Article
Gastroenterology & Hepatology
John W. Blackett, Misha Gautam, Rahul Mishra, Nicholas R. Oblizajek, Shivabalan Kathavarayan Ramu, Kent R. Bailey, Adil E. Bharucha
Summary: This study evaluated constipated patients using HR-ARM, BET, and defecography, and found that a reduced rectoanal gradient was the best predictor for prolonged BET and reduced rectal evacuation. Specific HR-ARM results supported a diagnosis of DD.
Article
Gastroenterology & Hepatology
Sushmitha Grama Srinivasan, Anjani Muthyala, Mayank Sharma, Kelly Feuerhak, Andrea Boon, Kent R. Bailey, Adil E. Bharucha
Summary: This study found three possibly interrelated abnormalities in DD, including aberrant activation of abdominal muscles during squeeze in DD, dyscoordination of abdominal muscles during various tasks in constipated women, and abdomino-anal dyscoordination.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Yoav Mazor, Margaret Schnitzler, Michael Jones, Anastasia Ejova, Allison Malcolm
Summary: There is variation in the management approach for patients with obstructed defecatory symptoms between gastroenterologists and colorectal surgeons. Gastroenterologists are more likely to refer for anorectal manometry while colorectal surgeons are more likely to refer for dynamic imaging. Knowledge of dynamic imaging findings influences treatment decisions for both specialties.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Matthew Woo, Armaan Pandey, Harman Gill, Dorothy Li, Michelle Buresi, Yasmin Nasser, Summit Sawhney, Christopher N. Andrews
Summary: The study found that the 3-dimensional high-definition anorectal manometry (3D-HDAM) system has limited performance in diagnosing dyssynergic defecation, and anorectal pressure parameters measured with the 3D-HDAM probe poorly predict prolonged balloon expulsion time. Rectoanal pressure differential (RAPD) remains the best predictor of prolonged balloon expulsion time.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Kei Ohara, Mitsuhiro Inagaki, Masanori Murakami
Summary: Rectosigmoid accumulation of markers can differentiate DD from slow transit constipation. However, non-rectosigmoid accumulation does not exclude the presence of DD.
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Review
Gastroenterology & Hepatology
Adil E. Bharucha, Guido Basilisco, Allison Malcolm, Tae Hee Lee, Matthew B. Hoy, S. Mark Scott, Satish S. C. Rao
Summary: Anorectal manometry is a comprehensive method for assessing anorectal sensorimotor functions, which is useful for diagnosing defecatory disorders and guiding management. The rectal balloon expulsion test is a convenient and cost-effective outpatient assessment tool for evaluating impaired evacuation.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Review
Gastroenterology & Hepatology
Satish S. C. Rao, Nitin K. Ahuja, Adil E. Bharucha, Darren M. Brenner, William D. Chey, Jill K. Deutsch, David C. Kunkel, Baharak Moshiree, Leila Neshatian, Robert M. Reveille, Gregory S. Sayuk, Jordan M. Shapiro, Eric D. Shah, Kyle Staller, Steven D. Wexner, Jason R. Baker
Summary: This article discusses the application and challenges of anorectal manometry (ARM) in the diagnosis and treatment of anorectal disorders. ARM can identify key pathophysiological abnormalities and is a critical component of biofeedback therapy. However, barriers to its utilization include a lack of education and training, challenges with testing protocols and interpretation, and confusion over billing practices.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Medicine, General & Internal
Qihong Liu, Wenyi Fang, Peilin Zhao, Yanqin He, HaiHua Gao, Xiao Ke
Summary: Three-dimensional high-resolution anorectal manometry (3DHRAM) is a new technique that can be used to diagnose anorectal disorders and pelvic floor disorders. This study confirmed the reliability of 3DHRAM in the diagnosis of paradoxical puborectalis syndrome (PPS) compared to X-ray defaecography.
Article
Gastroenterology & Hepatology
Gifty Kwakye, Lillias Holmes Maguire
Summary: Rectal prolapse often coexists with bowel and pelvic floor abnormalities. Surgery aims to correct the prolapse and improve function. History-taking, physical exam, and physiologic testing are important tools for surgical decision-making, while additional tests like defecography can help identify related issues for further evaluation.
CLINICS IN COLON AND RECTAL SURGERY
(2021)
Article
Gastroenterology & Hepatology
Myeongsook Seo, Jiyoung Yoon, Kee Wook Jung, Segyeong Joo, Jungbok Lee, Kyung Min Choi, Hyo Jeong Lee, In Ja Yoon, Woojoo Noh, So Young Seo, Do Yeon Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Suk-Kyun Yang, Seung-Jae Myung
Summary: Biofeedback therapy is widely used to treat chronic constipation patients, especially those with dyssynergic defecation. This study demonstrates that integrated pressurized volume parameters are better than conventional parameters in predicting responsiveness to biofeedback therapy, and the combination of these parameters and partial least squares regression is particularly promising. Integrated pressurized volume parameters can more effectively explain the physiology of the anorectal canal compared with conventional parameters.
