Editorial Material
Medicine, General & Internal
Sanjay Woodhull, Devan Raja Segar
Summary: A 13-year-old boy presented with a nocturnal cough and was diagnosed with achalasia based on barium swallow examination showing esophageal tapering. His symptoms improved after myotomy.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Surgery
Abdullah Ozgur Yeniova, In Kyung Yoo, Eunju Jeong, Joo Young Cho
Summary: Peroral endoscopic myotomy is considered as an effective treatment for achalasia patients. This study compared the safety and efficacy of POEM in treatment-naive patients and those with prior treatment failure. Results showed that POEM is safe and equally effective for both groups up to 6 months post treatment.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Gastroenterology & Hepatology
Eric E. Low, Rena Yadlapati, Lin Liu, Ranier Bustamante, Samir Gupta
Summary: The study team established a large cohort of individuals with achalasia within the Veterans Health Administration (VHA), allowing for further investigation of risk factors and outcomes of this esophageal motility disorder.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Surgery
Federica Riccio, Mario Costantini, Renato Salvador
Summary: Accurate diagnosis is crucial for successful treatment of achalasia, with barium swallow, upper endoscopy, and high-resolution manometry providing essential information about anatomy, absence of other diseases, and type of achalasia. Prognostic value is also found in high-resolution manometry, with best treatment results obtained in type II achalasia according to the Chicago classification. Additional imaging tests such as abdominal CT scanning and endoscopic ultrasound may be necessary if malignancy is suspected.
WORLD JOURNAL OF SURGERY
(2022)
Article
Gastroenterology & Hepatology
Emily Romanoff, Justin Zhuo, Annsa C. Huang, Deron Amador, Fouad Otaki, Afrin N. Kamal, Priya Kathpalia, David A. Leiman
Summary: This study aimed to determine adherence to established quality indicators for achalasia management. Through a retrospective multicenter evaluation, it was found that there is incomplete adherence to quality indicators in the diagnosis and treatment of achalasia, particularly in patient education.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Article
Surgery
Gad Marom, Harold Jacob, Ariel Benson, Tiberiu Hershcovici, Rachel Gefen, Jonathan B. Yuval, Ronit Brodie, Avraham Rivkind, Yoav Mintz
Summary: The study compared the standard POEM technique with the distal-to-proximal, or bottom-up technique using the Flush/Dual knife and found the latter to be equally effective, safer, faster, and easier. The results suggest considering the bottom-up technique for performing POEM in achalasia patients.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Review
Medicine, General & Internal
Francisco Tustumi
Summary: This article discusses non-conventional treatments for achalasia, including cardiectomy, endoluminal substances injection, stents, and drugs. Currently available studies on non-conventional treatments lack high-quality evidence, and future randomized trials are still needed.
FRONTIERS IN MEDICINE
(2022)
Article
Surgery
Michael B. Ujiki, Vanessa N. VanDruff
Summary: Peroral endoscopic myotomy (POEM) is an innovative and minimally invasive treatment for achalasia. Studies worldwide have shown that POEM is safe and effective for different types of achalasia.
WORLD JOURNAL OF SURGERY
(2022)
Article
Surgery
John Waters, Linda W. Martin, Daniela Molena
Summary: Esophagectomy for achalasia is recommended for patients with end-stage disease and treatment failure. The surgery can be safely performed using various techniques, with options for the replacement conduit being the stomach, colon, or small intestine. Complications may occur after esophagectomy, but experienced surgical centers yield favorable outcomes.
