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~)

수록정보
수록범위 : 1권1호(1994)~25권1호(2019) |수록논문 수 : 1,181
Journal of Neurogastroenterology and Motility
25권1호(2019년 01월) 수록논문
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Proton pump inhibitors are commonly utilized for the treatment of gastric acid-related diseases, such as gastroesophageal reflux disease, peptic ulcer disease, and Helicobacter pylori infection, and for the prevention of low-dose aspirin or nonsteroidal antiinflammatory drug-induced peptic ulcers. Vonoprazan is a first-in-class potassium-competitive acid blocker, which has distinct advantages compared to other conventional proton pump inhibitors in terms of the efficacy for acid suppression. Due to its strong gastric acid suppression capabilities, vonoprazan serves as an effective drug for the treatment of gastroesophageal reflux disease and H. pylori infection.
(J Neurogastroenterol Motil 2019;25:6-14)

KCI등재 SCI SCOPUS

2Thailand Dyspepsia Guidelines: 2018

저자 : Rapat Pittayanon , Somchai Leelakusolvong , Ratha-korn Vilaichone , Jarin Rojborwonwitaya , Sombat Treeprasertsuk , Pisaln Mairiang , Supphamat Chirnaksorn , Taned Chitapanarux , Uayporn Kaosombatwattana , Jaksin Sotti

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 15-26 (12 pages)

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The management of dyspepsia in limited-resource areas has not been established. In 2017, key opinion leaders throughout Thailand gathered to review and evaluate the current clinical evidence regarding dyspepsia and to develop consensus statements, rationales, levels of evidence, and grades of recommendation for dyspepsia management in daily clinical practice based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. This guideline is mainly focused on the following 4 topics: (1) evaluation of patients with dyspepsia, (2) management, (3) special issues (overlapping gastroesophageal reflux disease/ irritable bowel syndrome and non-steroidal anti-inflammatory drug/aspirin use), and (4) long-term follow-up and management to provide guidance for physicians in Thailand and other limited-resource areas managing such patients.
(J Neurogastroenterol Motil 2019;25:15-26)

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Gastroparesis and functional dyspepsia are 2 of the most common gastric neuromuscular disorders. These disorders are usually confused, having both similarities and differences. The pathophysiology of these disorders involves abnormal gastric motility, visceral hypersensitivity, mucosal inflammation, and various cellular changes. Both disorders have similar symptoms such as epigastric pain or discomfort, early satiety, and bloating. If patients suspected of having either gastroparesis or functional dyspepsia present with upper gastrointestinal symptoms, they should undergo upper endoscopy to exclude an alternative organic cause. Although the gastric emptying rate is frequently assessed during the clinical workup of patients with gastroparesis or functional dyspepsia, the correlation between gastric emptying and the symptoms is generally poor. Once the diagnosis of gastroparesis or functional dyspepsia is made, treatment should focus on the predominant symptom. Recently, various treatment modalities have been developed and validated. Prokinetic agents are generally used as treatment for both gastroparesis and functional dyspepsia. Acid-suppressive therapy, Helicobacter pylori eradication, and use of drugs that enhance gastric accommodation are employed for functional dyspepsia. Psychoactive drugs are also effective in symptom control. For gastroparesis, antiemetic agents, ghrelin receptor agonists, and serotonergic agents are used aside from prokinetic agents. Acupuncture and gastric electrical stimulation can be attempted. In severe cases, endoscopic and surgical interventions are considered for symptom control.
(J Neurogastroenterol Motil 2019;25:27-35)

KCI등재 SCI SCOPUS

4Colonic Electromechanical Abnormalities Underlying Post-operative Ileus: A Systematic and Critical Review

저자 : Cameron I Wells , Gregory O. Grady , Ian P Bissett

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 36-47 (12 pages)

