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5. Superficial oesophageal mucosal innervation may contribute to severity of symptoms in oesophageal motility disorders

Author

Sawada, Akinari, primary, Zhang, Mengyu, additional, Ustaoglu, Ahsen, additional, Nikaki, Kornilia, additional, Lee, Chung, additional, Woodland, Philip, additional, Yazaki, Etsuro, additional, Takashima, Shingo, additional, Ominami, Masaki, additional, Tanaka, Fumio, additional, Nachman, Fabio, additional, Ditaranto, Andrés, additional, Agotegaray, Joaquín, additional, Bilder, Claudio, additional, Savarino, Edoardo, additional, Gyawali, C. Prakash, additional, Penagini, Roberto, additional, Fujiwara, Yasuhiro, additional, and Sifrim, Daniel, additional

Published
2023
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8. Superficial oesophageal mucosal innervation may contribute to severity of symptoms in oesophageal motility disorders.

Author

Sawada, Akinari, Zhang, Mengyu, Ustaoglu, Ahsen, Nikaki, Kornilia, Lee, Chung, Woodland, Philip, Yazaki, Etsuro, Takashima, Shingo, Ominami, Masaki, Tanaka, Fumio, Ciafardini, Clorinda, Nachman, Fabio, Ditaranto, Andrés, Agotegaray, Joaquín, Bilder, Claudio, Savarino, Edoardo, Gyawali, C. Prakash, Penagini, Roberto, Fujiwara, Yasuhiro, and Sifrim, Daniel

Subjects
ESOPHAGEAL motility disorders, INNERVATION, ESOPHAGOGASTRIC junction, CALCITONIN gene-related peptide, CHEST pain, SYMPTOMS
Abstract

Summary: Background: Mechanisms underlying perception of dysphagia and chest pain have not been completely elucidated, although oesophageal mucosal afferent nerves might play an important role. Aims: To evaluate the relationship between oesophageal mucosal afferent nerves and the severity of dysphagia and chest pain in oesophageal motility disorders. Methods: We prospectively recruited patients with oesophageal motility disorders having dysphagia and/or chest pain from whom oesophageal biopsies were obtained. High‐resolution manometry classified patients into disorders of oesophagogastric junction (OGJ) outflow and disorders of peristalsis. Symptom severity was assessed using validated questionnaires including Brief Oesophageal Dysphagia Questionnaire (BEDQ). Immunohistochemistry was performed on oesophageal biopsies to evaluate the location of calcitonin gene‐related peptide (CGRP)‐immunoreactive mucosal afferent nerves. Findings were compared to existing data from 10 asymptomatic healthy volunteers. Results: Of 79 patients, 61 patients had disorders of OGJ outflow and 18 had disorders of peristalsis. CGRP‐immunoreactive mucosal nerves were more superficially located in the mucosa of patients with oesophageal motility disorders compared to healthy volunteers. Within disorders of OGJ outflow, the location of CGRP‐immunoreactive nerves negatively correlated with BEDQ score both in the proximal (ρ = −0.567, p < 0.001) and distal oesophagus (ρ = −0.396, p = 0.003). In the proximal oesophagus, strong chest pain was associated with more superficially located mucosal nerves than weak chest pain (p = 0.04). Multivariate analysis showed superficial nerves in the proximal oesophagus was independently associated with severe dysphagia in disorders of OGJ outflow (p = 0.008). Conclusions: Superficial location of mucosal nerves in the proximal oesophagus might contribute to symptoms, especially severe dysphagia, in disorders of OGJ outflow. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Recent advances in the treatment of gastrointestinal motility disorders in children.

Author

Nita, Andreia Florina, Chanpong, Atchariya, Nikaki, Kornilia, Rybak, Anna, Thapar, Nikhil, and Borrelli, Osvaldo

Subjects
GASTROINTESTINAL motility disorders, FECAL microbiota transplantation, GASTROPARESIS, ESOPHAGEAL atresia, ESOPHAGEAL achalasia
Abstract

Pediatric gastrointestinal motility disorders represent some of the most challenging clinical conditions with largely undefined pathogenetic pathways and therefore limited therapeutic options. Herein, we provide an overview of the recent advances in treatment options for these disorders and their clinical impact. PubMed and Medline databases were searched for relevant articles related to the treatment of achalasia, esophageal atresia, gastroparesis, PIPO and constipation published between 2017 and 2022. In this article, we review and summarize recent advances in management of gastrointestinal motility disorders in children with a particular focus on emerging therapies as well as novel diagnostic modalities that help guide their application or develop new, more targeted treatments. Gastrointestinal motility disorders represent one of the most challenging conundrums in pediatric age and despite significant advances in investigative tools, the palette of treatment options remain limited. Overall, while pharmacological options have failed to bring a curative solution, recent advances in minimal invasive therapeutic and diagnostic techniques have emerged as potential keys to symptom and quality of life improvement, such as ENDOFLIP, POEM, cine-MRI, fecal microbiota transplantation. [ABSTRACT FROM AUTHOR]

Published
2023
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22. Belching in children: Prevalence and association with gastroesophageal reflux disease.

