Dear ESNM Members,
it is our pleasure to announce that the first step of the Joint ANMS-ESNM task force being created with Prakash Gyawali (ANMS) and Edoardo Savarino (ESNM) as co-chairs have completed the first part of its work and produced a Curriculum, with different subdomains sub-divided in three tiers according to different degree of expertise, for physicians who are going to increase their knowledge in Neurogastroenterology and, perhaps, developing a future career in this field. The curriculum has been submitted and accepted for publication in our Journal, Neurogastroenterology and Motility, and will be presented at the upcoming Federation of Neurogastroenterology and Motility Congress in Amsterdam (August 2018). The next steps of the Joint ANMS-ESNM task force will be to develop criteria to assess quality of academic NGM centers, utilizing curriculum and training domains from this recent publication.
Edoardo Savarino - March 2018
Click here to read the curriculum
It is becoming increasingly evident that bidirectional signalling exists between the gastrointestinal tract and the brain, often involving the gut microbiota. This relationship, commonly dubbed the gut–brain axis (or the microbiota–gut–brain axis), involves various afferent and efferent pathways such as the vagus nerve and the hypothalamic-pituitary-adrenal pathway to regulate aspects of homeostasis such as satiety and hunger, and inflammation. Disruption of the gut–brain axis has been shown to be involved in the pathogenesis of a diverse range of diseases, including Parkinson disease and irritable bowel syndrome. This emerging area of research is evolving quickly.
For the ful collection by nature.com click here
Articles in the core collection have been made freely available for 6 months (until 11th July 2018)
· January 2017
The Semi-annual meeting of the Israel Gastroenterology Association
o Rome Foundation Symposium with Drs. Drossman, Simren, and Sperber
o Sessions on NeuroGI issues with Drs. Tack, Simren, Sifrim, Fass
o Workshop on Guidelines for the Treatment of GERD
· June 2017
Semi-annual meeting of Israel Gastroenterology Association
o Formulation of Guidelines for Manometry and pH-testing reports (with Dr. Sifrim)
o Lectures on IBS and GERD and a debate on the use of breath tests in the framework of “Choosing Wisely”
· Formulation of guidelines for the treatment of chronic constipation.
· Ongoing lectures to family doctors on GERD, constipation, gastroparesis, ENT issues as part of their CME programs
· Ongoing lectures to nurses specializing in diabetes and to endocrinologists on GI complications in diabetic patients as part of their CME programs
· The society is active in the attempt to include new drugs and technologies related to neuroGI in the Israeli basket of health services.
· Implementation of formal NeuroGI curricula for medical students in the Israeli medical schools.
· The chair, Prof. Dickman is active on the steering committee of the ESNM including preparation of the meeting in August 2017 in Cork, Ireland.
· The chair, Prof. Dickman is active on the committee for writing the syllabus for training in NeuroGI of the ASNM.
· The society is working actively with ESNM to foster collaborations with pharmaceutical companies to advance multicenter research, for example on gastroparesis.
· Young neuroGI doctors were sent to the workshop on manometry and pH testing in Izmir Turkey (directed by Dr. Bor) and will be sent to the workshop in Cluj Romania (Dr. Dumitrascu) in 2018.
· The society maintains a website for doctors and patients and conducts an Internet forum for joint consultation on complex clinical cases.
· Prof. Sperber is on the Board of Directors of the Rome Foundation, is the chair of the RF global survey of FGID epidemiology and has lectured in 2017 in meetings in Israel, Japan, the USA, Ireland, and India.
· Members of the society have published scientific papers in the medical literature and presented abstracts (oral and poster) at scientific meetings around the world.
· MJanuary 10-12, 2018 The Israeli Gastroenterology Assocaition had is biannual conference in Tgel Aviv, Israel, the Israeli Group of Neurogastroenterology was involved with 3 sessions
Ram Dickman - February 2018
The Italian Society of Neurogastroenterology and Motility (SINGEM) (originally GISMAD: Gruppo Italiano per lo Studio della Motilità dell’Apparato Digerente) was founded in 1983 during its first national meeting which was held in Bologna to gather investigators with a specific interest in physiological and pathophysiological aspects of esophageal, gastric, intestinal and colorectal motility patterns. Since then national meetings have been regularly organized every other year:
I Bologna - Novembre 1983
II Genova - Marzo 1986
III Cortina D’Ampezzo (Bl) - Gennaio 1988
IV Sirmione (Bs)- Aprile 1990
V Marina di Ravenna (Ra) - Luglio 1992
V I Sorrento - Settembre 1994
V II Perugia - Giugno 1996
V III St. Vincent - Febbraio 1999
IX Milano Marittima ( Ra) - Settembre 2000
X Marina di Ostuni( Br) - Maggio 2002
XI Palermo - Ottobre 2004
XII Gardone Riviera (Bs) - Aprile 2007
XIII Napoli - Settembre 2008
XIV Venezia-Mestre- Marzo 2011
XV Firenze, Aprile 2013
XVI Roma, 7-9 Maggio 2015
XVII Milano, 9-11 Marzo 2017
Over the years the interests of the society have expanded beyond GI motility to embrace all aspects of current Neurogastroenterology, thus attracting an increasing number of gastroenterologists, surgeons, biologists, pharmacologists, leading to the actual number of 196 active members.
In addition to the biannual national meeting, SINGEM implemented other scientific and educational events in Italy: hands-on courses designed to diffuse manometry and pH-metry skills among young Italian investigators collaborative studies among Centers with common interests, organization of and collaboration with groups of patients with different neurogastroenterological
diseases including achalasia and chronic intestinal pseudo-obstruction.
The 17th SINGEM meeting organized in Milan was preceded, according to an established tradition, by a practical course, with 80 trainees in Gastroenterology participating, while 200 registered delegates participated in the core meeting with a scientific program including 5 invited lectures, 9 oral presentations and 35 posters. Young investigators awards were distributed.
Due to recently introduced requirements of the Italian Ministry of Health for a Scientific Society to be officially acknowledged as such, the original statute of GISMAD has been updated and the opportunity was taken to change the original name into SINGEM. At the same time the website of the society is also undergoing a major renewal and can be reached at the address www.singem.it.
SINGEM is proudly an active member of ESNM
Giovanni Barbara - March 2018
Sixty-five participants from different disciplines gathered at the Palotti Haus in Freising at the occasion of the 25th annual meeting of the German Society of Neurogastronenterology and Motility (DGNM) from March 2-4, 2018. The meeting started on Friday afternoon with a dinner followed by a get together party. Saturday morning F. Reimann from Cambridge (UK) gave a state of the art lecture on nutrient sensing by enteroendocrine cells in the intestine.
During the 25th anniversary meeting, 33 talks were given in eight sessions. These were dedicated to basic science (ENS, translational – food intake stress, motility, inflammation, methods, ENS, microbiome, probiotics, pancreas) and clinical science (motility and diverticular disease) and given by mainly youngsters who reported on their ongoing projects. A highlight was the lecture given by Peter Neckel from Tübingen on tissue clearing in neurogastroenterology who had received the DGVS Research Award of the Neurogastroenterology Foundation in 2017.
At the general assembly on Saturday evening, members of the society were updated on the activities of the national and international societies. In addition, Beate Niesler gave a progress report on GENIEUR, the UEG-LINK project Help EU in IBS, and actual ESNM activities. Furthermore, she encouraged people to attend a retreat at Kloster Schöntal entitled Gut Brain Axis in Health and Diseases that she organized within the frame of the Heidelberg Center of Interdisciplinary Neuroscience. Martha Anna Schalla from Berlin and Stefanie Schmitteckert from Heidelberg were awarded with Martin Wienbeck Travel Grants.
After the Sunday lectures the meeting was concluded with a common lunch. The next meeting will take place in Berlin on March 22-24, 2019
Beate Niesler - March 2018
Between 21st and 24th March 2018, the Romanian Society of Gastroenterology together with Turkish Society of Gastroenterology, and the Romanian Society of Neurogastroenterology organized in Cluj-Napoca, Romania a Hands-on Course on Gastrointestinal Manometry and Functional Investigations.
The Course was endorsed by ESNM and funded by UEG Educational Grant. 20 trainees from Belarus, Egypt, Germany, Greece, Israel, Italy, Lebanon, Moldova, Poland Romania and Turkey have been trained in HR Esophageal and Anorectal Manometry, Impedance-pH metry and Breath tests. The course was a success due to the International Faculty: Serhat Bor, Giuseppe Chiarioni, Edoardo Savarino, Radu Tutuianu together with the local faculty Dan Dumitrascu (principal organizer), Vasile Drug, Teodora-Surdea Blaga and Ion Bancila.
A future similar course is plan for the next year.
