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Enteric Nervous System: Neuropathic Gastrointestinal Motility
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Enteric Nervous System: Neuropathic Gastrointestinal Motility

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 47118

Special Issue Editor

Dr. Carolina Pellegrini

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Interests: inflammatory bowel diseases; inflammation; intestinal functional disorders; animal models; gut–brain axis; obesity; patients
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Patients with both digestive and extra-digestive diseases, including inflammatory bowel diseases (IBDs), irritable bowel syndrome (IBS), intestinal infections, metabolic syndromes, and neurological disorders, are often characterized by severe gastrointestinal (GI) dysfunctions, such as dysphagia, infrequent bowel movements, and constipation. In this context, several pieces of evidence suggest that gut dysbiosis, impairments of enteric epithelial barrier, and intestinal immune/inflammatory responses promote neuroplastic changes in the enteric nervous system, which could contribute to bowel motor dysfunctions.

On this basis, the purpose of this Special Issue is to characterize the involvement of the enteric bacteria–neuro–immune system in the pathophysiology of GI dysmotility associated with digestive and extra-digestive diseases. The understanding of these aspects could be useful for the identification of common pathophysiologic features underling GI dysfunctions in a plethora of diseases and for providing further insights for the development of new therapeutic strategies.

Dr. Carolina Pellegrini
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastrointestinal dysmotility
  • intestinal inflammation
  • enteric bacteria–neuro–immune network
  • brain–gut axis
  • metabolic disorders
  • neurological disorders
  • enteric neuroplasticity

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Related Special Issue

Published Papers (7 papers)

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Research

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11 pages, 267 KiB  
Article
The Prevalence of Enteropathy Symptoms from the Lower Gastrointestinal Tract and the Evaluation of Anorectal Function in Diabetes Mellitus Patients
by Małgorzata Reszczyńska and Radosław Kempiński
J. Clin. Med. 2021, 10(3), 415; https://doi.org/10.3390/jcm10030415 - 22 Jan 2021
Cited by 13 | Viewed by 2461
Abstract
Complications affecting the gastrointestinal tract often occur in the course of diabetes mellitus (DM). The aim of this study was to evaluate enteropathy symptoms and anorectal function using high-resolution anorectal manometry (HRAM). Fifty DM patients and 20 non-DM controls were enrolled into the [...] Read more.
Complications affecting the gastrointestinal tract often occur in the course of diabetes mellitus (DM). The aim of this study was to evaluate enteropathy symptoms and anorectal function using high-resolution anorectal manometry (HRAM). Fifty DM patients and 20 non-DM controls were enrolled into the study. Clinical data and laboratory tests were collected, physical examination and HRAM were performed. Symptoms in the lower gastrointestinal tract were reported by 72% of patients. DM patients with a long disease duration reported anal region discomfort (p = 0.028) and a sensation of incomplete evacuation (p = 0.036) more often than patients with shorter diabetes duration. Overall, DM patients had a lower maximal squeeze pressure (MSP) (p = 0.001) and a higher mean threshold of minimal rectal sensation (p < 0.01) than control subjects. They presented with enhanced features of dyssynergic defection than the control group. MSP and maximal resting pressure (MRP) were significantly lower in the group of long-term diabetes (p = 0.024; p = 0.026 respectively) than in patients with a short-term diabetes. The same observation was noted for patients with enteropathy symptoms that control for MSP (p < 0.01; p < 0.01; p = 0.03) and MRP (p < 0.001; p = 0.0036; p = 0.0046), respectively, for incontinence, constipation, and diarrhea. Symptoms in the lower gastrointestinal tract are often reported by DM patients. All DM patients have impaired function of the external anal sphincter and present enhanced features of dyssynergic defecation and also impaired visceral sensation. Patients with long-standing DM and patients with enteropathy symptoms have severely impaired function of both anal sphincters. Full article
(This article belongs to the Special Issue Enteric Nervous System: Neuropathic Gastrointestinal Motility)
10 pages, 878 KiB  
Article
Caffeine and Gastric Emptying Time in Very Preterm Neonates
by Antonios K. Gounaris, Ioanna N. Grivea, Maria Baltogianni, Eleni Gounari, George Antonogeorgos, Fedra Kokori, Polytimi Panagiotounakou, Martha Theodoraki, Aikaterini Konstantinidi and Rozeta Sokou
J. Clin. Med. 2020, 9(6), 1676; https://doi.org/10.3390/jcm9061676 - 1 Jun 2020
Cited by 7 | Viewed by 3312
Abstract
Background: Caffeine has been commonly used for prevention and treatment of apnea-related symptoms in premature infants. However, its side effects have not been thoroughly studied. We investigated whether caffeine affects gastric motility in very-preterm (VP) neonates. Methods: The study is a randomized crossover [...] Read more.
Background: Caffeine has been commonly used for prevention and treatment of apnea-related symptoms in premature infants. However, its side effects have not been thoroughly studied. We investigated whether caffeine affects gastric motility in very-preterm (VP) neonates. Methods: The study is a randomized crossover clinical trial. Twenty-two neonates with mean birth weight (BW) (standard deviation—SD) 1077 (229) g and mean gestational age (GA) (SD) 28.6 (2.1) weeks were recruited. Each neonate had its gastric emptying time checked twice with ultrasound assessment of changes in antral cross sectional area (ACSA). All neonates were sequentially allocated to the caffeine group (A) and the control group (B). Complications from the gastrointestinal tract were documented throughout the study. Results: Statistically significant difference was found with regards to the gastric emptying time [median, (range)] between caffeine and control group (p = 0.040). Additionally, in the neonates with BW 1000–1500 g and GA ≥ 28 weeks, the gastric emptying time (minutes) was significantly longer during caffeine treatment [44.5 (36–68.2)] and [40 (34.5–66.5)] respectively, as compared to the gastric emptying time during no caffeine treatment [27 (24.2–30)] (p = 0.002) and [27 (24.5–30)] (p = 0.001). The incidence of gastrointestinal (GI) complications was significantly greater in neonates receiving caffeine [6 (27.%)] as compared with those without caffeine treatment [1 (4.6%)] (p = 0.039). Conclusions: During caffeine treatment, a significantly delayed gastric emptying time was noted in all study neonates, especially in these with BW 1000–1500 g and those with GA ≥ 28 weeks. Further larger studies are necessary in order to confirm this interesting finding. Full article
(This article belongs to the Special Issue Enteric Nervous System: Neuropathic Gastrointestinal Motility)
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Review

