Gastrointestinal Motility and Functional Gut Problems for the Practitioner

A special issue of Gastrointestinal Disorders (ISSN 2624-5647).

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 12858

Special Issue Editor


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Guest Editor
1. Professor and Founding Chair, Department of Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA
2. Department of Internal Medicine, Director of Gastroenterology Research and Director of the Center for Neurogastroenterology and GI Motility, Texas Tech University Medical Center and the Paul L. Foster School of Medicine, El Paso, TX 79905, USA
3. Honorary Professor, School of Medicine, University of Queensland, Brisbane, Australia
Interests: the physiology, pathophysiology and pharmacology of gastrointestinal smooth muscles; the role of the enteric nervous system and electrical activity relating to GI Motility disorders; the brain –gut integration and gut microbiota in functional GI disorders as well as the development of electrical stimulation and new Pharmacology in treating these entities
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Special Issue Information

Dear colleagues,

Welcome to “Gastrointestinal Motility and Functional Gut Problems for the Practitioner”, a new series for Gastrointestinal Disorders.

The biggest deficiency in Gastroenterology training programs in the US and worldwide is the teaching and understanding of gastrointestinal motility to trainees and physicians.  The fact that many entities can remain undiagnosed after upper and lower endoscopies, imaging modalities such as CT, MRI and even endoscopic ultrasound is not appreciated by trainees and practicing physicians.  Upon entering practice, a great volume of functional bowel disease patients awaits our newly minted gastroenterologists in their waiting rooms.  This reminds them of how some of their mentors had emphasized the art of medicine in the same sentence as the management of functional bowel and GI Motility disorders; but more likely they are keenly aware how they strove to avoid the dreaded irritable bowel, functional dyspepsia and gastroparesis patients in their clinical encounters.

Well I bear good tidings.  This new series I am editing will bring “GI motility to the masses” and make functional bowel disorders attractive because YES! You out there looking after patients both in small towns and large cities will be able to recognize and diagnose these entities. More importantly, this series will teach you that they are immensely treatable. Patient satisfaction from your expertise will be immeasurable and your reputation as the consummate gastroenterology clinician and motility specialist will be appreciated and respected by your colleagues.

Prof. Dr. Richard W. McCallum
Guest Editor

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Published Papers (2 papers)

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Research

6 pages, 226 KiB  
Communication
Development of a Motility Frailty Index in Patients with Gastroparesis
by Jared Winston, Patricia Guzman Rojas, Abigail Stocker, Prateek Mathur, Douglas Lorenz, Michael Daniels and Thomas Abell
Gastrointest. Disord. 2021, 3(2), 78-83; https://doi.org/10.3390/gidisord3020008 - 25 Apr 2021
Cited by 1 | Viewed by 3101
Abstract
Introduction: Patients with symptoms (Sx) of gastrointestinal (GI) motor disorders have limitations in physical strength and mobility. We hypothesized that physical frailty correlated with severity of GI symptoms, and that a motility frailty index (MFI) could be constructed. Patients: We conducted a prospective [...] Read more.
Introduction: Patients with symptoms (Sx) of gastrointestinal (GI) motor disorders have limitations in physical strength and mobility. We hypothesized that physical frailty correlated with severity of GI symptoms, and that a motility frailty index (MFI) could be constructed. Patients: We conducted a prospective pilot study on 40 patients, (38 F, 2 M, mean age 39.9 years) with the following diagnoses: 10 with diabetes mellitus and 30 with non-diabetic/idiopathic disorders. Upper and lower GI Sx were quantified using an FDA-compliant, traditional patient-reported outcomes (PRO) system. Methods: Patients underwent a series of physical performance measures involving standing balance (SB), usual walk speed (UW), and chair sit-and-stands (CS). A GI motility frailty index (MFI) was constructed by fitting several models with a combination of physical performance measures and correlating with PRO. Pearson’s correlation compared the constructed index with the GI Sx PRO to construct a GI MFI. Results: The studied patients collectively showed marked limitations in mobility compared with standard performance values with mean (sd) ratios of SB = 0.87 (0.20), UW = 0.45 (0.13), and CS = 0.38 (0.17). Correlations between physical mobility and GI Sx were noted for upper GI Sx (rho = 0.47, p = 0.002) but not for lower GI Sx. Conclusions: In this pilot study of patients with GI motility disorders, we found increased physical limitations on performance-based testing, which had a statistically significant positive correlation with severity of upper GI motor Sx using a standardized PRO system. A motility frailty index has been constructed that may serve as a basis for better quantifying limitations in patient mobility. Full article
7 pages, 1445 KiB  
Article
Median Arcuate Ligament Syndrome Clinical Presentation, Pathophysiology, and Management: Description of Four Cases
by Ihsan Al Bayati, Mahesh Gajendran, Brian R. Davis, Jesus R. Diaz and Richard W. McCallum
Gastrointest. Disord. 2021, 3(1), 44-50; https://doi.org/10.3390/gidisord3010005 - 26 Feb 2021
Cited by 7 | Viewed by 8896
Abstract
Median arcuate ligament syndrome (MALS), otherwise called celiac artery compression syndrome (CACS), is an uncommon disorder that results from an anatomical compression of the celiac axis and/or celiac ganglion by the MAL. Patients typically present with abdominal pain of unknown etiology exacerbated by [...] Read more.
Median arcuate ligament syndrome (MALS), otherwise called celiac artery compression syndrome (CACS), is an uncommon disorder that results from an anatomical compression of the celiac axis and/or celiac ganglion by the MAL. Patients typically present with abdominal pain of unknown etiology exacerbated by eating along with nausea, vomiting, and weight loss. MALS is a diagnosis of exclusion that should be considered in patients with severe upper abdominal pain, which does not correlate with the objective findings. The cardinal feature which is elicited in the diagnosis of MALS relies on imaging studies of the celiac artery, demonstrating narrowing during expiration. The definitive treatment is the median arcuate ligament’s surgical release to achieve surgical decompression of the celiac plexus by division of the MAL. This article describes our experience with this entity, focusing on symptom presentation, diagnostic challenges, and management, including long-term follow-up in four cases. Full article
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