Vasile Drug - March 2018
The 7th GMFH Summit was – everybody agreed to this – the very best so far, at the highest scientific level, with an extraordinary panel of experts and a highly motivated audience: In total 391 participants (31 faculty, 46 individual registrants, 314 key-opinion leaders brought in by the three sponsoring companies, Danone, Biocodex, Sanofi), from 55 (!) different countries around the globe, attended three plenary sessions and seven workshops, and visited 22 (few, but excellent) posters. Rooms were packed with people from the very first (see picture: Fernando Azpiroz and Francisco Guarner opening the meeting) to the last session. Details of the lectures can be caught from the website (www.gutmicrobiotaforhealth.com). The Board of Directors of the Section that met on Saturday agreed that the format and the size should stay about the same, at least in the years the ESNM is hosting the summit (next: in 2020), and the sponsors have confirmed their persistent interest in doing so.
Paul Enck - March 2018
The Spanish Society of Neurogastroenterology and Motility (Grupo Español de Motilidad Digestiva GEMD) was created 1992 by a group of enthusiastic gastroenterologists and surgeons interested in the study of GI-motility. The first meetings of the Society were rather meetings of a group of friends with common interest in GI-motility. They met to discuss practical aspects related to motility studies, like the pitfalls and advantages of the devices available for motility studies, interpretation of traces, and discussion of difficult patients. During the following years, the progressive incorporation of new gastroenterologists, physiologist, and a growing number of professionals interested in neurogastroenterology and motility has led to the actual Grupo Español de Motilidad Digestiva (GEMD), an active medical Society with more than 400 active affiliates.
November 17-18th 2017, GEMD celebrated its 25th annual meeting in Valencia. 150 registered delegates participated in the meeting. The annual meeting was preceded by the 7th Course of Neurogastroenterology and Motility for trainees in Gastroenterology. This is a 2-days course, designed to give the Spanish trainees in Gastroenterology a review of the most prevalent motor and functional gastrointestinal disorders, focusing on the clinical recognition, diagnosis, and practical management of patients in clinical situations.
During the annual meeting of the Society, up-to-date symposia on both basic and clinical aspects of neurogastroenterology and motility were presented by national and international experts. Specifically, this year’s meeting included symposia on oro-pharingeal dysphagia, colonic motility, anal incontinence, probiotics, diarrhoea and IBS. The latest research studies produced by the Spanish groups were presented in a free papers session, and the collaborative studies promoted by the Society were also presented during the meeting.
In addition to the annual national meeting, GEMD endorses and assists with reputed speakers different local meetings related to the topic, and promotes collaborative studies between the different groups across the country. Likewise, GEMD acts as a support for the healthcare authorities and the pharmaceutical and healthcare industry, giving advice on different issues related to development and commercialization of new treatments and devices. GEMD assist in the identification of key opinion leadersKOL and National Research Centres that can be suited for performing reliable studies, basic, translational, and clinical trials. In addition, GEMD is an active member of ESNM, and collaborates with the Spanish Societies of Gastroenterology, participating in the Steering Committees of the Societies, and playing a central role in the issues related to neurogastroenterology and motility. After 25 years, GEMD is an active and growing independent medical Society well consolidated as the reference for neurogastroenterology and motility in Spain.
Jordi Serra - November 2017
The celebration of 30 years anniversary of Scandinavian Association of Neurogastroenterology and Motility (SAGIM) was held at Tivoli Hotel Copenhagen the 24th November 2017. More than 65 keen participants and industrial business partners attended the meeting.
The meeting was organized by Lotte V. Fynne, Anne Krarup, Asbjørn M. Drewes and Mette W. Klinge and sponsored by SynMed, Kebomed, Meqnordic and Kyowa Kirin.
This year hot topics were defecation disorders master class, “electroceuticals” and new technics, diarrhoea master class and two smaller interesting topics in the neurogastroenterology and motility field; Opioid induced bowel disorders and cases from the oesophageal motility lab.
Asbjørn M. Drewes SAGIM´s president opened the annual meeting. We had the pleasure to present Peter Funch-Jensen as the jubilee principal speaker. He was one of SAGIM´s founders together with Hasse Abrahamsson and Jon Haffner. He presented a nostalgic speech reaching from the idea of SAGIM in 1986, the first meeting in October 1987 to what SAGIM has become during the thirty years.
Anton Emmanuel held the first master class, he was lecturing in defecation disorders and pelvic floor dysfunction. He requested us to remember that Hirsprungs disease is frequent occurring and sequelae are seen in adults. But he also mentioned to get a thorough history from the patient before starting treatment.
“Posters in the spotlight” followed his master class. Three young investigators presented their fascinating work.
Peter Christensen, Klaus Krogh and Mette Klinge presented aspects of electroceutical treatments for faecal incontinence and gastric electrical stimulation. Novel technics in treating incontinence were presented. Different hot topics were presented in session III by two experienced lectures. Asbjørn M Drewes and Daniel Sifrim presented cases on opioid induced bowel dysfunction and rarities in the oesophageal motility lab. The last master class in diarrhoea was presented by Ole Bonderup and closed by a case report about IBS-D presented by Anne Krarup. Mette Klinge made the closing remarks.
SAGIM general assembly closed the 30-year anniversary meeting. It was agreed that the day before next meeting in 2018 would be used for a networking PhD. day. As the tradition prescribes this meeting was a great time for intellectual interaction, new investigator collaborations and for friendship.
Asbjørn Mohr Drewes - November 2017
In November 2017, Lyon hosted an international meeting on « Guidelines on esophageal function testing and interpretation ». This event was endorsed by ESNM. An interactive clinical session was conducted on November 9th to discuss diagnostic and therapeutic management of difficult patients with functional digestive disorders. On November 10th, the conclusions of an international working group on GERD testing were reported during the “Lyon GERD consensus meeting”. The working group met several times at UEGW and DDW between 2014 and 2016 to provide guidelines on functional testing for the diagnosis of GERD (1). ESNM supported the UEGW meetings. During the “Lyon GERD consensus meeting”, outstanding speakers from Europe and USA (CP Gyawali, P Kahrilas, F Mion, J Pandolfino, S Roman, E Savarino, D Sifrim, A Smout, J Tack, R Tutuian, M Vaezi, M Vela, F Zerbib) presented the recommendations and discussed the limitations and the areas that required improvements. The meeting was well attended by more than 50 participants from all over the world (France, Switzerland, Belgium, Italy, UK, USA, Ireland, Norway, Netherlands, Spain, Romania, Germany, Lebanon, Morocco, South Africa, Colombia, United Arab Emirates, South Korea, and Australia). Discussion with the speakers was fruitful and launches the basis for future collaborative studies.
Sabine Roman - November 2017
Publications resulting from the preliminary conclusions
Roman S, Gyawali CP, Savarino E, Yadlapati R, Zerbib F, Wu J, Vela M, Tutuian R, Tatum R, Sifrim D, Keller J, Fox M, Pandolfino JE, Bredenoord AJ; GERD consensus group.
Ambulatory reflux monitoring for diagnosis of gastro-esophageal reflux disease: Update of the Porto consensus and recommendations from an international consensus group.
Neurogastroenterol Motil. 2017 Oct;29(10):1-15. doi: 10.1111/nmo.13067. Epub 2017 Mar 31. Review.
Gyawali CP, Roman S, Bredenoord AJ, Fox M, Keller J, Pandolfino JE, Sifrim D, Tatum R, Yadlapati R, Savarino E; International GERD Consensus Working Group.
Classification of esophageal motor findings in gastro-esophageal reflux disease: Conclusions from an international consensus group.
Neurogastroenterol Motil. 2017 Dec;29(12). doi: 10.1111/nmo.13104. Epub 2017 May 24. Review.
Savarino E, Bredenoord AJ, Fox M, Pandolfino JE, Roman S, Gyawali CP; International Working Group for Disorders of Gastrointestinal Motility and Function.
Expert consensus document: Advances in the physiological assessment and diagnosis of GERD.
Nat Rev Gastroenterol Hepatol. 2017 Nov;14(11):665-676. doi: 10.1038/nrgastro.2017.130. Epub 2017 Sep 27. Review.
From 24th to 26th November 2017. CANM - Croatian Association of Neurogastroenterology and Motility in collaboration with Croatian Society of Digestive Surgery and Croatian Society of Gastroenterology organized the symposia entitled “Probiotics in Digestive Medicine”.
The programme covered different topics regarding the gut microbiome including identification of healthy gut microbiome, diagnostic importance of dysbiosis and presentation of different microbiological techniques. In the second part of the conference, we covered the most important indications for probiotic usage such as IBD, FGID, H. pylori eradication therapy. Moreover, some emerging fields such as use of of probiotics in the perioperative phase and during chemotherapy was covered.
For the first time in Croatia, more than 220 participants (gastroenterologist, digestive surgeons, microbiologists, infective disease specialists, pharmacists, general practitioners, and oncologists) and 25 renowned speakers from nine European countries attended the meeting regarding probiotics in digestive medicine.
Endorsement from ESNM has improved the importance of the meeting and accentuated international visibility.