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Medicine, General & Internal
Zhang-xiang Wu, Chao Wang, Zheng Huang, Xue-han Liu, Mei Shen
Summary: This case study demonstrates that a combination of BoNTA injection and sEMG biofeedback therapy can improve wrist-hand extensor function in patients with spastic hemiplegia. Proper patient selection and appropriate post-injection exercises are crucial for hand rehabilitation in these patients.
Article
Pediatrics
Ahmed B. Radwan, Mohamed A. Gadallah, Mohammed R. Shahawy, Ayman A. Albagdady, Ayman A. Talaat
Summary: This study compared the changes in Rintala scores in children with FC and ODS managed by BT injection, BMP, and SBL, versus a control group managed by only BMP and SBL. The results showed no statistically significant difference between the two groups, indicating that BT injection did not provide additional improvement in defecatory function when assessed by Rintala score.
JOURNAL OF PEDIATRIC SURGERY
(2021)
Article
Gastroenterology & Hepatology
David O. Prichard, Jeffrey Fetzer
Summary: This study suggests that constipated men and women exhibit different recto-anal pressure patterns, with women being more prone to defecatory disorders and men being more likely to have abnormal balloon expulsion tests. These findings are independent of sex-specific physiological differences.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Article
Gastroenterology & Hepatology
Hans Gregersen, Ssu-Chi Chen, Wing Wa Leung, Cherry Wong, Tony Mak, Simon Ng, Sun Daming, Kaori Futaba
Summary: This study used Fecobionics to study defecatory disorders in comparison with slow transit constipation patients and normal subjects. The results showed significant differences in defecation parameters and indices among different groups, especially in identifying various subtypes in patients with obstructed defecation.
CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Leila Neshatian, Christof Karmonik, Rose Khavari, Zhaoyue Shi, Saba Elias, Timothy Boone, Eamonn M. M. Quigley
Summary: This study aimed to investigate the differences in brain activity patterns during defecation between patients with functional defecatory disorders (FDD) and controls. The results showed that FDD patients had decreased brain activity in regions associated with motivational-affective regulation and executive-cognitive function compared to controls.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
Thomas A. Zikos, Linda Nguyen, Afrin Kamal, Nielsen Fernandez-Becker, Kirsten Regalia, Monica Nandwani, Irene Sonu, Mildred Garcia, Philip Okafor, Leila Neshatian, Damanpreet Grewal, Patricia Garcia, George Triadafilopoulos, John O. Clarke
DIGESTIVE DISEASES AND SCIENCES
(2020)
Article
Gastroenterology & Hepatology
Leila Neshatian, Mary-Jane O. U. Williams, Eamonn M. Quigley
Summary: Rectal balloon distension during simulated evacuation can improve rectoanal gradient and reduce dysynergia in patients with chronic constipation, particularly those with normal rectal sensory function and balloon expulsion test results.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Review
Gastroenterology & Hepatology
Jason R. Baker, Baha Moshiree, Satish Rao, Leila Neshatian, Linda Nguyen, William D. Chey, Richard Saad, Jose M. Garza, Shamaila Waseem, Abraham R. Khan, John E. Pandolfino, C. Prakash Gyawali
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2020)
Article
Gastroenterology & Hepatology
Leila Neshatian, Chimi L. Fosso, Eamonn M. Quigley
JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES
(2020)
Article
Gastroenterology & Hepatology
Wendy Zhou, Thomas A. Zikos, John O. Clarke, Linda A. Nguyen, George Triadafilopoulos, Leila Neshatian
Summary: The study revealed a high prevalence of delayed small bowel transit and hypo-contractility patterns among POTS patients. Wireless motility capsule was found to be a useful tool in guiding treatment for POTS patients with gastrointestinal symptoms.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Article
Gastroenterology & Hepatology
Leila Neshatian, Angela Lee, Amber W. Trickey, Katherine D. Arnow, Brooke H. Gurland
Summary: Rectal prolapse patients exhibit varying symptom severity and healthcare utilization based on age. Older patients are more likely to report bothersome symptoms of pain and bleeding, while younger patients are more likely to experience obstructed defecation syndrome. Most patients report mucus discharge, but only a minority find it bothersome.
DISEASES OF THE COLON & RECTUM
(2021)
Article
Obstetrics & Gynecology
Shannon L. Wallace, Ekene A. Enemchukwu, Kavita Mishra, Leila Neshatian, Bertha Chen, Lisa Rogo-Gupta, Eric R. Sokol, Brooke H. Gurland
Summary: In this study, patients undergoing combined RP + POP surgery had a higher risk of complications but equivalent RP recurrence rates compared to patients undergoing RP-only surgery.