Author

Masui, Daisuke, Nikaki, Kornilia, Sawada, Akinari, Sonmez, Shirley, Yazaki, Etsuro, and Sifrim, Daniel

Subjects
*CHILD patients, *GASTROESOPHAGEAL reflux, *PHYSIOLOGY
Abstract

Background: Excessive belching is frequently reported in adult patients with gastro‐oesophageal reflux disease (GORD) and dyspepsia. Although postprandial gastric belching (GB) is considered a physiological mechanism for gastric venting, supra‐gastric belching (SGB) is considered a distinct behavioural disorder. We aimed to define the prevalence of different types of belching and its association with reflux disease in paediatric patients. Methods: We retrospectively analysed reflux monitoring studies from 287 patients (median age: 7.0 years; interquartile range 3.0–11.3 years) with a suspicion of GORD. Based on oesophageal acid exposure time (AET) patients were divided in 3 groups: (a) physiological AET, (b) borderline AET and (c) pathological AET. MII‐pH studies were manually edited and reflux disease parameters were measured together with quantification of GB and SGB. Key Results: Two hundred one children (70.0%) had physiological AET (median: 0.8; interquartile range 0.3–1.6), 52 (18.1%) had borderline AET (median: 4.2; interquartile range 3.4–5.3) and 34 (11.9%) had pathologic AET (median: 10.7; interquartile range 9.1–14.2). Gastric belching was observed in all studies. Gastric belching related reflux was more frequently observed in patients with borderline and pathological AET (p < 0.001). This was more common in older children. SGB were observed in only 7 (2.4%) children (age range: 8–17years) in our population and all patients had Physiological AET. Only 3 (1%) patients had pathological number of SGB (>13/24 h). Conclusions and Inferences: Gastric belching related reflux is observed in children with increased AET. SGB is very rare in the paediatric population. [ABSTRACT FROM AUTHOR]

Published
2022
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29. Persistent Postprandial Regurgitation vs Rumination in Patients With Refractory Gastroesophageal Reflux Disease Symptoms: Identification of a Distinct Rumination Pattern Using Ambulatory Impedance-pH Monitoring

Author

Nakagawa, Kenichiro, primary, Sawada, Akinari, additional, Hoshikawa, Yoshimasa, additional, Nikaki, Kornilia, additional, Sonmez, Shirley, additional, Woodland, Philip, additional, Yazaki, Etsuro, additional, and Sifrim, Daniel, additional

Published
2019
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35. Measurement of Esophageal Nocturnal Baseline Impedance: A Simplified Method.

Author

Yoshimasa Hoshikawa, Sawada, Akinari, Sonmez, Shirley, Nikaki, Kornilia, Woodland, Philip, Etsuro Yazaki, and Sifrim, Daniel

Subjects
GASTROESOPHAGEAL reflux, ABSOLUTE value, ELECTRIC impedance, HEARTBURN
Abstract

Background/Aims Mean nocturnal baseline impedance (MNBI) during multichannel intraluminal impedance pH-monitoring (MII-pH) reflects the status of esophageal mucosal integrity. MNBI is suggested as an adjunctive method to distinguish patients with true gastroesophageal reflux disease (GERD) from functional heartburn (FH) and might predict outcomes for anti-reflux treatment. However, current methodology for calculation of MNBI is time-consuming and subject to operator-dependent selection bias. We aim to simplify and provide a more objective method to calculate MNBI. Methods We retrospectively analyzed 100 MII-pH tracings from 20 patients with erosive reflux disease, 20 with non-erosive reflux disease (NERD), 20 with reflux hypersensitivity, 20 with functional heartburn (FH), and 20 healthy asymptomatic volunteers. We compared the current "conventional" MNBI analysis with our "simple" MNBI analysis measured by selecting the whole supine period using the impedance average calculation function in the MII-pH software. Results Absolute values were very similar and there was a strong correlation between conventional and simple MNBI values in the most distal channel in all groups (r = 0.8, P < 0.001) including patients with increased supine acid reflux. Distal esophageal simple MNBI negatively correlated with acid exposure time (r = -0.695, P < 0.001). Patients with erosive reflux disease and NERD had lower simple MNBI values in the most distal channel compared to other groups (P < 0.001). With a cutoff value of 1785 ohms, simple MNBI can discriminate patients with GERD from those with reflux hypersensitivity and FH (sensitivity 80.0% and specificity 89.7%). Conclusion Simple MNBI analysis provides very similar values and has an excellent correlation with conventional MNBI analysis. [ABSTRACT FROM AUTHOR]

Published
2020
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38. Su1086 - Measurement of Salivary Pepsin for Diagnosis of Adult Gastro-Oesophageal Reflux Disease (GORD) is not Yet Ready for Clinical Application

Author

Woodland, Philip J., primary, Singendonk, Maartje, additional, Nikaki, Kornilia, additional, Ooi, Joanne L., additional, Wong, Terence, additional, Koning, Romy, additional, Lee, Chung, additional, Glasinovic, Esteban, additional, Benninga, Marc A., additional, van Wijk, Michiel P., additional, and Sifrim, Daniel, additional

Published
2018
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40. Superficial Esophageal Mucosal Afferent Nerves May Contribute to Reflux Hypersensitivity in Nonerosive Reflux Disease

Author

Woodland, Philip, primary, Shen Ooi, Joanne Li, additional, Grassi, Federica, additional, Nikaki, Kornilia, additional, Lee, Chung, additional, Evans, James A., additional, Koukias, Nikolaos, additional, Triantos, Christos, additional, McDonald, Stuart A., additional, Peiris, Madusha, additional, Aktar, Rubina, additional, Blackshaw, L. Ashley, additional, and Sifrim, Daniel, additional

Published
2017
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41. 200ml Rapid Drink Challenge During High Resolution Manometry Predicts Oesophago-Gastric-JunctionObstruction Detected by Timed Barium Oesophagogram with High Sensitivity and Specificity

Author

Gabieta-Sonmez, Shirley, primary, Arguero, Julieta, additional, Ooic, Joanne L., additional, Nakagawa, Kenichiro, additional, Glasinovic, Esteban, additional, Woodland, Philip J., additional, Yazaki, Etsuro, additional, Nikaki, Kornilia, additional, Amarasinghe, Gehanjali, additional, and Sifrim, Daniel, additional

Published
2017
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