المؤلفون: Parkman, Henry P., Yates, Katherine P., Sarosiek, Irene, Bulat, Robert S., Abell, Thomas L., Koch, Kenneth L., Kuo, Braden, Grover, Madhusudan, Farrugia, Gianrico, Silver, Paul, Abdullah, Amirah, Maurer, Alan H., Malik, Zubair, Miriel, Laura A., Tonascia, James, Hamilton, Frank, Pasricha, Pankaj J., McCallum, Richard W.

المصدر: Alimentary Pharmacology & Therapeutics; Jun2023, Vol. 57 Issue 11, p1272-1289, 18p, 1 Diagram, 6 Charts, 2 Graphs

مصطلحات موضوعية: GASTROPARESIS, BUSPIRONE, GASTRIC emptying, SYMPTOMS, PLACEBOS

مستخلص: Summary: Background: Patients with gastroparesis and related disorders have symptoms including early satiety, postprandial fullness and bloating. Buspirone, a 5‐HT1 receptor agonist, may improve fundic accommodation. Aim: To determine if buspirone treatment improves early satiety and postprandial fullness in patients with symptoms of gastroparesis. Methods: This 4‐week multi‐centre clinical trial randomised patients with symptoms of gastroparesis and moderate‐to‐severe symptoms of fullness (Gastroparesis Cardinal Symptom Index [GCSI] early satiety/postprandial fullness subscore [ES/PPF]) to buspirone (10 mg orally) or placebo three times per day. The primary outcome was a change in the ES/PPF from baseline to 4 weeks. The primary analysis was per protocol intention‐to‐treat ANCOVA of between‐group baseline vs. 4‐week differences (DoD) in ES/PPF adjusted for baseline ES/PPF. Results are reported using both nominal and Bonferroni (BF) p values. Results and conclusions: Ninety‐six patients (47 buspirone, 49 placeboes; 92% female, 50% delayed gastric emptying, 39% diabetic) were enrolled. There was no between‐groups difference in the 4‐week ES/PPF primary outcome: −1.16 ± 1.25 (SD) on buspirone vs −1.03 ± 1.29 (SD) on placebo (mean DoD: −0.11 [95% CI: −0.68, 0.45]; p = 0.69). Buspirone performed better than placebo in patients with severe‐to‐very severe bloating at baseline compared to patients with none to moderate: (ES/PPF DoD = −0.65 vs. 1.58, pTX*GROUP = 0.003; pBF = 0.07). Among individual GCSI symptoms, only bloating appeared to improve with buspirone vs. placebo. Conclusions: Patients with moderate‐to‐severe early satiety/postprandial fullness and other symptoms of gastroparesis did not benefit from buspirone treatment to improve the ES/PPF primary outcome compared with placebo. There was a suggestion of the benefit of buspirone in patients with more severe bloating. Trial Registration: ClinicalTrials.gov NCT0358714285. [ABSTRACT FROM AUTHOR]

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المؤلفون: Lesmana, Elvira¹ (AUTHOR), Grover, Madhusudan¹ (AUTHOR) grover.madhusudan@mayo.edu

المصدر: Alimentary Pharmacology & Therapeutics. Nov2023, Vol. 58 Issue 9, p950-951. 2p.

مصطلحات موضوعية: *FECAL microbiota transplantation, *SUCCESS

مستخلص: LINKED CONTENT: This article is linked to Yau et al papers. To view these articles, visit https://doi.org/10.1111/apt.17703Test and https://doi.org/10.1111/apt.17729Test [ABSTRACT FROM AUTHOR]

المؤلفون: Grover, Madhusudan¹ (AUTHOR) grover.madhusudan@mayo.edu, Berumen, Antonio¹ (AUTHOR), Peters, Stephanie¹ (AUTHOR), Wei, Ting² (AUTHOR), Breen‐Lyles, Margaret¹ (AUTHOR), Harmsen, William S.³ (AUTHOR), Busciglio, Irene¹ (AUTHOR), Burton, Duane¹ (AUTHOR), Vazquez Roque, Maria⁴ (AUTHOR), DeVault, Kenneth R.⁴ (AUTHOR), Camilleri, Michael¹ (AUTHOR), Wallace, Michael⁴ (AUTHOR), Dasari, Surendra² (AUTHOR), Neumann, Helmut^5,6 (AUTHOR), Houghton, Lesley A.^4,7 (AUTHOR)

المصدر: Alimentary Pharmacology & Therapeutics. Nov2021, Vol. 54 Issue 9, p1179-1192. 14p. 1 Color Photograph, 1 Black and White Photograph, 1 Chart, 4 Graphs.

