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These disorders are real neurological disorders involving the gastrointestinal tract resulting in waxing and waning of digestive symptoms or chronic disabling digestive symptoms for which there is little identification. The symptoms show a clear pattern: 1. Often escalating 1-2 hours after a meal, 2. Then flaring again at bedtime, 3. Often disrupting sleep. Symptom severity is also worse upon awaking in the mornings. Upper-gut motility disturbances: 1. Gastroparesis (“gastro” meaning “stomach” and “paresis’ meaning “weakness”); a serious, chronic, debilitating digestive disease typical featured by serious nausea, vomiting spells, abdominal discomfort or pain, and other upper-gut symptoms. 2. Heartburn involves 10 of Americans on a daily basis and, in 50 of this group, is caused by a motor disorder of the stomach that leads to delayed gastric emptying. The resulting symptoms of bloating, a feeling of fullness with abdominal discomfort, and nausea cannot be treated by acid-suppressing drugs alone. 3. Swallowing difficulties and food getting stuck up in the throat may indicate the beginning of a more rare and debilitating nerve motor disorder within the esophagus known as achalasia. Mid-gut motility disturbances: 1. Milder forms of uncoordinated and sluggish movement of food through the mid-gut, with the typical feature of overwhelming abdominal pain, are known by doctors as functional abdominal pain. 2. Bloating, belching, nausea and vomiting may come in episodes, often activated by the simple act of eating. 3. Children may start to form food jags, anorexia, or food avoidance in order to moderate digestive symptoms. 4. Chronic intestinal pseudo-obstruction, a more serious form of mid-gut motility disorder causing severe abdominal pain linked with severe constipation, episodic, nausea, vomiting and profound malnourishment primarily involves young females. Lower-gut motility disturbances: 1.
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Chronic constipation induced by motility disturbances of the lower digestive tract, for many start in childhood and continuss into adulthood. Constipation of this nature may be so disabling to the sufferer as to greatly limit social functions and activities. 2. Irritable bowel syndrome (IBS) is the best identified motility disorder involving 20 of the North American population. Treatment Distention and stretching A couple of glasses of warm water often assist to produce contractions in the rectum due to stretching or bloating of the stomach wall. (gastrocolic reflex) Abdominal Massage A few minutes of gentle circular massage of the abdomen activates colonic movement and helps reflexive actions in the colon. Exercise The smooth muscle is exercised to maintain tone A ten minute walk will activate the muscles of the colon and trigger intestinal motility. Fiber Insoluble fiber assists retention of water in the colon and bulking of stool TABLE OF CONTENT Introduction Chapter 1 Intestinal Motility Disorder Chapter 2 Causes Chapter 3 Symptoms Chapter 4 Diagnosis Chapter 5 Treatment Chapter 6 Prognosis Chapter 7 Gastroparesis Chapter 8 Irritable Bowel Syndrome Epilogue 3.9 etoiles sur 5 de 24 Commentaires client Details of Intestinal Motility Disorder, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions Le Titre Du Livre Intestinal Motility Disorder, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions Auteur Kenneth Kee Nom de fichier intestinal-motility-disorder-a-simple-guide-to-the-condition-diagnosis-treatment-and-related-conditions.pdf TELECHARGER. Jan Tack KU Leuven Download citation Copy link Link copied Copy link Link copied Citations (9) Abstract This book describes the causes and clinical management of functional gastrointestinal disorders in a readily understandable way, with the aid of many clear illustrations.
