Functional Gastrointestinal Disorders Diagnosed by Rome III Questionnaire in Korea

Park, Jae Myung,Choi, Myung-Gyu,Cho, Yu Kyung,Lee, In Seok,Kim, Jin Il,Kim, Sang Woo,Chung, In-Sik Korean Society of Neurogastroenterology and Motili 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.3

<P><B>Background/Aims</B></P><P>Rome criteria classifying functional gastrointestinal disorder (FGID) were updated. The aims of this study were to assess the spectra of FGID and to evaluate the applicability of Rome III criteria in Korea.</P><P><B>Methods</B></P><P>New patients who visited 2 primary clinics and 2 tertiary care hospitals were consecutively invited to complete questionnaires. These consisted of questionnaires for FGID based on Rome III criteria and symptom checklist-90-revised for somatization, depression and anxiety.</P><P><B>Results</B></P><P>A total of 786 patients was participated. Among them, FGID was observed in 49.7%. In the patients with FGID, functional dyspepsia was most common (46.0%) followed by irritable bowel syndrome (IBS, 40.2%). Functional dyspepsia was most common both in the primary care clinics and tertiary care hospitals. Postprandial distress syndrome was the most common subtype and the frequency of epigastric pain syndrome was low. There were few responders for constipation as Bristol types 1 and 2 and for diarrhea as types 6 and 7 in subtype classification using the Bristol Stool Form Scale. Thereby, unspecified IBS defined by stool form was unexpectedly common in 43.9% of IBS, whereas unspedified IBS defined by Rome III definition was 5.1%. Patients with overlap FGIDs had higher score of anxiety, depression or somatization.</P><P><B>Conclusions</B></P><P>FGIDs were common both in primary care clinics and tertiary care hospitals of Korea. Overlap FGIDs is still common by Rome III criteria, which may limits its wide application.</P>

Alterations of Colonic Contractility in Long-term Diabetic Rat Model

Kim, Sun Joo,Park, Jae Hyung,Song, Dae Kyu,Park, Kyung Sik,Lee, Jeong Eun,Kim, Eun Soo,Cho, Kwang Bum,Jang, Byoung Kuk,Chung, Woo Jin,Hwang, Jae Seok,Kwon, Joong Goo,Kim, Tae Wan Korean Society of Neurogastroenterology and Motili 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.4

<P><B>Background/Aims</B></P><P>Dysfunction of the gastrointestinal tract occurs in about 76% of patients who are diabetic for more than 10 years. Although diabetes-related dysfunctions of the stomach such as gastroparesis have been extensively studied over the recent years, studies about the mechanism underlying colonic symptoms in long-term diabetes models are rare. Therefore, the goal of our study was to clarify the nature of colonic dysfunction in a long-term diabetic rat model.</P><P><B>Methods</B></P><P>The characteristics of colonic smooth muscle were investigated in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes. These results were compared to those obtained from Long-Evans Tokushima Otsuka (LETO) control rats.</P><P><B>Results</B></P><P>Spontaneous contractility of the proximal colon was significantly decreased in the diabetic rats compared to the controls, while the spontaneous contractility of the distal colon was not. The number of interstitial cells of Cajal networks in the proximal colon was greatly decreased in diabetic rats compared to the controls. Contractility of the proximal colon in response to carbachol, an acetylcholine receptor agonist, was significantly weaker in the diabetic rats. In addition, the degree of relaxation in response to nitric oxide in the proximal colon of diabetic rats also appeared to be attenuated.</P><P><B>Conclusions</B></P><P>The results from our study suggest that the decrease of interstitial cells of Cajal network, cholinergic receptors, and neuronal nitric oxide synthase in the proximal colon plays important roles in diabetes-related dysfunction of colon.</P>

Application and Interpretation of High-resolution Manometry for Pharyngeal Dysphagia

Ryu, Ju Seok,Park, Donghwi,Kang, Jin Young Korean Society of Neurogastroenterology and Motili 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.2

