqing Lin , Yuwen Li , Mengya Liang , Niandi Tan , Mengyu Zhang , Songfeng Chen , Yinglian Xiao

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 1호 발행 연도 : 2021 페이지 : pp. 55-62 (8 pages)

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Background/Aims
There is less acid burden in Chinese gastroesophageal reflux disease (GERD) patients. However, the Lyon consensus proposed a higher threshold of acid exposure time (AET > 6%) for GERD. The aims are to apply the updated criteria in Chinese GERD patients and clarify its influence on clinical outcome.
Methods
Patients who were referred for both esophageal high-resolution manometry and 24-hour esophageal pH monitoring due to reflux symptoms were retrospectively screened. Those patients with AET > 4% was included and grouped into either AET 4-6% or AET > 6%. Their manometric profile, reflux profile, and response to proton pump inhibitors (PPIs) were evaluated. Adjunctive evidence proposed in the Lyon consensus was added in patients with AET 4-6% for therapeutic gain. Another group of patients (n = 144) with AET < 4% were included as non-GERD patients.
Results
In total, 151 patients (102 males) were included with 113 patients AET > 6% (74.9%). GERD patients with AET > 4% were with more male, older patients, and higher body mass index compared with non-GERD patients. Meanwhile, GERD patients were less competent in esophagogastric junction pressure. However, the manometric and reflux profile were similar between patients with AET > 6% and 4-6%. The response rate of PPI therapy was 64.6% and 63.2%, respectively, in groups of AET > 6% and 4-6% (P > 0.05). When adjunctive evidence was added in patients with AET 4-6%, no therapeutic gain was obtained.
Conclusions
The efficacy of PPI therapy was similar in patients with AET > 6% and 4-6%. The increase of the AET threshold did not influence the clinical outcome of Chinese GERD patients.
(J Neurogastroenterol Motil 2021;27:55-62)

KCI등재 SCI SCOPUS

9Comparison of Short Versus Long Esophageal Myotomy in Cases With Idiopathic Achalasia: A Randomized Controlled Trial

저자 : Zaheer Nabi , Mohan Ramchandani , Mahiboob Sayyed , Radhika Chavan , Santosh Darisetty , Rajesh Goud , H V V Murthy , D Nageshwar Reddy

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 1호 발행 연도 : 2021 페이지 : pp. 63-70 (8 pages)

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Background/Aims
Per-oral endoscopic myotomy (POEM) is an established treatment for achalasia. The technique of POEM is still evolving and the impact of length of esophageal myotomy on the outcomes of POEM is not known. In this study, we aim to compare the outcomes of short (3 cm) versus long (6 cm and above) esophageal myotomy in patients undergoing POEM for achalasia cardia.
Methods
Consecutive patients with idiopathic achalasia (type I and II) were randomized to receive short (3 cm) or long esophageal myotomy (≥ 6 cm). Both groups were compared for clinical success, operative time, adverse events, and gastroesophageal reflux disease (GERD).
Results
Seventy-one consecutive patients with type I and II achalasia underwent POEM with short (n = 34) or long (n = 37) esophageal myotomy techniques. Mean length of esophageal myotomy in short and long groups was 2.76 ± 0.41 and 7.97 ± 2.40, respectively (P < 0.001). Mean operative time was significantly shorter in short myotomy group (44.03 ± 13.78 minutes and 72.43 ± 27.28 minutes, P < 0.001). Clinical success was comparable in both arms at 1-year (Eckardt score 0.935 ± 0.929 vs 0.818 ± 0.983, P = 0.627). Improvement in objective parameters including integrated relaxation pressure and barium column height at 5 minutes was similar in both groups. GERD was detected in 50.88% patients with no significant difference in short and long myotomy groups (44.44% vs 56.67%, P = 0.431).
Conclusions
A short esophageal myotomy is non-inferior to long myotomy with regards to clinical success, adverse events, and GERD in cases with type I and II achalasia. Reduced operating duration favors short esophageal myotomy in these patients.
(J Neurogastroenterol Motil 2021;27:63-70)

KCI등재 SCI SCOPUS

10Practice Patterns for Eosinophilic Esophagitis Patients in Busan and Gyeongnam: A Korean Multicenter Database Study

저자 : Su Jin Kim , Moo In Park , Gwang Ha Kim , Moon Won Lee , Kyoungwon Jung , Jin Lee , Sang Young Seol , Sam Ryong Jee , Hong Sub Lee , Jin Seok Jang , Jae Hwang Cha

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 1호 발행 연도 : 2021 페이지 : pp. 71-77 (7 pages)

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Background/Aims
The prevalence of eosinophilic esophagitis is increasing in Korea and there are few single-center studies regarding eosinophilic esophagitis in Korea. In particular, data about management for eosinophilic esophagitis are lacking. We aim to evaluate the practice patterns, including initial treatment and response, in the Busan city and Gyeongnam province area.
Methods
We retrospectively reviewed medical records to gain data on patient characteristics, medication, endoscopic images, and esophageal biopsy results. From January 2009 to December 2019, a total of 42 patients were diagnosed with eosinophilic esophagitis.
Results
The mean age was 50.7 (from 22 to 81) years and the cohort was predominantly male (78.6%, 33/42). The proton pump inhibitor was the preferred treatment as an initial trial for 64.3% (27/42) of patients, followed by swallowed topical steroids (16.7%, 7/42). Clinical improvement after proton pump inhibitor therapy was achieved in 88.9% (24/27) of patients. Two patients who did not achieve improvement showed a clinical and endoscopic response after swallowed topical steroids treatment. No patient received diet elimination or balloon dilatation therapy.
Conclusions
The treatment response of eosinophilic esophagitis was good in Busan city and Gyeongnam province area in Korea. Proton pump inhibitor therapy was the preferred and most effective treatment for eosinophilic esophagitis as the initial therapy.
(J Neurogastroenterol Motil 2021;27:71-77)

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