Goran Hauser - December 2017
The 25th UEG Week took place in Barcelona from the 28th October to the 1st November 2017 and was attended by other 12,000 delegates with over 1,000 lectures delivered. There were a number of highlights during this year’s UEG Week, but the sheer diversity of the programme, encompassing both clinical and basic science, was excellent under the UEG initiative of ‘Today’s science, tomorrow’s medicine’.
There was a bespoke neurogastroenterology and motility track including a one-day ‘advances in clinical gastroenterology and hepatology’ symposium, highlighting how the clinical management of functional GI disorders and gastroesophageal reflux disease has advanced over the last couple of years. There were excellent symposia on the clinical trials in functional gastrointestinal disorders and the management of pelvic floor disorders. Many congratulations to Professor Wilder Smith, From Bern in Switzerland, for being awarded the UEG Journal Best Paper Award for his publication entitled “Gastro-oesophageal reflux is common in oligosymptomatic patients with dental erosion: A pH-impedance and endoscopic study.” Similarly, congratulations to Dr Nicolas Cenac for his award as a UEG Rising Star.
Adam Farmer - December 2017
The European society on Neurogastroenterology and Motility has lost one of its leading authorities in the field of gastrointestinal peptides. After a long and devastating illness Theo Peeters has passed away in his home in Leuven on July 11th 2017.
Theo Peeters was a biochemical engineer by training and after a postdoctoral fellowship at the
University of Kentucky in Lexington, he started his scientific career at the University of Leuven in 1970 with the development of biochemical assays to support the ongoing clinical research. Soon he was able to start his own basic research laboratory and became professor in 1993. His research has contributed to our understanding on the role of the gut peptides, motilin and ghrelin, in the control of motility and food intake. He was one of the pioneers to show that the antibiotic erythromycin acts as a motilin agonist to accelerate gastric emptying. The development of this new class of gastroprokinetics remained the main focus of his interest until the end of his career.
Theo Peeters has been member of the steering committee of several societies including the ESNM (2000-2006) where he served as long-term treasurer until 2008, and has been a great mentor for numerous young scientists both at the national and international level. He has organized several international meetings with great enthusiasm and was a real ambassador for the University of Leuven. Theo Peeters was more than a scientist: he had a broad interest in bioinformatics, astronomy, history, philosophy and religion. This allowed him to integrate different visions and to have a strong personal opinion on certain topics.
We will miss him.
Inge Depoortere - July 2017
The Turkish Neurogastroenterology Motility Study Group was created in 2008. It continues to work under the umbrella of the Turkish Society of Gastroenterology. Since it was established every year there has been 3 to 4 scientific activities held annually in university and training hospitals in different regions of Turkey. Five activities were organized in 2016. A one-day meeting on Impedance / Impedance HR was held at Kocaeli University on March 2016. In this meeting, the theoretical information was followed by the analysis on the tracings.
The second meeting on Esophageal High Resolution Manometry (HRM) was held on June 11, 2016 at the Department of Gastroenterology at the University of Ankara. After the theoretical information about HRM in the morning, the HRMs of the cases were studied in the afternoon, and then the traces were analyzed after being interpreted.
In the National Gastroenterology Week, the commonly drugs used such as PPI, simethicone, domperidone, alginic acid and probiotics were discussed in the panel. Talks were organized regarding the efficacy of those drugs, with pro/con-type of discussion. On the last day of the meeting, a 1-day GERD course was organized. In the first part of the course, reflux pathophysiology, symptoms, diagnostics such as 24-hour impedance pH, mucosal impedance, ambulatory capsule pH monitoring, endoscopic classification of esophagitis with video images and classification of Barrett's esophagus were evaluated. In the second part of the meeting, life style changes in GERD treatment, drugs used in GERD therapy (antacids, alginic acid, prokinetics, acid inhibitors), surgery treatment by the view of surgeon, endoscopic treatment by the view of gastroenterologist were discussed. At the end of the course, GERD therapy was summarized according to Turkish GERD consensus report.
Mehmet Bektas MD, Coordinator TSG Neurogastroenterology & Motility Study Group - August 2017
Poland was this year’s partner country of the Annual Meeting of the German Society of Gastroenterology held in Dresden, September 13-16, 2017. Members of the Polish Group of Neurogastroenterology and Motility were among Polish gastroenterologists and scientists invited for “Viszeralmedizin 2017”. They presented three talks during the session “Neurogastroenterology – from Bench to Bedside”: “The blood-brain-gut barrier – an emerging concept in gastroenterology” (Wojciech Marlicz), “The role of gut microbiota in Parkinson’s disease” (Agata Mulak) and “The role of nutrition in irritable bowel syndrome” (Jakub Fichna). The session was co-chaired by prof. Grażyna Rydzewska – President of the Polish Society of Gastroenterology and prof. Ewa Małecka-Panas – Secretary of the Society.
One week later, during the national meeting of Polish gastroenterologists organized by prof. Ewa Małecka-Panas and prof. Anita Gąsiorowska in Łódź, September 22-23, 2017, the Polish Neurogastro Group prepared a session on neurogastroenterology chaired by Elżbieta Czkwianianc, Krzysztof Gil and Agata Mulak. Common pathogenetic links between IBS and metabolic syndrome were presented by Marek Waluga, Wojciech Marlicz talked about the influence of diet and exercising on the gut microflora and Jakub Fichna gave a lecture on the role of endocannabinoids in metabolic disorders. The session was followed by a stimulating discussion.
Photo: Members of the Polish Neurogastro Group, Łódź, September 23, 2017. From left to right: Krzysztof Gil, Agata Mulak, Marek Waluga, Jakub Fichna, Wojciech Marlicz
Agata Mulak – September 2017
The Polish Neurogastroenterology and Motility Group has become fully affiliated to the European Society of Neurogastroenterology and Motility (ESNM) in April 2017. The formal reactivation of the Group in the structures of the Polish Society of Gastroenterology took place in 2015. The members of the current Management Board of the Group elected in 2016 are: president – Agata Mulak, vice-president – Krzysztof Gil, treasurer – Marek Waluga, secretary – Adam Smereka, and members – Tomasz Brzozowski, Krzysztof Celiński, Jakub Fichna, Leszek Paradowski. Currently, the Polish Neurogastroenterology and Motility Group consists of 28 members.
Historically, there are several important Polish traces in the European community of researchers studying the brain-gut axis interactions. Prof. Stanisław Konturek, the Polish nestor of gastroenterology, had been one of the founding members of the ESNM. Among former members of the ESNM Steering Committee were also Prof. P.J. Thor (1992-1998) and Prof. R.M. Herman (1998-2004). Prof. L. Paradowski, the head of the former Polish Motility Group for several years, had been the editor of the Polish book on functional gastrointestinal disorders (published in 2007 and 2012).
In 2008 in Zagan (Poland), the International Conference of the Polish Motility Group was co-organized by the Department of Gastroenterology and Hepatology of Wroclaw Medical University, Poland. Prof. Paul Enck, a continuous supporter of the Polish Neurogastroenterology and Motility Group, was the distinguished guest of that meeting.
In the recent years, there is a growing interest in the field of neurogastroenterology in Poland. The members of the Polish Neurogastroenterology and Motility Group have been actively participating in a rapidly developing network among Polish and international research centers. In years 2012-2016, Prof. T. Brzozowski and Dr. A. Mulak served as Management Committee Members of COST action BM1106 – GENIEUR (The Genes in Irritable Bowel Syndrome Research Network Europe) chaired by Dr. Beate Niesler and Prof. Magnus Simrén. In 2015, Prof. J. Fichna received the prestigious United European Gastroenterology Rising Star Award. In March 2017, Dr. A. Mulak represented Poland in the Rome IV Regional Central-East European Meeting organized by Prof. Dan Dumitrascu and Prof. Vasile Drug during the Meeting of the Romanian Society of Neurogastroenterology in Iasi, Romania.
Recently, members of the Polish Neurogastro Group have been invited to actively participate in the session “Neurogastroenterology – from Bench to Bedside” during the Annual Meeting of the German Society of Gastroenterology, which will be held in Dresden, September 13-16, 2017. On September 23, 2017, a session on neurogastroenterology will be also held during the national meeting of Polish gastroenterologists in Lodz, Poland. Topics of the session include common pathogenetic links between IBS and metabolic syndrome, the influence of diet and exercising on the gut microflora and the role of endocannabinoids in metabolic disorders.
As members of the ESNM, we hope to participate in further development of international research networking in the field of neurogastroenterology.
Agata Mulak – June 2017
We are happy to report that the Israeli Neurogastroenterology group held a very comprehensive and fruitful meeting aimed at designing a common form for reporting results of high resolution manometry (HRM) and esophageal pH-impedance studies. We believe that a national standardized report that contains essential information and is simple to read will allow caring physicians to better understand the results and thus improve the tests clinical value.