<P>The pharyngeal phase of swallowing is a complex event consisted with subsequent muscular contractions and pressure generation to move a bolus from the mouth to the esophagus. Recently, high-resolution impedance manometry (HRIM) was developed and used for the evaluation of pharyngeal dysphagia. Although HRIM provides precise pharyngeal pressure information, it has yet to be used as part of routine clinical practice for the assessment of dysphagia. The main reasons are thought to be that the test method and result interpretation are not easily applicable and standardized. The anatomical landmarks for HRIM parameters are velopharynx, tongue base, epiglottis, low pharynx, and upper esophageal sphincter. With HRIM, the pressure and timing data could be obtained at a precise anatomical structure. In the present review, we will review how to apply HRIM for the evaluation of pharyngeal dysphagia, including the interpretation of its parameters.</P>

The Important Roles of Interstitial Cells of Cajal and Cholinergic Receptors on Diabetes Related Dysfunction of Colon

Korean Society of Neurogastroenterology and Motili 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.4

Role of Acid and Weakly Acidic Reflux in Gastroesophageal Reflux Disease Off Proton Pump Inhibitor Therapy

Sung, Hea Jung,Cho, Yu Kyung,Moon, Sung Jin,Kim, Jin Su,Lim, Chul Hyun,Park, Jae Myung,Lee, In Seok,Kim, Sang Woo,Choi, Myung-Gye Korean Society of Neurogastroenterology and Motili 2012 Journal of Neurogastroenterology and Motility (JNM Vol.18 No.3

<P><B>Background/Aims</B></P><P>Available data about reflux patterns and symptom determinants in the gastroesophageal reflux disease (GERD) subtypes off proton pump inhibitor (PPI) therapy are lacking. We aimed to evaluate reflux patterns and determinants of symptom perception in patients with GERD off PPI therapy by impedance-pH monitoring.</P><P><B>Methods</B></P><P>We retrospectively reviewed the impedance-pH data in patients diagnosed as GERD based on results of impedance-pH monitoring, endoscopy and/or typical symptoms. The characteristics of acid and weakly acidic reflux were evaluated. Symptomatic and asymptomatic reflux were compared according to GERD subtypes and individual symptoms.</P><P><B>Results</B></P><P>Forty-two patients (22 males, mean age 46 years) were diagnosed as GERD (17 erosive reflux disease, 9 pH(+) non-erosive reflux disease [NERD], 9 hypersensitive esophagus and 7 symptomatic NERD). A total of 1,725 reflux episodes were detected (855 acid [50%], 857 weakly acidic [50%] and 13 weakly alkaline reflux [< 1%]). Acid reflux was more frequently symptomatic and bolus clearance was longer compared with weakly acidic reflux. In terms of globus, weakly acidic reflux was more symptomatic. Symptomatic reflux was more frequently acid and mixed reflux; these associations were more pronounced in erosive reflux disease and symptomatic NERD. The perception of regurgitation was related to acid reflux, while that of globus was more related to weakly acidic reflux.</P><P><B>Conclusions</B></P><P>In patients not taking PPI, acid reflux was more frequently symptomatic and had longer bolus clearance. Symptomatic reflux was more frequently acid and mixed type; however, weakly acidic reflux was associated more with globus. These data suggest a role for impedance-pH data in the evaluation of globus.</P>

Health Related Quality of Life in Functional Gastrointestinal Disorders in Asia

Choi, Myung-Gyu,Jung, Hye-Kyung Korean Society of Neurogastroenterology and Motili 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.3

<P>The importance of health-related quality of life (HRQOL) continues to grow, as clinicians and clinical researchers have recognized the impact of the functional gastrointestinal disorders. Limited information is available on the performance of HRQOL questionnaires in Asia. Furthermore, the effect across different cultural settings of functional gastrointestinal disorders on HRQOL has been little studied in Eastern countries. We summarized recent studies on HRQOL in Korean patients with functional gastrointestinal disorders as well as other Asian literatures. Functional gastrointestinal disorders-related symptoms had a great effect on the HRQOL of Korean patients. These results and their considerable prevalence in Korea indicate that functional gastrointestinal disorders have a substantial social impact in this country.</P>