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Post-operative ileus (POI) is an inevitable consequence of major abdominal surgery, and may be prolonged in up to 30% of patients. Ileus is commonly presumed to result from paralysis of the GI tract, though there is little direct evidence to support this view. The aim of this review is to systematically search and critically review the literature investigating post-operative colonic electrical and mechanical activity. MEDLINE and Embase databases were systematically searched for articles investigating post-operative colonic motor or electrical activity in human patients. Nineteen original articles investigating post-operative colonic motor or electrical activity were identified. Most studies have used low-resolution techniques, with intermittent recordings of colonic motility. Numerous studies have shown that colonic electrical and motor activity does not cease routinely following surgery, but is of abnormal character for 3-6 days following laparotomy. One recent high-resolution manometry study identified hyperactive cyclic motor patterns occurring in the distal colon on the first post-operative day. Low-resolution studies have shown colonic slow waves are not inhibited by surgery, and are present even in the immediate post-operative period. Recovery of normal motility appears to occur in a proximal to distal direction and is temporally correlated with the clinical return of bowel function. No studies have investigated motility specifically in prolonged POI. Future studies should use high-resolution techniques to accurately characterise abnormalities in electrical and mechanical function underlying POI, and correlate these changes with clinical recovery of bowel function.
(J Neurogastroenterol Motil 2019;25:36-47)

KCI등재 SCI SCOPUS

5Brain-Gut-Microbiota Axis in Alzheimer's Disease

저자 : Karol Kowalski , Agata Mulak

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 48-60 (13 pages)

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Disturbances along the brain-gut-microbiota axis may significantly contribute to the pathogenesis of neurodegenerative disorders. Alzheimer's disease (AD) is the most frequent cause of dementia characterized by a progressive decline in cognitive function associated with the formation of amyloid beta (Aβ) plaques and neurofibrillary tangles. Alterations in the gut microbiota composition induce increased permeability of the gut barrier and immune activation leading to systemic inflammation, which in turn may impair the blood-brain barrier and promote neuroinflammation, neural injury, and ultimately neurodegeneration. Recently, Aβ has also been recognized as an antimicrobial peptide participating in the innate immune response. However, in the dysregulated state, Aβ may reveal harmful properties. Importantly, bacterial amyloids through molecular mimicry may elicit cross-seeding of misfolding and induce microglial priming. The Aβ seeding and propagation may occur at different levels of the brain-gut-microbiota axis. The potential mechanisms of amyloid spreading include neuron-to-neuron or distal neuron spreading, direct blood-brain barrier crossing or via other cells as astrocytes, fibroblasts, microglia, and immune system cells. A growing body of experimental and clinical data confirms a key role of gut dysbiosis and gut microbiota-host interactions in neurodegeneration. The convergence of gut-derived inflammatory response together with aging and poor diet in the elderly contribute to the pathogenesis of AD. Modification of the gut microbiota composition by food-based therapy or by probiotic supplementation may create new preventive and therapeutic options in AD.
(J Neurogastroenterol Motil 2019;25:48-60)

KCI등재 SCI SCOPUS

6Assessment of Esophageal Motor Disorders Using High-resolution Manometry in Esophageal Dysphagia With Normal Endoscopy

저자 : Dan Wang , Xiu Wang , Yao Yu , Xiaowen Xu , Jing Wang , Yuting Jia , Hong Xu

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 61-67 (7 pages)

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Background/Aims
The distribution and esophageal motor characteristics of Chinese patients with esophageal dysphagia who exhibit no structural abnormalities on esophagogastroduodenoscopy remain unclear. Our aim is to assess the esophageal motor patterns using highresolution manometry (HRM) and classify them according to the Chicago classification version 3.0 (CC v3.0). Furthermore, we compared the CC v3.0 and the previous version 2.0 (CC v2.0) for diagnosis of motor disorders.
Methods
Two hundred thirty-six (mean age 48.4 ± 12.2 years, 61.9% female) patients with esophageal dysphagia were included for analysis of motor function using HRM. All participants were administered a questionnaire to determine Eckardt scores before HRM.
Results
According to the CC v3.0, 57 (24.2%) patients showed evidence of esophagogastric junction outflow obstruction and were classified as Group 1. Eighteen (7.6%) patients with major disorders of peristalsis were classified as Group 2. Minor disorders of peristalsis (Group 3) were much more frequent (129 [54.7%] patients). Thirty-two (13.6%) patients had normal esophageal manometry were classified as Group 4. All patients with abnormal pH or pH impedance monitoring (n = 44) had minor motor disorders (ineffective esophageal motility [IEM] = 34, fragmented peristalsis = 10). Based on motor category, the Eckardt score was 4.7 ± 0.1 in Group 1, 4.5 ± 0.3 in Group 2, 3.5 ± 0.1 in Group 3, and 3.9 ± 0.1 in Group 4.
Conclusions
IEM was the most common esophageal motor disorder in patients with esophageal dysphagia who showed no structural abnormality on endoscopy. While a high Eckardt score suggests outflow obstruction or a major motor disorder, a low score suggests IEM.
(J Neurogastroenterol Motil 2019;25:61-67)