The meeting was attended by an unprecedented number of 30 gastroenterologists, all with a special interest in neurogastroenterology. The guest speaker was Professor Daniel Sifrim, a leader in the field of neurogastroenterology, who opened the meeting with a thorough overview of HRM. His lecture included a review of what the test should be included, what results reported, and new special protocols for specific problems. This was followed by a "round table" discussion, moderated by Prof Ram Dickman and Dr Roy Dekel that discussed the development of a national standardized manometry report form.
The meetings second session began with another state-of-the-art lecture by Professor Sifrim about pH-impedance monitoring. This was followed by another "round table" discussion about the development of a standardized national report form for pH-impedance results.
The meeting was concluded by a lecture by Dr Rita Brun reviewing the developing Smart Pill technology.
Ari Silbermintz, M.D., Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel
Functional gastrointestinal disorders (FGIDs) are prevalent disorders in gastroenterological practice in secondary care. Nevertheless, despite these being common disorders, trainees’ exposure to dedicated training is variable across the UK. Therefore, the aims of this course were threefold. Firstly, to improve the basic knowledge base regarding these disorders. Secondly to provide the delegates with a sound grasp of the indications, as well as the interpretation, of motility and physiological testing and finally to appreciate other healthcare professional who can help with the management of patients with FGIDs as well as the patient perspective. 23 gastroenterology trainees from across the UK attended the event.
Friday 3rd March
The meeting commenced with the view of a trainee in getting experience in FGIDs (Dr D Vasant). Following this a motion entitled “This House believes IBS does not exist” was debated. Dr Imran Aziz spoke for the motion with Dr Anton Emmanuel speaking against. Reassuringly, for the meeting organisers, the motion was defeated by 21 votes to 2!
Saturday 4th March
The lecture session began with a summary of the FGIDs and their epidemiology. Professor Qasim Aziz covered the mechanisms of pain genesis and maintenance in FGIDs. Drs Akbar (NGM Chair) and Aziz provided a practical summary of how they manage IBS-D and IBS-C respectively in sessions entitled “Tips from the Coalface.” Lectures were then given on the main FGIDs including oesophageal disorders (Dr Philip Woodland), centrally mediated abdominal pain syndromes (Dr Peter Paine), gallbladder and sphincter of Oddi (Dr Shyam Menon) and functional bloating (Dr Anu Agrawal).
In the early part of the afternoon, the delegates were split into small groups and rotated around the following stations:
1. Nuclear medicine including SeHCAT testing – Dr John Oxtoby
2. Wireless motility capsule – Dr Adam Farmer
3. Breath testing – Dr Anthony Hobson
4. Oesophageal manometry and 24-hour pH-metry – Dr Philip Woodland
5. Proctography – Ms Cathy Bradbury
6. Breath testing – Dr Anthony Hobson
A series of perspectives lectures followed from the viewpoint of general practice (Dr Marianne Holmes), dieticians (Ms Celia Spruce) and from a patient from the IBS network (Ms Vicky Grant). This last lecture was particularly poignant for the delegate who gained an insight into the marked reduction in quality of life in patients with FGIDs.
Sunday 5th March
The meeting concluded with delegates presenting and discussing difficult functional gastrointestinal disorders cases.
Adam Farmer - June 2017
More than 120 participants and 25 industrial partners attended to the annual meeting of the French Group of Neurogastroenterology (GFNG) on June 22-23, 2017 in Nantes. Organized by Michel Neunlist, Malvyne Rolli-Derkinderen, Emmanuel Coron and Stanislas Bruley des Varannes, the theme was the regulation of the intestinal epithelial barrier by the microenvironment: importance of the enteric nervous system.
We had the pleasure to welcome the President of ESNM, Giovanni Barbara, talking on the alteration of intestinal permeability in functional gastrointestinal disorders.
A session was dedicated to functional GI disorders in newborns. Nikhil Thapar gave an overview on the role of the enteric nervous system and Alexis Mosca on the role of gut microbiota.
The “Diagnostic and therapeutic innovations in neurogastroenterology” session underlined the novel uses of interventional and imaging endoscopy as well as the great potential of intestinal organoids.
Brain-gut interactions in psychiatric and neurodegenerative (Parkinson disease) diseases were discussed and neuroimmune interactions in IBD and IBS were also subjects of presentations. The emerging role of the autonomous nervous system in cancer initiation and development was the topic of a key note lecture held by Claire Magnon.
The clinical symposium was on the management of fecal incontinence. A case-based discussion was also organized for the students of the “clinical neuro-gastroenterology diploma”.
Young Investigators had the opportunity to present their work (8 selected oral communications, and 8 selected posters). This year, the organization committee gave two awards, one to the best oral presentation (Marion Rincel, Bordeaux) and one to the best poster (Jacques Gonzales, Nantes).
Keeping in line with its tradition, the GFNG meeting was also a great time for friendship and we enjoyed a sunset cruise on the Erdre river.
Sabine Roman - June 2017
Since 2005, the Romanian Society of Neurogastroenterology organizes biennial congresses under the name of NeurogastRO, all with international participation. This year the NEUROGASTRO 2017 meeting was held in Iasi, between 16-18 of March 2017 together with the Rome Foundation Central and East European Meeting. The specialists in functional gastrointestinal disorders and in digestive motility gathered together with the Faculty of the Rome Foundation (Douglas Drossman, Dan Dumitrascu) and other experts to discuss the recent progress in the field and the new Rome IV criteria.
Hot topics like: genetics in IBS (Beate Niesler), Gut microbiota (Mirjana Rajilic-Staojanovic), Functional Abdominal Pain (Adam Farmer), HRM in Achalasia (Radu Tutuian), and the Pathophysiology of IBS (Guy Boeckxstaens) were included in the program. Important opinion leaders in the field and also young people from Belarus, Bulgaria, Croatia, Macedonia, Moldova, Poland, Russia, Serbia and of course Romania presented data about Functional Digestive Disorders in their countries. Local faculties presented also their research results and gave state-of the art lectures.
The meeting was successful and had 200 attendants. Participants had the opportunity to share experience and to design new action directions.
Vasile Drug - June 2017
The 1st NeuroGastro Day Switzerland took place on Saturday, June 17th, 2017, on the premises of the University Hospital Zurich.
Guided by PD Dr. Pohl, 63 attendants participated in this successful event. The scientific program rotated around three main topics: “Microbiome and Irritable Bowel Syndrome”, “Gastroesophageal Reflux and Esophageal Dysmotility” and “Placebo and Food Intolerance”.
After introduction by PD Dr. Pohl, Prof. Barbara (Bologna, Italy) gave in-depth insight on “Microbiota – friend or foe?” focusing on interaction between the microbiome, IBS and nutrition. Fellows presented challenging cases from the clinic regarding IBS, nutrient intolerance and bloating, followed by state of the art talks by PD Dr. Pohl (Zurich) and PD Dr. Burri (Basel).
The esophageal session was started out by a fascinating case of a “hyperacidic patient”, followed by a balanced view on what surgical reflux procedures offer nowadays (Dr. Borbély, Bern). Dr. Wiesel and Dr. Nichita (Lausanne) educated the audience about supragastric belching and the added value of impedance to High Resolution Manometry (HRiM). A vividly discussed case on a lymphocytic esophagitis patient was followed by a state of the art talk on “Dysphagia Assessment” by Prof. Tutuian (Berne).
After lunch, the second international guest speaker, Prof. Enck (Tuebingen, Germany), gave a stimulating lecture about “placebo and nocebo”, explaining placebo and nocebo effects in- and outside of functional gastrointestinal disorders.
Scientific lectures were accredited by the SGG (Schweizerische Gesellschaft für Gastroenterologie); we thank our dedicated sponsors Allergan®, sigma-tau®, Permamed® and Lasermed® for their support of the event.
The program was extremely well received, making this 1st SwissNGM Neurogastro day a huge success and setting the stage for a new and unique convention series to focus on Neurogastroenterology and Motility in Switzerland.
Daniel Pohl - June 2017
Turkish Society of Gastroenterology organized the National Gastroenterology Week (TSG-2016), which took place on November 22-27, 2016 at Antalya, Turkey in one of the best hotels of the world (Regnum Carya, which also hosted the G20 summit). The conference was attended by 938 delegates including 442 gastroenterologists, 201 Turkish lecturers, 10 foreign lecturers, 98 endoscopy nurses/technicians, 25 nurse lecturers and 162 industry representatives. The number of oral presentations was 74, poster presentations 318 and video presentations 6; in total, 398. The general topics were esophageal and stomach diseases, liver and pancreas diseases, IBS, motility and constipation.
Here, we would like to give brief information about the motility part of the meeting only.
One of the post-graduate courses addressed the developments in Medicine 2016. Radu Tutuian from Switzerland delivered an inspiring talk about the last developments with “GERD: 2016”, which was followed by two speeches on Esophageal Motility Disorders by Robert Bulat from Tulane University, New Orleans USA and Constipation: 2016 by Henriette Heinrich from London. Magnus Simren delivered two enlightening speeches about the IBS and Rome IV criteria entitled, respectively, “IBS: 2016” and “Functional GI Diseases: Rome IV; What's New?”.