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The concrete and practical advice provided will be most helpful in the clinical practice of both the general practitioner and the medical specialist. Functional disorders of the gastrointestinal tract, such as gastroesophageal reflux disease, functional dyspepsia, and irritable bowel syndrome, are very common and chronic conditions. Despite the recent publication of many scientific papers on their diagnosis and treatment, much remains unclear, and management is still considered challenging. This practice-oriented book will be an ideal source of reliable up-to-date guidance for all who care for these patients. Each compartment has its own structure, related to its function. We distinguish the esophagus, stomach, small bowel, and large bowel or colon. Glands produce juices that play an important role in digestion, the salivary glands produce saliva, the stomach secretes hydrochloric acid and pepsin, the liver produces bile, and the pancreas produces amylase, lipase, and tryptase. The various compartments differ in diameter and are delimited by sphincters that open and close at the correct moments. View Diagnostic Techniques Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.15-30 Albert J. Bredenoord Andre Smout Jan Tack The diagnosis of disorders of gastrointestinal motility and functional disorders of the gastrointestinal tract can be facilitated by various investigational techniques. The most important of these will be discussed in this chapter. View Principles of Drug Therapy for Disorders of Gastrointestinal Function Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.31-37 Albert J. Bredenoord Andre Smout Jan Tack The aim of diagnostic and physiological tests in patients with presumed disorders of gastrointestinal function is to establish a firm diagnosis, which allows specific treatment. However, the number of efficacious and specific treatment modalities for disorders of gastrointestinal function is limited.
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Very often, the treating physician has to resort to the usage of drugs that were developed for other conditions (off-label use), which may lead to confusion and can be implicated in the occurrence of adverse events. To date, no cure is available for disorders of gastrointestinal function. The therapeutic aim when dealing with disorders of gastrointestinal function is to alleviate the symptom burden associated with these conditions. Treatment approaches are directed either toward changing the contractility of the gastrointestinal tract, its secretory activity, or decreasing sensitivity (perception) of the gastrointestinal tract (Fig. 3.1). View The Esophagus Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.39-57 Albert J. Bredenoord Andre Smout Jan Tack The esophageal lining consists of multiple layers of squamous epithelium. The transition from esophageal to gastric mucosa is called the z-line, because of the z-shaped appearance that one can find during endoscopy (Fig. 4.1). View Gastric Motility Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.59-67 Albert J. Bredenoord Andre Smout Jan Tack After its passage through the esophagus, the food bolus reaches the stomach where it is temporarily stored until grinding and further aboral transport occurs. View Small Bowel Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.69-73 Albert J. Bredenoord Andre Smout Jan Tack During fasting, the stomach and small bowel exhibit a recurrent pattern of contractions and quiescence, which is called the migrating motor complex (MMC). During the passage of phase III, nonabsorbable remnants are cleared from the antrum, and intestinal phase III ensures further evacuation of small bowel content into the large intestine. This activity is referred to as the intestinal housekeeper function of the MMC. View Colon Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.75-89 Albert J.
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Bredenoord Andre Smout Jan Tack The most important function of the colon is to reabsorb water and electrolytes from the liquid chyme that arrives from the small bowel. Under normal circumstances approximately 1500 ml of chyme is delivered to the cecum per day. After reabsorption only 150 ml remains (Fig. 7.1). View Anorectum Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.91-101 Albert J. Bredenoord Andre Smout Jan Tack The last part of the gastrointestinal canal, the rectum and the anus, take care of a number of specialized functions. These are to retain the produced feces until a suitable moment for defecation has arrived and, subsequently, to achieve effective expulsion of the fecal mass. The rectum and the anal sphincter exert these functions in close collaboration with the pelvic floor. Disordered functioning of the anus, rectum, and pelvic floor can result in two groups of functional problems: impaired defecation and fecal incontinence. View Biliary System Chapter Jan 2016 A Guide to Gastrointestinal Motility Disorders pp.103-107 Albert J. Bredenoord Andre Smout Jan Tack The bile produced in the liver is transported to the duodenum through the bile ducts. Bile mixes with the food bolus in the duodenum and facilitates digestion and absorption of certain nutrients. The liver produces bile at a constant volume, while bile is only required after a meal. Therefore, a storage system is present, which consists of the gallbladder. Whether bile is transported to the duodenum or the gallbladder is controlled in an elegant way, the volume of bile transported to the duodenum is dependent of the production in the liver, the contents and contraction of the gallbladder, and the contraction of the sphincter of Oddi. The bile ducts itself do not play a role in the regulation of bile transport as there is no peristalsis in these ducts. View Citations (9) References (0).