KCI등재 SCI SCOPUS

7High-resolution Manometry Findings During Solid Swallows Correlate With Delayed Reflux Clearance and Acid Exposure Time in Non-erosive Reflux Disease Patients

저자 : Mentore Ribolsi , Dario Biasutto , Antonio Giordano , Paola Balestrieri , Michele Cicala

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 68-74 (7 pages)

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Background/Aims
The role of esophageal motility in determining gastroesophageal reflux disease (GERD) severity has not been completely evaluated. A few studies have investigated high-resolution manometry (HRM) patterns during solid swallows. The present study evaluates the HRM patterns of non-erosive reflux disease (NERD) patients during both liquid and solid swallows and their correlation with the severity of GERD.
Methods
In 23 NERD patients and 15 healthy volunteers (HVs) HRM was performed during a standard solid meal in a seated position, followed by 24-hour impedance-pH monitoring.
Results
Of the 31 patients, 10 showed a pathological acid exposure time (AET; NERD patients), 13 a normal pH profile with positive symptom association probability (SAP; reflux hypersensitivity patients), and 8 normal AET and SAP (functional heartburn patients). Mean distal contractile integral and distal latency values, in all patient groups and HVs, were significantly higher during solid swallows. In the group of 10 NERD patients, the number of large breaks of the esophageal peristalsis was 16 out of 100 liquid swallows (16%) and 31 out of 171 solid swallows (18%). Fourteen out of 100 liquid swallows (14%) and 25 out of 171 solid swallows (15%) resulted ineffective. Mean reflux clearing time at multichannel intraluminal impedance-pH was 17.6 ± 3.7 seconds. NERD patients presented, during solid swallows, a significantly higher proportion of large peristaltic breaks and of ineffective swallows than reflux hypersensitivity and functional heartburn patients.
Conclusion
HRM during solid swallows reveals motor abnormalities, undetected during liquid swallows, which might be involved in delaying reflux and acid clearance in patients with GERD.
(J Neurogastroenterol Motil 2019;25:68-74)

KCI등재 SCI SCOPUS

8Combined Multichannel Intraluminal Impedance and High-resolution Manometry Improves Detection of Clinically Relevant Esophagogastric Junction Outflow Obstruction

저자 : Byeong Geun Song , Yang Won Min , Hyuk Lee , Byung-hoon Min , Jun Haeng Lee , Poong-lyul Rhee , Jae J Kim

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 75-81 (7 pages)

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Background/Aims
Esophagogastric junction outflow obstruction (EGJOO) is a diagnostically heterogeneous group with variable clinical relevance. We studied whether evaluation of bolus transit by multichannel intraluminal impedance (MII) is useful for discriminating clinically relevant EGJOO.
Methods
A total 169 patients diagnosed as having EGJOO between June 2011 and February 2018 were analyzed. All the patients received a combined MII and high-resolution manometry (CMII-HRM). MII was reported as having abnormal liquid bolus transit (LBT) if < 80% of swallows had complete bolus transit. EGJOO was defined as a median integrated relaxation pressure of > 20 mmHg and when the criteria for achalasia were not met. Patients who progress to achalasia, show significant passage disturbance, or require pneumatic dilatation were defined as having a clinically relevant EGJOO.
Results
Among the patients with EGJOO (n = 169), the clinically relevant group (n = 10) is more likely to have dysphagia (100% vs 25.2%, P < 0.001), compartmentalized pressurization (CP; 90.0% vs 22.0%, P < 0.001), and abnormal LBT (100% vs 66.7%, P = 0.032) compared to the non-relevant group (n = 159). The combination of dysphagia, CP, and abnormal LBT showed the best predictive power for clinically relevant EGJOO (sensitivity 90%, specificity 92.5%, positive predictive value 42.9%, negative predictive value 99.3%, positive likelihood ratio 11.9, and negative likelihood ratio 0.1). When CMII-HRM was used, an additional 8.3% of clinically relevant EGJOO cases were identified as compared with HRM alone.
Conclusion
Clinically relevant EGJOO can be predicted using CMII-HRM.
(J Neurogastroenterol Motil 2019;25:75-81)

