There is accumulating evidence that microbial colonization of the small intestine plays a role in the pathophysiology of disorders of gut–brain interaction. Functional dyspepsia is characterised in a major subset by low grade duodenal inflammation (eosinophils and mast cells), duodenal dysbiosis and altered mucosal barrier dysfunction. While low-grade inflammation might be the consequence of microbial dysbiosis, the inflammation may play a key role in sensory dysfunction. This disease process resulting in the manifestation of dyspeptic symptoms is likely modified by environmental factors most notably dietary factors or medications.

A meta-analysis of clinical studies describing Endoflip™ use for measurements of esophagogastric junction distensibility index (EGJ-DI) in healthy subjects reveals that only 5.4% of subjects have an EGJ-DI of 2 mm²/mmHg or lower, values below it can be considered abnormal. The clinical use of an upper limit for normality of EGJ-DI seems questionable.

The manuscript is a retrospective review of 215 patients who underwent transvaginal rectocoele repair in asingle tertiary referral centre between 2006 and 2018, with good functional results.

Among 558 people with a Rome IV functional bowel disorder, excluding IBS, latent class analysis identified five unique clusters characterized by a profile of gastrointestinal symptoms, extra-intestinal symptoms, and mood. However, correlation between these clusters and the Rome IV functional bowel disorder diagnoses was poor, and 75% of people were classified as having mild IBS using our previous IBS-derived model. The functional bowel disorders may be better characterized as a spectrum of IBS rather than separate disorders.

Antroduodenal motility patterns are different among etiologies of gastroparesis. A dysmotility spectrum was identified with different patterns ranging from post-surgery to idiopathic and diabetic gastroparesis.

During high-resolution anorectal manometry (HR_ARM), the raw data are converted into software-derived summary variables (e.g., rectoanal gradient during evacuation) that capture only a snapshot of the collected data. Computing different, more useful indices from the raw data requires time-consuming extraction of raw data from the program. We devised a reverse engineering method to compute anorectal pressures from pressure topography images in HR_ARM reports. Confirming the accuracy of this method, these pressures were significantly correlated with software-generated values. This method can be harnessed to compile large HR_ARM datasets across centers and to uncover newer, potentially more useful parameters.

Bladder pain syndrome is present in 26.9% of functional dyspepsia patients and is associated with higher gastrointestinal, psychological distresses and sleep symptom burdens, and with reduced quality of life. We recommend to systematically assess the presence of bladder pain syndrome in patients with functional dyspepsia.

In patients with similar acid burden and similar motor function, the presence of a hiatus hernia, less non-acid reflux and lower post-reflux swallow-induced peristaltic wave index led to greater impairment of distal esophageal mucosal integrity compared with no hernia. HH impairs distal esophageal mucosal integrity possibly through excessive bile reflux.

A 12-question multiple-choice anonymous survey was distributed electronically to all adult gastroenterology fellowship program directors across the United States. Many trainees expressed some unwillingness and discomfort in managing patients with disorders of gut-brain disorders (DGBI).

Irritable bowel syndrome (IBS) is a functional bowel disorder with a predominance in women; IBS in men is less studied. The present study improves the understanding of men's experience of IBS.

The occurrence of more cyclic short antegrade motor patterns and less HAPC's (from the proximal to the mid-colon) is more prevalent in patients with major LARS. These findings help to understand the differences in pathophysiology in patients developing major versus no/minor bowel complaints after TME for rectal cancer.

In this first prospective pediatric study of intrapyloric botulinum injections, we found improvements in nausea and vomiting in 64% of patients. Pyloric EndoFLIP was feasible in children as young as 11 years, and there was a trend towards lower pyloric distensibility associated with delayed gastric emptying.

In a proof-of-concept trial of 27 patients enrolled in a virtual Tai Chi program designed specifically for irritable bowel syndrome with constipation delivered over 7 weeks, we demonstrated moderate to excellent feasibility with significant improvement in IBS Symptom Severity Scores (IBS-SSS).

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Loperamide had no effect on isolated excitatory neuromuscular action in specimens of human colonic circular muscle (left). In preparations with isolated inhibitory neuromuscular action (right), loperamide reduced isometric relaxation during electrical field stimulation. Naloxone, added after loperamide, further reduced the isometric relaxation.