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Although most have stones without symptoms when symptoms appear it is not uncommon to continue with problems and complications whose management requires high costs.. DIFFERENCES IN PAIN IN POSTOPERATIVE CHOLECYSTECTOMY LAPAROTOMY PATIENTS WITH THE KOCHER INCISION AND MIDLINE INCISION TECHNIQUES Article Full-text available Jan 2020 Juan Fariz Oktorian Warsinggih Rahardjo Muhammad Asykar Palinrungi View. At this point it is revealed (17)(18)(19)) that vagal fibers do not have a direct connection with the submucosal plexus but ends in the myenteric plexus, especially the one disposed along the grater gastric curves, whereby the vagal impulses reach the submucous plexus only on the path of the myenteric lymph node (20,21). Article Full-text available Jan 2018 Chirurgia Dragos Predescu Silviu Constantinoiu Background. A few decades ago, esophageal substitution was mainly dedicated particularly in postcaustic esophageal stenosis; currently, the reconstruction has expanded its palette of indications to other areas of benign esophageal pathology (severe motor disorders, esophageal achalasia with multiple relapses, peptic stenosis, etc.) but has also become a quasi-obligatory final time in the esophagectomy for cancer whenever it is possible. The techniques of esophageal reconstruction using the stomach, regardless of the indication and the chosen technical option, remain a valuable and effective method. A number of striking arguments advocate for one or another type of gastric graft: anatomic factors more than convenient (vascularization, sufficient length, a wall structure favorable for suture, etc.) and a sustainable surgical intervention (length, approach, complexity of the surgical steps digestive disorders after surgery, post-therapeutic functionality, etc.). Choosing a technique or another, beyond pathological arguments, should take into account remote functionality, with a clear impact on metabolic status and quality of life.
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So, according to this criterion, can we functionally justify a type or another of gastric restoration. Finally, the proof of an adequate solution is relatively easy to appreciate: has swallowing been restored and if so, the result has been maintained over time. For oncological cases, the assessment should also take into account the chronological criterion of the postoperative survival rate.Methods:The statistically rated lot ranged from 1981 to 2016 and included 268 patients with surgical interventions for esophageal stenosis, distributed according to etiopathogenesis and indication in 201 reconstructions for post-caustic stenosis, and 67 for post-esophagectomy replacement for neoplasm. Reflux was alkaline in 7 patients, all with pyloroplasty, 5 with whole stomach and 2 with Akiyama procedure; in 1 case with Gavriliu procedure the reflux was acid.Conclusions:Stomach is a good option in esophageal substitution. Concerning the remote results, a good functionality is found with a reasonable metabolic status. The two phenomena on which the function of the graft depends - secretory activity and motor activity - seem to be restored in time but these does not occur concurrently, the recovery of the secretory function being much faster. View Show abstract. While the exact mechanism of spirometry-induced gastro-oesophageal reflex is unknown, it is likely attributable to an increased intra-abdominal pressure, resulting in upward vectorial forces on gastric contents. As such, it is possible that reflux during forced expiration may be symptomatic of diaphragm weakness.. Effect of spirometry on intra-thoracic pressures Article Full-text available Dec 2018 BMC Res Notes Nicholas B. Tiller Andrew Simpson Objective. Due to the high intra-thoracic pressures associated with forced vital capacity manoeuvres, spirometry is contraindicated for vulnerable patients. However, the typical pressure response to spirometry has not been reported.
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Eight healthy, recreationally-active men performed spirometry while oesophageal pressure was recorded using a latex balloon-tipped catheter. Results. The deleterious consequences of spirometry might be associated with intra-thoracic pressures that approach maximal values during forced expiration. View Show abstract Liquid Gastroesophageal Reflux Characterization by Investigating Multichannel Intraluminal Impedance-pH Monitoring Data Conference Paper Jul 2019 A. Rasouli Hossein Rabbani Mostafa Raisi Peyman Adibi Multichannel Intraluminal Impedance-pH (MII-pH) monitoring is designed to detect intraluminal bolus movement without the use of radiation and allows for detection of Gastroesophageal reflux (GER). Automatic analysis of MII-pH data are available however since the recordings are complex and filled with artifacts; a thorough and time-consuming review of the recordings, episode by episode, is still required. The proposed method was designed to segment GER events in a set of 100 episodes of two minutes interval of MII data based on a decision tree approach. An amount of 24 hours of MII-pH data belonging to eight patients were recorded, digitized and stored along with standardized timings of GER events that had been characterized by two gastroenterologist experts. The performance of the algorithm was evaluated using 100 individual GER events. The algorithm has been shown to perform correctly in over 95 of cases. View Show abstract Nutrition Management in Patients With Chronic Gastrointestinal Motility Disorders: A Systematic Literature Review Article Full-text available Apr 2019 NUTR CLIN PRACT Sara Lehmann Suzie Ferrie Sharon Carey Background. The aim of this study was to systematically review effects of nutrition interventions on outcomes in patients with chronic gastrointestinal (GI) motility disorders. There is currently a lack of evidence?based guidelines for nutrition management in this group, likely a result of the rarity of the conditions. Methods.