Three additional courses were held during the congress titled "Motility Course for Endoscopy Nurses & Technicians”, to which more participants than expected attended. Ege University Motility group demonstrated and explained the different technologies including high-resolution esophageal and anorectal manometry, 24h impedance-pH etc. “Basic Life Support Course for Endoscopic Nursing & Technicians” and “Ultrasonography Course”.
In total nine satellite symposia were presented and six of them were related to upper gastrointestinal system, PPIs, constipation etc. Although there are limited new achievements regarding the “PPI world”, industry preferred to support the meeting with many different educational satellite symposia such as “inspirations from UEGW & DDW”, “What is new in the kitchen (new medications at the upper gastrointestinal tract)" etc.
Sunday there was only one additional course entitled “Advanced GERD” organized by Neurogastroenterology and Motility Study Group of TSG. About 70 delegates attended this full day course and all aspects of GERD were discussed.
The 2017 annual TSG meeting will take place on December 1 – 6, 2017 in Antalya, Turkey in the same place.
More than 200 delegates attended the XVII National Congress of Gastrointestinal Motility (GISMAD) held in Milan, March 9th-11th, 2017. The Congress was preceded by a Course on the new techniques to study oesophageal and anorectal function with about 100 attendees. It was followed by a participated meeting in which more than 90 patients with achalasia, coming from all the Country, shared their problems with a panel of experts and many others interacted from home through streaming.
The Congress was endorsed by the European Society of Neurogastroenterology and Motility (ESNM). Three distinguished speakers were invited from Europe. Frank Zerbib from Bordeaux held a keynote lecture on the current and future recommendations for reflux monitoring. Jan Tack from Leuven made a comprehensive update on fuctional dyspepsia. Maura Corsetti from Nottingham reviewed the treatment of IBS-C.
Italian experts discussed more recent advances in eosinophilic oesophagitis, the endoscopic vs surgical approach to achalasia and the medical treatment of gastro-oesophageal reflux disease. A lecture was dedicated to an update on intestinal transplantation and a symposium reviewed the influences of the intestinal microbiota on the brain gut axis both in the gastroenterology and hepatology.
The Congress was a unique opportunity to discuss the most controversial clinical issues in the area of neurogastroenterology and motility and to receive an update both on the more recent research and clinical data in the field. Last but not least 40 young researchers had the opportunity to present and discuss their own work during the oral communications and the poster session.
Also, there was time for fun! In the evening of March 9th a wonderful dinner was organised and a jazz concert entertained our guests during testing of the dishes and wines.
The congress ended with the designation of the best oral and poster presentation and with the announcement of the winners of the young and senior investigator awards.
Let’s meet in a two years’ time at the next GISMAD congress!
Roberto Penagini, Guido Basilisco, Edoardo Savarino - March 2017
Approximately one week ago I received a letter from Professor Ram Dickman, the Head of the Israel Neuro-gastroenterology Association, about a hands-on course in neuro-gastroenterology and motility disorders which was to take place in Izmir, Turkey. The conference was organized under the auspices of the European society of neuro-gastroenterology and motility (ESNM)
At first, I was somewhat apprehensive inasmuch as the conference was to take place in Turkey, in light of recent security incidents in the region. In addition, I was concerned about the very tight and full schedule of the conference which intended to cover much material in only two days. Despite my concerns and prevarication, I decided in the end to attend the conference.
Although the conference was already “full” by the time I made my late registration, Professor Dickman helped me and my registration was accepted.
I landed at the airport in Izmir at 23:00 and was met by a representative of the conference who drove me to the hotel. At the hotel, I was pleasantly surprised to see that the Chairman of the Turkish Neuro-gastroenterology Association Union and organizer of the course, Professor Serhat Bor was waiting in the lobby and welcomed each conference participant individually. I felt quite honored by Professor Bor’s personal attention and found it to be very moving.
As stated above, the course lasted two days. It included both frontal and bedside lectures. The doctors presented interesting cases to help us learn the use of various software programs and to learn to analyze the results of the different tests we were taught. These included esophageal manometry, anorectal manometry, PH + IM. Each conference participant at the conference had his or her own computer so they could practice the various programs.
The participants were divided into four groups; each team was coached by a highly experienced expert in his or her specific field. Professor Serhat Bor and Professor Mark Fox headed the groups studying motility disorders of the upper gastrointestinal tract; Professor Adam Farmer and Henriette Heinrich led the groups studying reflux disease and anorectal diseases.
The conference gave me invaluable experience and the possibility to meet and talk with many professionals in the field from around the world, during which time we could share with each other input about our work methods and different cases we have had to deal with.
The conference was an unforgettable experience both professionally and socially, thanks to the conference organizers who made the effort to create a good overall atmosphere. In addition to the professional activities, which were enhanced by the professionalism of the lecturers and the participants alike, we were taken on guided trips and feted with lavish, authentically Turkish meals.
The conference helped me greatly, on both the professional and the interpersonal levels. With this in mind I would be happy to attend future conferences on the subject, and I strongly recommend other physicians interested in the field to attend in the future.
Dr. Fahmi Shibli, Institute of Gastroenterology and Hepatology, Ha'Emek Medical Center – Afula, Israel
Eighty five participants from different disciplines gathered at the Seminaris Hotel in Berlin-Dahlem for the 24th annual meeting of the German Society of Neurogastronenterology and Motility (DGNM) from March 10 to 12, 2017. The meeting started on Friday afternoon with a patient information session entitled "Diagnosis and treatment of IBS" followed by a get together. Saturday morning Johann Ockenga from Bremen gave a plenary lecture on diet and its influence on motility from a pathological point of view taking also practical approaches into account.
In the following, 39 talks on basic science (secretion and nutrition; IBD, inflammation and cell models; microbiome, pancreas, ENS; ENS and mast cells, motility) and clinical science (IBS and nutrition, IBS and diverticular disease) were given by mainly youngsters who reported on their ongoing projects in eight sessions. Besides, Veronica Geng introduced the Manfred-Sauer-Stiftung and their activities on supporting paraplegic people in order to improve neurogenic bowel issues. A highlight was the lecture given by Miriam Goebel-Stengel who had received the DGVS Research Award of the Neurogastroenterology Foundation in 2016.
During the general assembly on Saturday evening, members of the society were updated on the activities of the national and international societies. Beate Niesler gave a progress report on GENIEUR. Then, the whole crowd met for socialising and networking. It was decided to approve up to 10 travel stipends of 500 Euro each to the ESNM NeuroGASTRO 2017 meeting in Cork later this year.
After the Sunday lectures the meeting was concluded by an "Allergan Lunch Symposium" wrapping up the state of the art in IBS treatment and future perspectives.
The next meeting will take place in Freising on March 2-4, 2018.
Beate Niesler - March 2017
The NeuroGut Young researcher meeting that took place in Gothenburg March 9+10 2017 aimed to give a comprehensive depiction of the field and its various career opportunities to the attending 10 early stage researchers from NeuroGut as well as local students and researchers. The meeting was intended to enable young researchers to develop and discuss novel ideas and explore career opportunities beyond the NeuroGut period.
Four European experts in Neurogastroenterology travelled to Gothenburg and shared their expertise on Mucosal Crosstalks and Immunology (Javier Santos from Barcelona), Brain-Gut Axis (Susanna Walter from Sweden), Clinical Neurogastroenterology (Ad Masclee from the Netherlands) and Microbiota (Mirjana Rajilić-Stojanović from Serbia). Local experts giving talks about practical aspects of functional bowel disorders in healthcare (Hans Törnblom), on how get from data to knowledge with examples from Gothenburgs neurogastro research group (Magnus Simrén), on recent developments in Systems Medicine (Marija Cvijovic), and a report of first-hand experience in academic vs industry research (Lena Öhman), complemented them. The speakers also shared their inspiring personal background stories and were available during the breaks and informal get-togethers, leading to lively discussions, networking and brainstorming throughout the whole meeting.
Taken together the meeting was a great success, tailored to early stage researchers from both clinical and basic science backgrounds and complementing their knowledge about the other by covering a wide range of subjects with a common theme. The consistently positive feedback showed this was a fruitful meeting that inspired new ideas, enhanced knowledge and brought together people for new research collaborations.
Annikka Polster - March 2017
Croatian Functional Bowel Diseases group was founded within the Croatian Society of Gastroenterology. The Croatian gastroenterology society has 546 regular and affiliated members and gathers all gastroenterologists, gastroenterology residents and other specialists involved in the field of gastroenterology and hepatology such as paediatricians, infectologists and surgeons from the whole country. The Croatian Society of Gastroenterology is a member of United European Gastroenterology and World Gastroenterology Organisation.