INTERNATIONAL UROGYNECOLOGY JOURNAL
(2021)
Article
Gastroenterology & Hepatology
Brooke H. Gurland, Gaurav Khatri, Roopa Ram, Tracy L. Hull, Ervin Kocjancic, Lieschen H. Quiroz, Rania F. El Sayed, Kedar R. Jambhekar, Victoria Chernyak, Raj Mohan Paspulati, Vipul R. Sheth, Ari M. Steiner, Amita Kamath, S. Abbas Shobeiri, Milena M. Weinstein, Liliana Bordeianou
Summary: Supplemental digital content can be found in the text.
DISEASES OF THE COLON & RECTUM
(2021)
Article
Obstetrics & Gynecology
Brooke H. Gurland, Gaurav Khatri, Roopa Ram, Tracy L. Hull, Ervin Kocjancic, Lieschen H. Quiroz, Rania F. El Sayed, Kedar R. Jambhekar, Victoria Chernyak, Raj Mohan Paspulati, Vipul R. Sheth, Ari M. Steiner, Amita Kamath, S. Abbas Shobeiri, Milena M. Weinstein, Liliana Bordeianou
Summary: The Pelvic Floor Disorders Consortium comprises a multidisciplinary team of experts dedicated to improving patient care, developing educational programs, and creating clinical guidelines for pelvic floor conditions. With unique perspectives from different specialties, the Consortium aims to bridge gaps and enable collaboration among practitioners involved in evaluation and treatment of patients with pelvic floor disorders. The inclusive guidance provided in this document is the collective effort of the PFDC Working Group on Magnetic Resonance Imaging of Pelvic Floor Disorders.
INTERNATIONAL UROGYNECOLOGY JOURNAL
(2021)
Article
Gastroenterology & Hepatology
John Gubatan, Thomas Zikos, Estelle Spear Bishop, John Wu, Andres Gottfried, Laren Becker, Aida Habtezion, Leila Neshatian
Summary: During the COVID-19 pandemic, patients with common functional gastrointestinal and motility disorders reported more gastrointestinal symptoms, increased medication use, and healthcare utilization.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Review
Radiology, Nuclear Medicine & Medical Imaging
Brooke H. Gurland, Gaurav Khatri, Roopa Ram, Tracy L. Hull, Ervin Kocjancic, Lieschen H. Quiroz, Rania F. El Sayed, Kedar R. Jambhekar, Victoria Chernyak, Raj Mohan Paspulati, Vipul R. Sheth, Ari M. Steiner, Amita Kamath, S. Abbas Shobeiri, Milena M. Weinstein, Liliana Bordeianou
Summary: The Pelvic Floor Disorders Consortium is a multidisciplinary organization aiming to collaborate and improve care for patients with pelvic floor conditions through the development of guidelines and educational programs.
AMERICAN JOURNAL OF ROENTGENOLOGY
(2021)
Article
Gastroenterology & Hepatology
George Triadafilopoulos, John O. Clarke, Afrin Kamal, Leila Neshatian
Summary: This pilot study examines the durability and reproducibility of HR-ARM findings, showing that only a minority of patients had stable measurements, raising questions about the validity of a single measurement.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Article
Gastroenterology & Hepatology
Leila Neshatian, Christof Karmonik, Rose Khavari, Zhaoyue Shi, Saba Elias, Timothy Boone, Eamonn M. M. Quigley
Summary: This study aimed to investigate the differences in brain activity patterns during defecation between patients with functional defecatory disorders (FDD) and controls. The results showed that FDD patients had decreased brain activity in regions associated with motivational-affective regulation and executive-cognitive function compared to controls.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
L. Neshatian, J. P. Lam, B. H. Gurland, T. Liang, L. Becker, V. R. Sheth
Summary: Background: The pathophysiology of pelvic organ prolapse is largely unknown. Objective: This study aimed to compare the psoas and puborectalis muscle mass composition and cross-sectional area among patients with or without pelvic laxity. Results: The severity of pelvic organ prolapse appears to be associated with increasing psoas muscle fat fraction, which is a biomarker for reduced skeletal muscle mass.
TECHNIQUES IN COLOPROCTOLOGY
(2022)
Letter
Gastroenterology & Hepatology
C. Prakash Gyawali, Jason R. Baker, Baha Moshiree, Satish Rao, Leila Neshatian, Linda Nguyen, William D. Chey, Richard Saad, Jose M. Garza, Shamaila Waseem, Abraham R. Khan, John E. Pandolfino
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)