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A systematic review of all study types to evaluate current evidence?based nutrition interventions was performed using Medline, Embase, and CINAHL databases. Two independent reviewers participated in the process of this systematic review. A total of 15 studies and a total of 524 subjects were included. Best treatment of this population group was found to include a stepwise process, progressing from oral nutrition to jejunal nutrition and lastly to parenteral nutrition. Small particle, low?fat diets were significantly better tolerated than the converse, with jejunal nutrition prior to consuming oral food significantly improving oral intake and motility. In more progressive cases, percutaneous endoscopic gastrostomy with jejunal extension nutrition had lower reported symptoms than other enteral routes. Exclusive long?term parenteral nutrition is a feasible option for advanced cases, with a 68 survival rate at 15 years duration, though oral intake with parenteral nutrition is associated with higher survival rates. Conclusion. Treatment of patients with GI motility disorders should first trial oral nutrition. For patients who progress to jejunal or parenteral feeds, the primary aim should be to maintain or reinstate oral intake to reduce morbidity and mortality risk. Higher?quality studies are still required in this area, particularly in the areas of chronic intestinal pseudo?obstruction and systemic sclerosis. View Show abstract Tests, scans and investigations, 10. Hydrogen breath test Article May 2017 Ian Peate There are several procedures that are undertaken in order to help make a diagnosis or to assess a patient's response to treatment, or their disease progression. Hydrogen breath testing is one of these procedures. This test is used widely; it is a non-invasive way to assist with the diagnosis of a number of conditions. The test investigates the pathophysiology of functional gastrointestinal disorders.
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This article provides the reader with an overview of the hydrogen breath, with a focus on the procedure and a discussion of the role and function the healthcare assistant and the assistant practitioner (HCA and AP) play in relation to this procedure. View Show abstract Mastication and Swallowing Chapter Jan 1996 John E Kellow Mastication (chewing) requires the co-ordinated action of the muscles of the jaw, tongue, cheeks and palate. The end result is that a food bolus is periodically forced backwards by the tongue against the palate into the oropharynx, thereby initiating swallowing. The act of swallowing (deglutition) is a programmed motor response; it originates from the medullary swallowing center and encompasses the subsequent motor events in the oropharynx and esophagus, at the same time affording protection to the airway. View Show abstract Anatomical and Physiological Overview Chapter Jan 1991 Emmett T Cunningham Martin W. Donner Bronwyn Jones Stuart M. Point The seemingly effortless act of swallowing, is, in reality, quite complex, involving approximately 50 paired muscles and virtually all levels of the central nervous system. For historical reasons, and as a matter of convenience, students of swallowing have somewhat arbitrarily divided this act into three anatomically and temporally distinct stages, or phases. The first, or oral phase, is primarily preparatory, and is that period during which foodstuffs are chewed and mixed with saliva, thus providing the proper texture and consistency for smooth transit through the pharynx and esophagus. The second, or pharyngeal phase, begins when the bolus passes the faucial pillars to enter the upper pharynx, and ends when it crosses the pharyngoesophageal sphincter. The third, or esophageal phase, covers that period during which the bolus is transported from the pharynx to the stomach via the esophagus.