KCI등재 SCI SCOPUS

9Gender-specific Effect of Micronutrient on Non-erosive Reflux Disease and Erosive Esophagitis

저자 : Su Youn Nam , Bum Joon Park , Yeong-ah Cho , Kum Hei Ryu

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 82-90 (9 pages)

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Background/Aims
The effect of dietary micronutrients on non-erosive reflux disease (NERD) and reflux esophagitis is unclear. We aim to evaluate the gender-specific effect of micronutrient on erosive esophagitis and NERD.
Methods
A total of 11 690 participants underwent endoscopy and completed 3-day recordings for dietary intake and questionnaires for reflux symptoms from 2004 to 2008. To evaluate the effect of dietary micronutrients on NERD or erosive esophagitis, adjusted regression analysis with odds ratio (OR) and 95% confidence interval (CI) was used. In addition, we performed gender-specific analysis.
Results
Prevalence of NERD and erosive esophagitis was 6.8% and 11.2% in men and 9.1% and 2.4% in women. In adjusted analysis, high intake of vitamin A (OR, 0.78; 95% CI, 0.64-0.96), retinol (OR, 0.73; 95% CI, 0.59-0.90), vitamin B2 (OR, 0.68; 95% CI, 0.54- 0.87), vitamin B6 (OR, 0.75; 95% CI, 0.58-0.96), folic acid (OR, 0.77; 95% CI, 0.62-0.96), calcium (OR, 0.66; 95% CI, 0.53-0.82), and iron (OR, 0.68; 95% CI, 0.53-0.87) had an inverse association with NERD. However, erosive esophagitis has no relationship with micronutrients except vitamin C (OR, 0.78; 95% CI, 0.62-0.98). High dietary intake of calcium reduced the risk of NERD in men and high dietary intake of many micronutrients reduced NERD in women.
Conclusions
While many dietary micronutrients reduced NERD, they had no effect on erosive esophagitis. The effect of micronutrient on NERD was more prominent in women than men.
(J Neurogastroenterol Motil 2019;25:82-90)

KCI등재 SCI SCOPUS

10Validation of the Korean Version of the Gastroesophageal Reflux Disease Questionnaire for the Diagnosis of Gastroesophageal Reflux Disease

저자 : Eun Jeong Gong , Kee Wook Jung , Yang-won Min , Kyoung Sup Hong , Hye-kyung Jung , Hee Jung Son , Do Yeon Kim , Jungbok Lee , Oh Young Lee

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 25권 1호 발행 연도 : 2019 페이지 : pp. 91-99 (9 pages)

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Background/Aims
The Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed and validated as a tool for the diagnosis of gastroesophageal reflux disease (GERD) in patients with gastrointestinal symptoms. However, the GerdQ and the cutoff value for determining GERD has not been validated in Korea.
Methods
Patients with symptoms suggestive of GERD were consecutively recruited. The Korean version of GerdQ was developed through a forward-backward translation process according to the cross-cultural adaptation method. Endoscopically documented esophagitis, abnormal results on 24-hour ambulatory pH recording with symptom association monitoring, or response to proton pump inhibitor treatment were used as diagnostic references for GERD. The reproducibility and test characteristics of the Korean version of GerdQ were assessed.
Results
A total of 149 patients with a median age of 55 years were analyzed. The intra-class correlation coefficient of 2 subsequently measured GerdQ scores was 0.651 (95% CI, 0.518-0.748). The cutoff value of 8 was found to have the highest sensitivity (64.9%; 95% CI, 56.2-73.7) and specificity (71.4%; 95% CI, 56.5-86.4) for the diagnosis of GERD. The questionnaire had a high positive predictive value (88.1%; 95% CI, 81.2-95.0), but a low negative predictive value (38.5%; 95% CI, 26.2-50.3) for GERD. Any symptom improvement on proton pump inhibitor treatment showed a sensitivity of 93.0% (95% CI, 88.3-97.7) and a specificity of 48.6% (95% CI, 32.0-65.1) for GERD.
Conclusion
The Korean version of GerdQ is a useful complementary tool in the diagnosis of GERD.
(J Neurogastroenterol Motil 2019;25:91-99)

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