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17 pages, 1860 KiB  
Review
Current Overview on Clinical Management of Chronic Constipation
by Jakub Włodarczyk, Anna Waśniewska, Jakub Fichna, Adam Dziki, Łukasz Dziki and Marcin Włodarczyk
J. Clin. Med. 2021, 10(8), 1738; https://doi.org/10.3390/jcm10081738 - 16 Apr 2021
Cited by 37 | Viewed by 16096
Abstract
Constipation is one of the major gastrointestinal disorders diagnosed in clinical practice in Western countries. Almost 20% of population suffer from this disorder, which means constipation is a substantial utilization of healthcare. Pathophysiology of constipation is complex and multifactorial, where aspects like disturbance [...] Read more.
Constipation is one of the major gastrointestinal disorders diagnosed in clinical practice in Western countries. Almost 20% of population suffer from this disorder, which means constipation is a substantial utilization of healthcare. Pathophysiology of constipation is complex and multifactorial, where aspects like disturbance in colonic transit, genetic predisposition, lifestyle habits, psychological distress, and many others need to be taken into consideration. Diagnosis of constipation is troublesome and requires thorough accurate examination. A nonpharmacological approach, education of the patient about the importance of lifestyle changes like diet and sport activity state, are the first line of therapy. In case of ineffective treatment, pharmacological treatments such as laxatives, secretagogues, serotonergic agonists, and many other medications should be induced. If pharmacologic treatment fails, the definitive solution for constipation might be surgical approach. Commonness of this disorder, costs of medical care and decrease in quality life cause constipation is a serious issue for many specialists. The aim of this review is to present current knowledge of chronic constipation and management of this disorder. Full article
(This article belongs to the Special Issue Enteric Nervous System: Neuropathic Gastrointestinal Motility)
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21 pages, 411 KiB  
Review
The Brain-Gut Axis: Psychological Functioning and Inflammatory Bowel Diseases
by Spyros Peppas, Claudia Pansieri, Daniele Piovani, Silvio Danese, Laurent Peyrin-Biroulet, Andreas G. Tsantes, Enrico Brunetta, Argirios E. Tsantes and Stefanos Bonovas
J. Clin. Med. 2021, 10(3), 377; https://doi.org/10.3390/jcm10030377 - 20 Jan 2021
Cited by 56 | Viewed by 6896
Abstract
The brain-gut axis represents a complex bi-directional system comprising multiple interconnections between the neuroendocrine pathways, the autonomous nervous system and the gastrointestinal tract. Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a chronic, relapsing-remitting inflammatory disorder of the gastrointestinal tract [...] Read more.
The brain-gut axis represents a complex bi-directional system comprising multiple interconnections between the neuroendocrine pathways, the autonomous nervous system and the gastrointestinal tract. Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a chronic, relapsing-remitting inflammatory disorder of the gastrointestinal tract with a multifactorial etiology. Depression and anxiety are prevalent among patients with chronic disorders characterized by a strong immune component, such as diabetes mellitus, cancer, multiple sclerosis, rheumatoid arthritis and IBD. Although psychological problems are an important aspect of morbidity and of impaired quality of life in patients with IBD, depression and anxiety continue to be under-diagnosed. There is lack of evidence regarding the exact mechanisms by which depression, anxiety and cognitive dysfunction may occur in these patients, and whether psychological disorders are the result of disease activity or determinants of the IBD occurrence. In this comprehensive review, we summarize the role of the brain-gut axis in the psychological functioning of patients with IBD, and discuss current preclinical and clinical data on the topic and therapeutic strategies potentially useful for the clinical management of these patients. Personalized pathways of psychological supports are needed to improve the quality of life in patients with IBD. Full article
(This article belongs to the Special Issue Enteric Nervous System: Neuropathic Gastrointestinal Motility)
13 pages, 909 KiB  
Review
Could Chronic Idiopatic Intestinal Pseudo-Obstruction Be Related to Viral Infections?
by Emanuele Sinagra, Gaia Pellegatta, Marcello Maida, Francesca Rossi, Giuseppe Conoscenti, Socrate Pallio, Rita Alloro, Dario Raimondo and Andrea Anderloni