View Show abstract Neuro-muscular junctions of longitudinal and circular muscle fibers of the guinea-pig esophagus and their relation to myenteric plexus Article May 1996 J Auton Nerv Syst De-Shan Zhou Junzo Desaki Terumasa Komuro The structure of the neuromuscular junctions (NMJs) and their relation to the myenteric plexus were studied by zinc iodide-osmic acid (ZIO) staining and by scanning electron microscopy in the guinea-pig esophagus. The esophageal muscle coat consisted of the inner circular and outer longitudinal striated muscle fibers. The myenteric plexus was located between the two muscle layers along its whole length and was characterized by a loose and irregular network. It was demonstrated that unmyelinated nerve fibers form NMJs with the muscle fibers of both layers. The NMJs in the longitudinal muscle can be classified as 'plate' type, whereas those of the circular muscle resemble the 'grape' type. The different NMJs in the two muscle layers probably correspond to different contractile properties. The whole-mount preparations with ZIO staining also demonstrated that some NMJs receive minute branches from the myenteric plexus. Therefore, it is likely that the myenteric plexus is involved in the control of striated muscles of the guinea-pig esophagus. View Show abstract ResearchGate has not been able to resolve any references for this publication. Specialized care for patients with gastrointestinal complaints is not to be simplified in that there are gastroenterology specialists to treat dyspeptic complaints. In the recent years, a lot of effort has been put into creating guidelines and algorithms for patients with these complaints in an attempt to rationalize approaches. For this year, the Society of General Practice of the Czech Medical Association of J. E. Purkyni has ordered a second update of guidelines for general practitioners on Upper and Lower Dyspeptic Syndrome and a team of authors has commenced work.
The present article provides an overview of suggestions for update in four key areas: functional dyspepsia, peptic ulcer, gastroesophageal reflux disease, and nonsteroidal anti-inflammatory drug gastropathy. Read more Article Effect of Octreotide on Gastrointestinal Motility in Children with Functional Gastrointestinal Sympt. Motility was recorded for another hour after feeding in 12 children. The US Centers for Disease Control and Prevention estimates 20.9 million norovirus infections annually in the United States. Subjects reporting for care of acute gastroenteritis (AGE) at a military treatment clinic during 3 known norovirus outbreaks were identified. Each AGE subject was matched with up to 4 subjects with unrelated medical encounters. Medical encounter data were analyzed for the duration of military service time (or a minimum of 1 year) to assess for incident FGD or GERD. Relative risks were calculated using regression models. We identified 1718 subjects from 3 outbreaks. After controlling for important demographic covariates, the incidence of constipation, dyspepsia, and GERD was approximately 1.5-old higher (P View full-text Article Full-text available Rome IV Diagnostic Questionnaire Complements Patient Assessment of Gastrointestinal Symptoms for Pat. Patient assessment of upper gastrointestinal symptoms (PAGI-SYM) questionnaire assesses severity of gastrointestinal symptoms in gastroparesis (Gp), dyspepsia, and gastroesophageal reflux disease. Rome IV Diagnostic Questionnaire (R4DQ), used to diagnose various functional gastrointestinal disorders, may also help to better understand symptoms of Gp. Aim. Patients with symptoms of Gp referred to our center from May 2016 to January 2018 filled out PAGI-SYM and R4DQ. Out of 357 patients, 225 had delayed gastric emptying including 121 with idiopathic gastroparesis (IGp), 60 with diabetic gastroparesis (DGp), 25 with atypical Gp, and 19 with postsurgical gastroparesis (PSGp).