WORLD JOURNAL OF SURGERY
(2022)
Article
Gastroenterology & Hepatology
John E. Pandolfino, Dustin A. Carlson, Josie McGarva, Peter J. Kahrilas, Michael Vaezi, David Katzka, Tiffany H. Taft
Summary: The study developed a new Achalasia Patient-Reported Outcomes (APRO) Questionnaire, identified three subscales through investigation of patients with normal motility and achalasia, and found that symptom anxiety and hypervigilance moderate the relationship between APRO and quality of life.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2022)
Review
Medicine, General & Internal
Sumit Midya, Debasish Ghosh, Mohamed Wajih Mahmalat
Summary: The addition of fundoplication to Heller's cardiomyotomy for achalasia can help prevent postoperative reflux symptoms, but there is uncertainty on the best type of fundoplication to use. Different fundoplications showed varying effects on postoperative reflux and dysphagia in combination with LHC, with Nissen fundoplication causing increased risk of severe dysphagia. Additional research is needed to determine the most effective fundoplication approach for achalasia treatment.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2022)
Review
Gastroenterology & Hepatology
Sebastien Rolland, William Paterson, Robert Bechara
Summary: Achalasia is a motor disorder characterized by impaired relaxation of the lower esophageal sphincter and absent peristalsis in the esophageal body. Pneumatic dilation, laparoscopic Heller myotomy, and peroral endoscopic myotomy are three well-established treatments for achalasia. Each treatment has its own risks and benefits.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Samuel Torres-Landa, Trevor D. Crafts, Amy E. Jones, Elizabeth N. Dewey, Stephanie G. Wood
Summary: The study evaluated surgical outcomes in patients with achalasia compared to non-achalasia patients following esophagectomy. Results showed no significant difference in overall complications, readmission, reoperation, or mortality between both groups. Postoperative sepsis was higher in the achalasia group, while organ space SSI was higher in the non-achalasia group.
JOURNAL OF GASTROINTESTINAL SURGERY
(2021)
Article
Gastroenterology & Hepatology
Hiroki Sato, Yohei Nishikawa, Hirofumi Abe, Hironari Shiwaku, Junya Shiota, Chiaki Sato, Hiroyuki Sakae, Masaki Ominami, Yoshitaka Hata, Hisashi Fukuda, Ryo Ogawa, Jun Nakamura, Tetsuya Tatsuta, Yuichiro Ikebuchi, Hiroshi Yokomichi, Shuji Terai, Haruhiro Inoue
Summary: Screening and surveillance of POEM are crucial in detecting esophageal carcinoma. ESD is feasible for achalasia cases, but can be challenging on the POEM-line due to fibrosis. Surveillance endoscopy is recommended for specific high-risk cases and those with a history of esophageal carcinomas.
DIGESTIVE ENDOSCOPY
(2022)
Article
Surgery
Barbara F. Nadaleto, Fernando A. M. Herbella, Marco G. Patti
Summary: Epiphrenic diverticulum is a rare condition usually associated with achalasia. Symptoms are mainly related to the underlying motility disorder, not the diverticulum itself. Diagnosis typically involves endoscopy and barium esophagogram, while treatment options include laparoscopic, thoracoscopic, and endoscopic procedures.
WORLD JOURNAL OF SURGERY
(2022)
Review
Gastroenterology & Hepatology
Kok-Ann Gwee, Yeong Yeh Lee, Hidekazu Suzuki, Uday Chand Ghoshal, Gerald Holtmann, Tao Bai, Giovanni Barbara, Min-hu Chen, Andrew Seng Boon Chua, Peter R. Gibson, Xiaohua Hou, Jinsong Liu, Atsushi Nakajima, Nitesh Pratap, Sanjeev Sachdeva, Kewin Tien Ho Siah, Alex Yu Sen Soh, Kentaro Sugano, Jan Tack, Victoria Ping Yi Tan, Xudong Tang, Marjorie Walker, Deng-Chyang Wu, Ying-Lian Xiao, Khairil Khuzaini Zulkifli, Clarissa Toh
Summary: Contemporary systems categorize patients into sub-classes based on symptoms to enable targeted treatment, but overlapping symptom categories negatively impact outcomes, lacking guidance on management. An APAGE working group developed clinical practice guidelines for management of patients with functional dyspepsia (FD) who have overlaps with other functional gastrointestinal disorders. They identified putative pathophysiology and provided a management algorithm for primary and secondary care clinicians.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Review
Gastroenterology & Hepatology
Stuart M. Brierley, Beverley Greenwood-Van Meerveld, Giovanni Sarnelli, Keith A. Sharkey, Martin Storr, Jan Tack
Summary: This review provides an overview of the potential of the gastrointestinal endocannabinoid system as a therapeutic target for the management of pain in irritable bowel syndrome. It discusses the role of endocannabinoid system in regulating gastrointestinal function and pain processing, compares cannabinoids to other treatment modalities, and explores emerging therapeutic candidates targeting the endocannabinoid system for pain relief in irritable bowel syndrome.
NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Taher Omari, Charles Cock, Peter Wu, Michal Marcin Szczesniak, Mistyka Schar, Jan Tack, Nathalie Rommel
Summary: This study aimed to establish a methodology for diagnosing oropharyngeal disorders using P-HRM-I. The results showed that UES relaxation pressure was the best indicator for differentiating patients from controls and diagnosing UES disorders. A diagnostic scheme was also devised to identify patients with UES disorder or propulsive disorder. Additionally, the study found that patients with pharyngeal pressurizations and evidence of reduced UES relaxation and/or distensibility had higher aspiration scores.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Jan Tack, Borislav Vladimirov, Ivo Horny, Chui Fung Chong, Jessica Eisner, Richard Czerniak, Yohei Takanami
Summary: This study compared the effectiveness and safety of vonoprazan and esomeprazole in preventing heartburn symptoms in patients with GERD who had a partial response to esomeprazole treatment. The results showed no significant difference in efficacy and safety between the two treatments, and vonoprazan was well tolerated.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Gastroenterology & Hepatology
Pierfrancesco Visaggi, Matteo Ghisa, Elisa Marabotto, Arianna Venturini, Delio Stefani Donati, Massimo Bellini, Vincenzo Savarino, Nicola de Bortoli, Edoardo Savarino
Summary: Eosinophilic esophagitis (EoE) is a growing cause of chronic esophageal morbidity. It is characterized by eosinophilic infiltrates of the esophagus and organ dysfunction. Esophageal motor abnormalities may contribute to symptoms and should be considered in treatment and evaluation of patients with EoE.
Review
Gastroenterology & Hepatology
Maria Rosa Ingrosso, Michael Camilleri, Jan Tack, Gianluca Ianiro, Christopher J. Black, Alexander C. Ford
Summary: This study evaluated the efficacy and safety of drugs for gastroparesis through a network meta-analysis. The results showed that oral dopamine antagonists and tachykinin-1 antagonists were more effective than placebo. For individual symptoms, oral metoclopramide showed good efficacy for nausea, fullness, and bloating. However, the confidence in the evidence for most comparisons was low to moderate, indicating a need for more effective therapies for gastroparesis.
Review
Pharmacology & Pharmacy
Emidio Scarpellini, Jan Tack
Summary: Background: Since the end of 2019, SARS-CoV-2 has caused the COVID-19 pandemic, and gastrointestinal (GI) symptoms during and after COVID-19 are receiving increasing attention. Methods: We review and comment on the prevalence, pathophysiology, and potential treatment options for GI disturbances in COVID-19. Results: Numerous reports show that a significant portion of COVID-19 patients experience GI symptoms both during and after the disease, with some experiencing symptoms for several months, even after vaccination. There is an ongoing debate regarding the association between GI symptoms and the outcome of COVID-19 patients. However, it is widely recognized that patients with chronic liver disease have a worse outcome. The similarities between GI symptoms and postinfectious functional dyspepsia and irritable bowel syndrome suggest that the gut microbiota may play a role. Preliminary reports and clinical trials have shown that modulating the gut microbiota could be an effective approach for treating and preventing COVID-19. Conclusion: GI symptoms have a significant impact on the natural course of both long-COVID-19 and non-long-COVID-19. Modulating the gut microbiota appears to be a promising target for disease treatment and prevention.