J. Clin. Med. 2021, 10(2), 268; https://doi.org/10.3390/jcm10020268 - 13 Jan 2021
Cited by 7 | Viewed by 3414
Abstract
Chronic idiopathic intestinal pseudo-obstruction (CIIPO) is a disease characterized by symptoms and signs of small bowel obstruction in the absence of displayable mechanical obstruction. Due to the known neuropathic capacity of several viruses, and their localization in the intestine, it has been hypothesized [...] Read more.
Chronic idiopathic intestinal pseudo-obstruction (CIIPO) is a disease characterized by symptoms and signs of small bowel obstruction in the absence of displayable mechanical obstruction. Due to the known neuropathic capacity of several viruses, and their localization in the intestine, it has been hypothesized that such viruses could be involved in the pathogenesis of CIIPO. The most frequently involved viruses are John Cunningham virus, Herpesviridae, Flaviviruses, Epstein–Barr virus and Citomegalovirus. Therefore, the present narrative review aims to sum up some new perspectives in the etiology and pathophysiology of CIIPO. Full article
(This article belongs to the Special Issue Enteric Nervous System: Neuropathic Gastrointestinal Motility)
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14 pages, 254 KiB  
Review
IBS-Symptoms in IBD Patients—Manifestation of Concomitant or Different Entities
by Patrycja Szałwińska, Jakub Włodarczyk, Antonino Spinelli, Jakub Fichna and Marcin Włodarczyk
J. Clin. Med. 2021, 10(1), 31; https://doi.org/10.3390/jcm10010031 - 24 Dec 2020
Cited by 25 | Viewed by 5296
Abstract
Irritable bowel syndrome (IBS) is a functional heterogenous disease with a multifactorial pathogenesis. It is characterized by abdominal pain, discomfort, and alteration in gut motility. The occurrence of similar symptoms was observed in patients in clinical remission of inflammatory bowel diseases (IBD) that [...] Read more.
Irritable bowel syndrome (IBS) is a functional heterogenous disease with a multifactorial pathogenesis. It is characterized by abdominal pain, discomfort, and alteration in gut motility. The occurrence of similar symptoms was observed in patients in clinical remission of inflammatory bowel diseases (IBD) that is Crohn’s disease (CD) and ulcerative colitis (UC), which pathogenesis is also not fully understood. Hence, arose the question if these symptoms are “true IBS” imposed on IBD, or is it a subclinical form of IBD or even pre-IBD? In this article, based on a narrative overview of the literature, we try to find an answer to this query by discussing the pathogenesis and overlaps between these conditions. Full article
(This article belongs to the Special Issue Enteric Nervous System: Neuropathic Gastrointestinal Motility)
27 pages, 2219 KiB  
Review
You Talking to Me? Says the Enteric Nervous System (ENS) to the Microbe. How Intestinal Microbes Interact with the ENS
by Mauro Giuffrè, Rita Moretti, Giuseppina Campisciano, Alexandre Barcelos Morais da Silveira, Vincenzo Maria Monda, Manola Comar, Stefano Di Bella, Roberta Maria Antonello, Roberto Luzzati and Lory Saveria Crocè
J. Clin. Med. 2020, 9(11), 3705; https://doi.org/10.3390/jcm9113705 - 18 Nov 2020
Cited by 43 | Viewed by 8442
Abstract
Mammalian organisms form intimate interfaces with commensal and pathogenic gut microorganisms. Increasing evidence suggests a close interaction between gut microorganisms and the enteric nervous system (ENS), as the first interface to the central nervous system. Each microorganism can exert a different effect on [...] Read more.
Mammalian organisms form intimate interfaces with commensal and pathogenic gut microorganisms. Increasing evidence suggests a close interaction between gut microorganisms and the enteric nervous system (ENS), as the first interface to the central nervous system. Each microorganism can exert a different effect on the ENS, including phenotypical neuronal changes or the induction of chemical transmitters that interact with ENS neurons. Some pathogenic bacteria take advantage of the ENS to create a more suitable environment for their growth or to promote the effects of their toxins. In addition, some commensal bacteria can affect the central nervous system (CNS) by locally interacting with the ENS. From the current knowledge emerges an interesting field that may shape future concepts on the pathogen–host synergic interaction. The aim of this narrative review is to report the current findings regarding the inter-relationships between bacteria, viruses, and parasites and the ENS. Full article
(This article belongs to the Special Issue Enteric Nervous System: Neuropathic Gastrointestinal Motility)
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