Using PAGI-SYM, DGp had more severe retching and vomiting compared to IGp. PSGp had more severe upper abdominal pain compared to IGp. Conclusions. In this study, Gp patients were characterized using the PAGI-SYM and R4DQ. DGp had more severe retching and vomiting, while PSGp had more severe upper abdominal pain. PDS and CNVS were the most prevalent Rome IV diagnoses. The combination of PDS and CNVS was typically seen in patients with Gp. R4DQ can be helpful to characterize Gp patients. View full-text Article Long-term effects of laparoscopic antireflux surgery in children with gastroesophageal reflux diseas. Nevertheless, little is known about long-term effects and possible late-onset complications of this procedure. Objectives: The aim of our study was to assess long-term results of treatment of GERD with minimally invasive surgery. Material and methods: 132 children (65 boys and 67 girls) after antireflux surgery were investigated. All the patients were at least 12 months after surgery. Results: No improvement or recurrence of GERD was found only in 5 patients (3.8). More often patients reported some new symptoms, which are absent before surgery. Surprisingly, the symptomatic patients had almost no abnormalities in control X-ray, pH-metry and esophageal manometry. In another patient with dysphagia we demonstrated clearly elevated LES pressure with incomplete relaxation. Conclusions: Laparoscopic antireflux surgery is an effective method of diminishing symtoms of GERD. Nevertheless, one should be aware of the possibility of long-term side effects. The complications mostly should be described as post-operative functional gastrointestinal disorders. They seem not to be directly related to the mistake in surgery. Read more Chapter Dyspepsia in Children: Epidemiology, Clinical Presentation, and Causes March 2011 O. Jadresin Chronic abdominal pain is the most common gastrointestinal symptom in children.
According to the definition of Apley and Nash,Despite the fact that disorders are by definitionKeywordsDyspepsia-Children-Epidemiology-Clinical presentation Read more Looking for the full-text. You can request the full-text of this book directly from the authors on ResearchGate. Request full-text Already a member. Log in ResearchGate iOS App Get it from the App Store now. Install Keep up with your stats and more Access scientific knowledge from anywhere or Discover by subject area Recruit researchers Join for free Login Email Tip: Most researchers use their institutional email address as their ResearchGate login Password Forgot password. Keep me logged in Log in or Continue with LinkedIn Continue with Google Welcome back. Keep me logged in Log in or Continue with LinkedIn Continue with Google No account. All rights reserved. Terms Privacy Copyright Imprint. This practice-oriented book will be an ideal source of reliable up-to-date guidance for all who care for these patients. He subsequently worked on several clinical research projects on GI motility at the Mayo Clinic, Rochester, USA and at the University of Utrecht, the Netherlands which resulted in a PhD thesis on gastroesophageal reflux disease in 2006. His clinical training was performed in Nieuwegein, the Netherlands and at the Royal London Hospital in London, UK. He currently works as a consultant Gastroenterologist at the Amsterdam Medical Center where he is dedicated to patients care, scientific research and education. His main focus is on achalasia, reflux disease and eosinophilic esophagitis. He is one of the pioneers of high-resolution manometry and impedance monitoring of the esophagus. The esophageal clinic in the AMC Amsterdam hosts the largest population of benign esophageal diseases in the Netherlands. Dr Bredenoord is an author of over 150 papers, books and book chapters on esophageal diseases and organizes regular courses in Europe, North America and Asia.
Dr Bredenoord is associate editor of Neurogastroenterology and Motility and co-founder of the International HRM working group. Andre Smout was born in 1950 in Amsterdam, the Netherlands. He studied medicine at the University of Amsterdam and thereafter specialized in gastroenterology in Rotterdam and Utrecht. Since 1984 he has worked as a consultant gastroenterologist at the University Medical Centers of Utrecht and Amsterdam. For almost 40 years Andre Smout's research, clinical and teaching activities have been devoted to gastrointestinal motility and neurogastroenterology. In later years the emphasis of his scientific activities was on gastroesophageal reflux disease and esophageal motility disorders. He is author of more than 425 peer-reviewed scientific publications, several books and many book chapters on gastrointestinal motility and functional bowel disorders. Jan Tack is Head of Clinic in the Department of Gastroenterology, Professor in Internal Medicine and Chairman of the Department of Clinical and Experimental Medicine at the University of Leuven, and a principal researcher in TARGID (the Translational Research Center for Gastrointestinal Disorders) at the University of Leuven. Professor Tack’s scientific interest focuses on clinical and physiological aspects of neurogastroenterology and motility, and on this topic he has published more than 40 book chapters and over 580 articles, which received more than 17000 citations. He has won several awards for basic and clinical research in gastrointestinal science and is currently Editor-in-Chief of the United European Gastroenterology Journal, a board member of the Rome Foundation and a member of the Steering Committee of European Society for Neurogastroenterology and Motility. Learn More. This article has been cited by other articles in PMC. Abstract Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9-23 of the population across the world.
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