Initial group of 15 gastroenterologist founded CFBD and we elected prof. Dragan Jurčić, MD, PhD for president in 2015. General Assembly was held in September 201, when we elected vice-president, prof. Goran Hauser MD, PhD. Up to 62 gastroenterologists have now joined our group. During the last ESNM Steering Committee Meeting in Vienna 2016 we were accepted as affiliated society to ESNM and that was approved during the ESNM General Assembly.
From its beginnings we are dedicated to encourage excellence and advancement as well as to promote evidence based medicine and improve training and practice in the field of Neurogastroenterology and motility. The members of the group strived to achieve high standards in this area.
Our aims are:
The group organises regular meetings twice a year, and several courses for gastroenterology residents and general practitioners.
The Society strongly supports international and interdisciplinary collaboration of its members and coordinates the arrangements for visiting the centres of clinical and research excellence especially for its young members.
ESNM’s Irish representative, Dr. Niall Hyland was recently appointed Vice President - Meetings of the British Pharmacological Society and co-organised the symposium ‘The Long Reach of the Bowel: Translating Microbiome Science into Therapeutics for Systemic Human Diseases’ in London December 13th – 16th.
The topics included "Mining the human microbiome for bioactive small molecules", "Gastrointestinal hormonal responses on GPR119 activation in lean and diseased rodent models; "Bacterial signaling in the gut-brain axis"; "Renal and vascular sensory receptors that modify blood pressure control in response to changes in gut microbial metabolites" and "Engineered probiotics that reduce systemic ammonia levels in urea cycle disorder mice".
The symposium provided translational insights and a balanced view of the promise and challenges of microbiome hypothesis generation and testing, especially with respect to its metabolic role and presented the latest pharmacological tools and potential therapeutic approaches for drug discovery using bacteria.
It wasn´t the largest UEG week ever, but it was among the largest, with > 13.000 participants, nearly 2.500 attendants of the Postgraduate Course, more than 3.500 abstracts submitted and more than 2.100 abstracts presented, orally or as posters. And more than 300 were related to neurogastro topics: IBS, dyspepsia, pain, constipation, incontinence, microbiota, food (all fully searchable on the UEG website).
Nearly 600 invited lectures were recorded and are now visible online (visit myUEG at UEG.com), and among them more than 130 with neurogastroenterological content. A few of "our" topical sessions sticked far out and received overall attention: A Therapy Update on Chronic Constipation, an Update on Functional Upper GI Symptoms, and a Session on Management of Severely Disturbed GI Functions; and Microbiota as topics everywhere.
We had proposed two Rising Stars the year before, and in fact three received the award: Mira M. Wouters, Belgium, Andreas Stengel, Germany and Edoardo Saravino, Italy. And of the 20 recipients of the National Scholar Awardees 2016, 3 had neurogastro topics: Sacha Sidani, Canada, Tonje Nesvik Hustoft, Norway, and Dilyara Safina, Russia: make sure they become members of ESNM, if they aren´t yet.
Finally with UEG week, our multi-lingual Gut Microbiota E-Learning Course (in English, Spanish and German) went online as "premium content" at the UEG Education platform to become a learning tool for all European gastroenterologists, and is CME accredited. https://www.ueg.eu/education/online-courses/gut-microbiota/
Paul Enck - December 2016
www.neurogastro2017.org launched in December and outlines the key meeting themes which span basic, translational and clinical neurogastroenterology. Abstract submission as well as online Registration are open!
The meeting themes include; Dietary Interventions Including Probiotics, Prebiotics and Synbiotics; Enteric Plasticity; Neurogastroenterology: Across the Lifespan; New Technologies in Clinical Neurogastroenterology; Biomarkers in Irritable Bowel Syndrome; Treatment of Visceral Pain – Lessons from Pancreatitis; Challenges in Severe Digestive Disorders; Stress and Functional Gastrointestinal Disorders; Enterochromaffin Cells, Endocrine Cells and Brush Border Cells: Role in signaling from the lumen; Food Allergies, Intolerances and FODMAPS. The themes will form the basis for plenary lectures, symposia, free oral sessions and posters over three days.
Keep up to date with meeting information by logging on to, www.neurogastro2017.org.
The Swiss Society of Neuro-Gastroenterology and Motiliy (SwissNGM) general assembly and working group meeting took place on Wednesday 7th of December, 2016, at the «Spital Tiefenau», Bern, Switzerland. Following the assembly was a scientific program hosted by Prof. Radu Tutuian (Spital Tiefenau) and PD Dr. Daniel Pohl (President SwissNGM), dedicated to the topic «GERD-Therapy: The «Gap» between PPIs and fundoplication».
The scientific lectures were supported and accredited by the SGG (Schweizerische Gesellschaft für Gastroenterologie) and endorsed by ESNM.
The program started with a inspiring talk by Prof. Philip Katz, Past President of the American College of Gastroenterology (ACG), about unmet needs in GERD therapy. It was followed by two talks about the Swiss experience with electrical stimulation of the lower esophageal sphincter (EndoStim®) and the LINX® System by PD Dr. Yves Borbély, Bern, and Prof. Thomas Frick, Zurich, respectively. The fourth talk was held by Dr. Luca Dughera, Italy, advocating his experience in non-ablative radiofrequency GERD treatment (Stretta®).
The presentations offered a «reallife» insight in the pros and cons of procedures in GERD-therapy and stimulated vivid discussion among participants, moderators and presenters.
The British Society of Gastroenterology (BSG) Annual Meeting took place from Monday 20th to Thursday 23rd June in Liverpool. The BSG now has in excess of 3,000 members and the conference was attended by 2,200 delegates. During the plenary session Professor Michael Camilleri (Mayo Clinic, USA) gave the the Sir Arthur Hurst Lecture entitled “Advances in the Management of Chronic Constipation and Diarrhoea.”
The Neurogastroenterology and motility section of the society organized a number of symposia over the course of the meeting. Other highlights included oral presentations on functional dyspepsia by Professor Nick Talley (University of Newcastle, Austrailia) and Professor Qasim Aziz (Wingate Institute, London, UK). The best oral abstract was awarded to Dr Genhanjali Amarasinghe (Wingate Insitute, London, UK) for her work on vagal nerve stimulation in oesophageal pain hypersensitivity. Other oral presentations included work on different mechanisms of disease in subtypes of IBS as demonstrated by MRI (Dr Ching Lam, Nottingham, UK), the efficacy of eluxadoline in treatment of IBS-D in clinically relevant subgroups (Dr Leonard S Dove, Allergan, USA) and the measurement of the effect of ispaghula on gut content and function using MRI (Dr Giles Major, Nottingham, UK).
Overall there were in excess of 30 neurogastroenterology posters presented with the best poster being awarded to Professor Chris Probert (University of Liverpool, UK) for his transitional work concerning the feasibility of studying volatile organic compounds in constipation in Parkinson’s disease.
The abstracts for the meeting are available via the Gut website. http://gut.bmj.com/content/7/Suppl_1.toc
The 2017 annual BSG meeting will take place from 19 – 22 June 2017 in Manchester, UK.
The Second ESNM, Turkish Society of Gastroenterology and EgeUniversity Hands on Motility Course had been performed on 16- 17 of June, 2016 in Izmir Turkey.
The course was supported by UEG educational Grant and accredited by EACCME. In total 20 participants and four faculties attended from 11 countries.
The program covered different teaching formats such as small group teaching (5 participants each room and one faculty), hands-on training (each room had cases for demonstration), case based discussions (one half day dedicated for case discussions accompanied with live video clips from different classical or difficult cases).In addition to this each attendee had a computer and personal guidance by the faculty for the analysis of different tracings.
Oesophageal high-resolution manometry (normal and pathologic) and 24h pH / multichannel intraesophageal impedance monitoring, high resolution anorectal manometry and other investigations of continence function were shown by RaduTutuian, Francois Mion, Rami Sweiss and SerhatBor who also served also as course coordinator.
The first course was been performed in November 13-14, 2014 and completed with a big success. Feedbacks were very good; 4.9/5. In total 9 females and 11 males from 10 countries attended. Three more countries were added to the faculty list, which now reached 13 different countries.
Serhat Bor - October 2016
The second federated neurogastroenterology and motility meeting took place from the 24-28th August at the Hyatt Regency Hotel in San Francisco. The scientific content of the meeting addressed a broad range of cutting edge research topics encompassing basic, translational and clinical aspects of neurogastroenterology and motility. There were multiple formats across the meeting including state of the art lectures and original scientific abstract presentations both in oral and poster format. There were in excess of 600 delegates present at the meeting.
The meeting began with two young investigator initiatives. Firstly, there was the Little Brain Big Brain (LBBB) meeting and secondly the Young Investigator Forum (YIF), with 15 young attendees from 8 different countries, who participated in a one on one mentoring programme with established leaders in the field.