مصطلحات موضوعية: *IRRITABLE colon, *INTESTINES, *SMALL intestine, *ABDOMINAL pain, *SYMPTOMS, *PAIN threshold

مستخلص: Summary: Background: Irritable bowel syndrome (IBS) patients often experience meal‐associated symptoms. However, the underlying mechanisms are unclear. Aim: To determine small intestinal mechanisms of lipid‐induced symptoms and rectal hypersensitivity in IBS Methods: We recruited 26 IBS patients (12 IBS‐C, 14 IBS‐D) and 15 healthy volunteers (HV). In vivo permeability was assessed using saccharide excretion assay. Rectal sensitivity was assessed using a barostat before and after small bowel lipid infusion; symptoms were assessed throughout. Next, an extended upper endoscopy with probe‐based confocal laser endomicroscopy (pCLE) was performed with changes induced by lipids. Duodenal and jejunal mucosal biopsies were obtained for transcriptomics. Results: Following lipid infusion, a higher proportion of HV than IBS patients reported no pain, no nausea, no fullness and no urgency (P < 0.05 for all). In a model adjusted for sex and anxiety, IBS‐C and IBS‐D patients had lower thresholds for first rectal sensation (P = 0.0007) and pain (P = 0.004) than HV. In vivo small intestinal permeability and mean pCLE scores were similar between IBS patients and HV. Post‐lipid, pCLE scores were higher than pre‐lipid but were not different between groups. Baseline duodenal transient receptor potential vanilloid (TRPV) 1 and 3 expression was increased in IBS‐D, and TRPV3 in IBS‐C. Duodenal TRPV1 expression correlated with abdominal pain (r = 0.51, FDR = 0.01), and inversely with first rectal sensation (r = −0.48, FDR = 0.01) and pain (r = −0.41, FDR = 0.02) thresholds. Conclusion: Lipid infusion elicits a greater symptom response in IBS patients than HV, which is associated with small intestinal expression of TRPV channels. TRPV‐mediated small intestinal chemosensitivity may mediate post‐meal symptoms in IBS. [ABSTRACT FROM AUTHOR]

المؤلفون: Maalouf, Elisia¹ (AUTHOR), Grover, Madhusudan¹ (AUTHOR) grover.madhusudan@mayo.edu

المصدر: Alimentary Pharmacology & Therapeutics. Jan2023, Vol. 57 Issue 2, p261-262. 2p.

مصطلحات موضوعية: *IRRITABLE colon, *PAIN management, *ABDOMINAL pain

مستخلص: LINKED CONTENT: This article is linked to Lembo et al paper. To view this article, visit https://doi.org/10.1111/apt.17274Test [ABSTRACT FROM AUTHOR]

المؤلفون: Grover, Madhusudan¹ (AUTHOR) grover.madhusudan@mayo.edu, Berumen, Antonio¹ (AUTHOR), Peters, Stephanie¹ (AUTHOR), Wei, Ting² (AUTHOR), Breen‐Lyles, Margaret¹ (AUTHOR), Harmsen, William S.³ (AUTHOR), Busciglio, Irene¹ (AUTHOR), Burton, Duane¹ (AUTHOR), Vazquez Roque, Maria⁴ (AUTHOR), DeVault, Kenneth R.⁴ (AUTHOR), Camilleri, Michael¹ (AUTHOR), Wallace, Michael⁴ (AUTHOR), Dasari, Surendra² (AUTHOR), Neumann, Helmut^5,6 (AUTHOR), Houghton, Lesley A.^4,7 (AUTHOR)

المصدر: Alimentary Pharmacology & Therapeutics. Nov2021, Vol. 54 Issue 9, p1215-1216. 2p.

مصطلحات موضوعية: *PATHOLOGICAL physiology, *AUTHORS

مستخلص: LINKED CONTENT: This article is linked to Grover et al and Elwing & Sayuk papers. To view these articles, visit https://doi.org/10.1111/apt.16591Test and https://doi.org/10.1111/apt.16603Test [ABSTRACT FROM AUTHOR]