REVIEWS ON RECENT CLINICAL TRIALS
(2023)
Editorial Material
Gastroenterology & Hepatology
Pierfrancesco Visaggi, Edoardo Vincenzo Savarino
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Article
Gastroenterology & Hepatology
Bert Broeders, Elise Devolder, Michael Jones, Magnus Simren, Shrikant I. Bangdiwala, Ami D. Sperber, Olafur S. Palsson, Jan Tack
Summary: According to a study by the Rome Foundation in Belgium, the prevalence of DGBI is similar in the French and Dutch language groups, but the Dutch-speaking population has higher psychosocial well-being. French-speaking participants have higher scores for depression and non-gastrointestinal somatic symptoms, while the Dutch-speaking population has higher scores for overall physical and mental health quality of life.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Johann P. Hreinsson, Reuben K. M. Wong, Jan Tack, Peter Whorwell, Marc A. Benninga, Viola Andresen, Bruno Bonaz, Suck Chei Choi, Enrico S. Corazziari, Javier Santos, Shin Fukudo, Motoyori Kanazawa, Xuicai Fang, Shrikant I. Bangdiwala, Ami D. Sperber, Olafur S. Palsson, Magnus Simren
Summary: This study compared the prevalence of gut-brain interaction disorders (DGBI) between Asia and Western Europe, and found that DGBI is generally more prevalent in Western Europe, which is associated with severe psychological and non-GI somatic symptoms.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Chamara Basnayake, Sawangpong Jandee, Annelies Geeraerts, Hannelore Geysen, Ans Pauwels, Lien Timmermans, Tim Vanuytsel, Nathalie Rommel, Jan Tack
Summary: This study aimed to investigate the impact of position, different volumes and consistencies of swallows, and perception of bolus passage on high-resolution esophageal manometry (HRM) metrics. The results showed significant differences in HRM metrics with different positions, volumes, and consistencies of swallows. Interpretation of HRM studies should consider normative values specific to position and bolus type.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Gastroenterology & Hepatology
Gregory O'Grady, Chris Varghese, Gabriel Schamberg, Stefan Calder, Peng Du, William Xu, Jan Tack, Charlotte Daker, Hayat L. Mousa, Thomas P. Abell, Henry Parkman, Vincent Ho, L. Alan Bradshaw, Anthony N. Hobson, Christopher A. Andrews, Armen Gharibans, BSGM Working Grp
Summary: Chronic gastric symptoms are common, but it is difficult to differentiate specific mechanisms. Body surface gastric mapping (BSGM) is a non-invasive method that measures and maps gastric myoelectrical activity. The adoption of BSGM in clinical practice is expanding, and a working group was formed to standardize clinical BSGM methods. The group reviewed the principles, methods, and clinical applications of BSGM, as well as identified knowledge gaps and future research priorities.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Gastroenterology & Hepatology
Pierfrancesco Visaggi, Brigida Barberio, Giulio Del Corso, Nicola de Bortoli, Christopher J. Black, Alexander C. Ford, Edoardo Savarino
Summary: A network meta-analysis was conducted to compare the efficacy of different drugs for active eosinophilic esophagitis (EoE). The results showed that most available drugs were more effective than placebo in treating EoE. However, significant heterogeneity among the trials hindered the establishment of a solid therapeutic hierarchy.
Review
Biochemistry & Molecular Biology
Giovanni Marasco, Pierfrancesco Visaggi, Mariagiulia Vassallo, Miriam Fiocca, Cesare Cremon, Maria Raffaella Barbaro, Nicola De Bortoli, Massimo Bellini, Vincenzo Stanghellini, Edoardo Vincenzo Savarino, Giovanni Barbara
Summary: Eosinophilic gastrointestinal diseases (EGIDs) are a group of pathological conditions characterized by eosinophil infiltration in the gut. They can be classified into different types based on the specific tract involved. The epidemiology of EGIDs is evolving rapidly, and research on treatment options is ongoing.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Editorial Material
Surgery
Sarah K. Thompson
WORLD JOURNAL OF SURGERY
(2023)