The main meeting opened on Thursday 25th August with the Rome Symposium, which addressed the multidimensional clinical profile which aims to improve patient centered treatment.
The programme on Friday 26th August began with a breakfast symposium that evaluated treatment goals in gastro-oesophageal reflux disease which was followed by a plenary session focused upon the enteric neuropathies which was opened by Professor John Wiley, president of the ANMS. The highlight of this session was Professor Roberto di Giorgio’s (University of Bolonga, Italy) lecture concerning the clinical manifestations of neuronal dysfunction who described his institution’s initial experience with orthotopic liver transplantation for mitochondrial neurogastrointestinal encephalopathy (MNGIE).
The secondary plenary session was devoted to the application of stem cells technology in the potential treatment of enteric neuropathies. During the lunch break, there were over 170 poster presentations across a diverse array of clinical and basic science topics. Topics in the afternoon included sessions on the microbiome, clinical biomarkers, esophageal disorders and food intolerances which included a session on food intolerances during which Professor Magnus Simrén (University of Gothenburg, Sweden) gave an excellent state of the art lecture on the use of low FODMAPs interventions in IBS. The day finished with an evening symposium that discussed the novel mechanisms and management of abdominal pain in functional bowel disorders.
Saturday 27th August began with parallel sessions on emerging technologies, visceral nociception, paediatric functional disorders and eosinophilic esophagitis. Over the lunch break in excess of 150 poster presentations were made. Afternoon sessions included the neuroimmunology of the gut brain axis, anorectal, gastric and intestinal disorders. Professor Fernando Azpiroz (University of Barcelona, Spain) gave an erudite lecture concerning the pathophysiology, diagnosis of gas, bloating and distension describing some excellent long term outcome data concerning EMG biofeedback.
Adam Farmer - October 2016
The organizing committee of the 14th Little Brain Big Brain meeting is pleased to report on a highly successful meetingheld from August 22nd – 25th, 2016 on the campus of the University of California,Santa Cruz. The meeting preceded the 2nd Federation of Neurogastroenterology and Motility meeting in San Francisco, CA and included 30 young investigators from across the globe – 10 from the USA/Canada, 14 from Europe and 6 from Australia. The attendees were selected from a record number of applications by an external review panel of senior scientists and leaders in the field. Funding for the meeting was generously provided by ESNM, ANMS, ANGMA, a grant from NIH/NIDDK and a variety of industry sponsors.
The meeting was designed as a forum for young investigators to propose and discuss novel ideas in neurogastroenterology and metabolic disease. This structure provided a constructive learning environment where participants gained understanding of the breadth of research in the field. The meeting also served as an informal gathering for participants to meet peers and potential collaborators who have technological and intellectual tools unavailable in their own institutions. The overwhelmingly positive feedback from participants suggests that this meeting launched many fruitful collaborations and supports the careers of the next generation of leaders in neurogastroenterology.
The recent Federation of Neurogastroenterology and Motility Meeting (FNM) in San Francisco provided the springboard to launch and promote “NeuroGASTRO 2017” – the European Society of Neurogastroenterology and Motility’s (ESNM) European meeting. NeuroGASTRO 2017 will run from August 24th- 26th and will be held at University College Cork (UCC) located near the heart of Cork city in Ireland and home to the APC Microbiome Institute. Founded in 1845, UCC is one of the oldest institutes of higher learning in Ireland. Situated on the banks of the River Lee, the university is just a five minute stroll from the city’s bustling business, shopping and entertainment districts. The university’s elegant combination of the old and the new will provide an inspiring and tranquil setting for NeuroGASTRO 2017, the centrepiece of which is the 19th century gothic quadrangle.
The first meeting of the NeuroGASTRO 2017 Scientific Committee took place at FNM and we look forward to the development of an exciting and comprehensive program for the meeting. Addressing basic, translational and clinical aspects of hot topics in neurogastroenterology, this stimulating content will be delivered across three days of plenary sessions, symposia and free presentations with further opportunity for lively debate during social events. Further information can be accessed at the meeting’s website, http://www.neurogastro2017.org/.
The view from the 33rd floor of 100 Pine Street, home of the Consulate General of Ireland in San Francisco, provided an inspiring backdrop for an evening of drinks and Irish food to celebrate Cork hosting NeuroGASTRO 2017 and we were delighted to welcome colleagues, friends and representatives from the ESNM, the American Neurogastroenterology and Motility Society (ANMS) and the Australasian NeuroGastroenterology and Motility Society (ANGMA). In particular, we would like to thank the Consul General - Philip Grant, Vice Consul - Colum Hatchell and Ms Jacqueline Keelan for their hospitality and Prof. Eamonn Quigley (Houston Methodist Hospital and APC Microbiome Institute) for providing a uniquely Irish and local perspective on the scientific and social charms of UCC and Cork. The Local Organisers would like to acknowledge the support of the Cork Convention Bureau, Failte Ireland – Business Tourism and Lori Ennis (ANMS).
The ESNM, Irish Society of Gastroenterology – Neurogastroenterology and Motility Section and APC Microbiome Institute look forward to welcoming you to Cork city in 2017!
Niall Hyland and Gerard Clarke - October 2016
Photo 1. Pictured (L to R) at the Consulate General of Ireland in San Francisco, Dr. Niall Hyland (APC Microbiome Institute, University College Cork; Local Representative NeuroGASTRO 2017), Dr. Gerard Clarke (APC Microbiome Institute, University College Cork; Local Representative NeuroGASTRO 2017), Mr. Colum Hatchell (Vice Consul, Consulate General of Ireland San Francisco) and Dr. Siobhain O’Mahony (APC Microbiome Institute, University College Cork; Local Representative TANDEM).
In 2018, it will be ESNM’s turn to host the biannual Meeting of the Federation of Neurogastroenterology and Motility (FNM). The meeting, named FNM 2018, will be the third scientific meeting of the Federation. The first and second FNM meetings were held in Guangzhou (2014) and San Francisco (2016). Before the formation of the FNM, similar joint international neurogastroenterology and motility meetings were held biannually under the name “Joint International NGM Meeting”. The last of these was the 2014 meeting in Bologna, of which many of us have particularly good memories.
It has been decided that the FNM 2018 meeting will be held in Amsterdam, the Netherlands, from Wednesday August 29 - Saturday September 1, 2018.
The RAI convention center in Amsterdam has been selected as the venue. The RAI (pronounced as “rye” rather than as “ray”) is located within the city ring and can easily be reached by foot, tram, metro, train, taxi, Uber, and bicycle of course.
Participants can choose from hundreds of options for accommodation in Amsterdam, according to preference and budget. Airbnb is widespread. There are 7 hotels within 1 km from the RAI.
The meeting will include a Postgraduate Course on Gastrointestinal Motility (taking place on the 29th of August).
A committee composed of representatives from the three member societies of the FNM (ESNM, ANMS, ANMA) and the two associate member societies (ANGMA and SLNG) will gather in spring 2017 to develop the core scientific programme.
The Section on Neurogastroenterology and Motility of the Dutch Society of Gastroenterology, chaired by Arjan Bredenoord (Amsterdam), feels honoured to act as the local host of FNM 2018.
Arjan and I are looking forward to seeing you in Amsterdam!
André Smout – October 2016
More than one-third of new patient referrals to secondary care gastroenterology clinic are ultimately diagnosed with a functional gastrointestinal disorder (FGIDs). Moreover, FGIDs also form a substantial proportion of gastroenterology consultations in primary care. Resources from the UEG (www.ueg.eu), ESNM (www.esnm.eu) and Gut Microbiota for Health e-learning (www.gutmicrobiotaforhealth.com) have contributed to improved learning and understanding of these disorders amongst both specialists and non-specialists alike.
For many busy practicing clinicians, and indeed academics, it can be an arduous task to keep up with recent developments in the literature. I would highlight two particularly useful portals in this regard. The Faculty of 1000 (f1000.com) is composed of over 5,000 faculty members who recommend recent important articles across the varied fields of biomedicine as well as rating them and providing a short summary of the data therein.In my experience the Faculty of 1000 is useful for three main reasons. Firstly, for identifying key papers in areas within Neurogastroenterology. Secondly, for highlighting papers in journals that I don't normally read and finally providing confirmation by an another expert of a paper I have read, in order to provide a second opinion. The ESNM’s journal Neurogastroenterology and Motility have recently introduced monthly accompanying podcasts of featured articles chosen by the editors-in-chief. These podcasts take the form of an interview with the senior author in order to provide an accessible summary of their research. These podcasts are available both through the journal website (http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2982) and also through YouTube (https://www.youtube.com/channel/UC8I9E-r5Ejouopc4XjieKUw) and iTunes.
Adam Farmer – July 2016
Neurogastroenterology and Motility Special Interest Group established within the Irish Society of Gastroenterology (ISG), the Society’s Winter Meeting was told in December.
The ISG has become an affiliate of the European Society of Neurogastroenterology and Motility (ESNM). The Neurogastroenterology and Motility Special Interest Group is being led by (Chair) Dr Gerard Clarke (Department of Psychiatry and Neurobehavioural Science & APC Microbiome Institute) and Dr Niall Hyland (Department of Pharmacology and Therapeutics & APC Microbiome Institute) at University College Cork (UCC).
In 2017, Ireland will host the European Society’s Neurogastroenterology and Motility European meeting, ‘NeuroGASTRO 2017’, at UCC. Further information on the Group’s activities and NeuroGASTRO 2017 will follow at future ISG National Meetings. In the meantime, we would encourage the ISG membership with an interest in this field to join this Special Interest Group when renewing their membership. ISG members who align themselves with the ISG’s Neurogastroenterology and Motility Special Interest Group will be offered membership benefits associated with ESNM including free access to the ESNM journal Neurogastroenterology and Motility.
Niall Hyland - July 2016
The gastrointestinal (GI) tract is the major depot of the key bioactive messenger serotonin (or 5-hydroxytryptamine, 5-HT), a monoamine that, together with related transporters and receptors, regulates a variety of digestive functions, including enteric motor and secretory reflexes. Enterochromaffin cells (ECs) are the main cell site (the other being, although to a lesser extent, enteric neurons) of 5-HT synthesis and storage throughout the GI mucosa (Gershon & Tack, Gastroenterology 2007). Despite the impressive acquisitions on 5-HT and related biological effects obtained in recent years, the critical aspects governing serotonin metabolism in the gut remain unclear.
A science break-through paper finally addressed this critical question (Yano et al., Cell 2015). Based on the mounting evidence that the gut microbiota / microbiome exerts an influential role on body homeostasis and that dysbiosis may contribute to various diseases (Arumugan et al., Nature 2011), Yano et al. used a wide array of technical approaches, including germ-free and conventionalized mice, knock out models and other techniques to show that indigenous spore-forming bacteria (Sp) from the mouse and human gut microbiota specifically influence 5-HT biosynthesis in ECs. The gut microbiota, via Sp, can evoke ECs to release 5-HT which affects a vast repertoire of effects, i.e. from gut physiology up to extradigestive functions, such as platelet aggregation.
The findings of Yano et al. provide unambiguous evidence indicating, for the first time, that indeed specific bacteria (i.e., spore-forming) have cross-talk with specific elements of the epithelial lining (i.e., ECs) and this interplay is key to digestive function and body homeostasis. Further study is eagerly awaited to support gut microbiota manipulation (i.e., via tryptophan hydroxylase engineered probiotics or newly designed non-absorbable antibiotics) in the clinical setting.
The diagnosis of gastroparesis is currently based on clinical symptoms and measurement of gastric emptying. The EndoFLIP® is a relative novel technique that was initially proposed to assess the distensibility of the esophago-gastric junction during distension using 8 cross-sectional areas assessed with impedance planimetry (McMahon et al. Am J Physiol Gastrointest Liver Physiol. 2007;292(1):G377-84). The group of Philadelphia evaluated pylorus distensibility in patients with gastroparesis using EndoFLIP® (Malik et al. Neurogastroenterol Motil 2015; 27:524-31). Postprandial fullness and early satiety were inversely correlated with pylorus cross sectional area, but not with distensibility. However, the correlation was weak and a wide range of values was observed. Further the group of Rouen compared pylorus distensibility in controls and in patients with gastroparesis (Gourcerol et al. Aliment Pharmacol Ther 2015; 41: 360-7). Pylorus distensibility was significantly higher in controls than in patients with gastroparesis. A weak but significant correlation was observed between pylorus distensibility and symptoms and gastric emptying. Finally, pylorus dilation was performed in patients with low distensibility. Symptoms improvement was associated with increased pylorus distensibility in these patients.
Assessing pylorus distensibility using the EndoFLIP® might be useful to segregate patients with gastroparesis and orientate treatment. However, a wide range of values was observed among patients and the correlation between symptoms and distensibility was weak. Further studies are required to determine the yield of the method in the work up of patients with gastroparesis.
S. Roman - February 2016
Belgium has a long-standing history of active research in neurogastroenterology and motility. This is embodied in the research community “Belgian Network on Gastrointestinal Regulatory Mechanisms” (www.girem.be), a research network supported by the Research Foundation-Flanders (FWO), and started 25 years ago under the dynamic leadership of Theo Peeters. The goal of the network is to facilitate collaboration between the different research groups involved and to contribute to the internalization of the scientific research carried out in the participating institutions. The participating Flemish institutions are the Translational Research Center for Gastrointestinal Disorders (TARGID) at the University of Leuven, the Laboratory of Cell Biology and Histology at the University of Antwerp, the Laboratory of Experimental Medicine and Pediatrics, Division of Gastroenterology at the University of Antwerp, the Gastrointestinal Neuropharmacology Unit at the University of Ghent, the Comparative Physiology Unit at the University of Ghent and the Neurophysiology laboratory at the University of Brussels.
In Israel, being a gastroenterologist means that you have already completed your 4-5 yrs residency in Internal Medicine and then, another 2-3 yrs residency in Gastroenterology (board exams and licenses). Then, becoming a neurogastroenterologist is only a question of personal choice since there is no structured training program for this sub-sub-specialty of gastroenterology.
In 2015 several diagnostic tools for upper GI function where evaluated and discovered like the pepsin detection in saliva (Peptest®), measuring mucosal impedance might be interesting to diagnose GERD, mucosal impedance might be evaluated during the 24-h pH-impedance monitoring, analyses of the Post-reflux Swallow-induced Peristaltic Wave Index and Nocturnal Baseline Impedance Parameters, the combination of impedance and high resolution manometry which might be useful for the diagnosis of esophageal motility disorders...
The Steering Committee of ESNM has selected the abstracts from UEGWeek 2016 relating to neurogastroenterology and rated the top-10 best considering an even distribution on basic (b), translational (t) and clinical (c) abstracts. These are shown in rank order below.
We sincerely congratulate the authors and look forward to see the full publications and to follow their future research!
1. OP404 (c) Identification of a Gut Microbial Signature Linked to Severity of Irritable Bowel Syndrome
J. Tap, M. Derrien, L. Öhman, R. Brazeilles, S. Cools-Portier, J. Doré, B. Le Nevé, H. Törnblom, M. Simren
2. OP056 (c) Diagnosis of Dyssynergic Defecation by Questionnaire and Physical Examination
G. Chiarioni, M. Ruffini, F. Cidoni, V. Ghidini, W.E. Whitehead
3. P0444 (t) Double-Blind Randomised Controlled Trial of the Effect of Dietary Fermentable Carbohydrates on the Colon Using Magnetic Resonance Imaging: Supplementary Oligofructose Increases Colonic Volume but so Does the Low Fodmap Diet
G. Major, S. Krishnasamy, C. Mulvenna, S. Pritchard, C. Hoad, L. Marciani, M. Lomer, P. Gowland, R. Spiller, on behalf of the University of Nottingham GI MRI Research Group
4. OP060 (c) Sacral Nerves Stimulation for Refractory Constipation: Preliminary Results of a Multicenter Randomized Cross-Over Double Blind Study
F. Zerbib, L. Siproudhis, P.-A. Lehur, C. Germain, F. Mion, A.-M. Leroi, B. Coffin, A. Le Sidaner, V. Vitton, C. Bouyssou-Cellier, G. Chene
5. OP111 (t) Intestinal Microbiota in Patients with IBS – High Throughput Sequencing of the Mucosa and Luminal Microbiota
N. Maharshak, R. K. Tamar, A. Lundqvist, B. R. Sartor, I. M. Carroll, Y. Ringel
6. OP162 (c) Bifidobacterium Longum NCC3001 Improves Drepssion and Reduces Brain Emotional Reactivity in Patients with Irritable Bowel Syndrome (IBS) : A Randomized, Double Blind, Placebo-Controlled Trial
M. I. Pinto-Sanchez, G. B. Hall, K. Ghajar, A. Nardelli, C. Bolino, C. Welsh, A. Rieder, J. Traynor, C. Gregory, J. Lau, A. C. Ford, G. E. Bergonzelli, M. Surette, S. Collins, P. Moayyedi, P. Bercik
7. OP265 (b) LA-DQ8 Celiac Susceptibility Gene is Important in the Development of Behavioural and Motility Changes Associated with Gluten Sensitivity
M. Pigrau Pastor, G. DePalma, S. Sidani, P. Miranda, J. Lu, J. McCarville, E. F. Verdu, S. M. Collins, P. Bercik
8. OP293 (t) OOD-Induced Dopamine Release in Extra-Striatal Regions of the Brain Reward System Predicts Food Intake in Healthy Humans
N. Weltens, L. Cool, J. Ceccarini, J. Tack, K. Van Laere, L. Van Oudenhove
9. OP 304 (b) Enteric Neuropathy Impairs Expression of Alpha7 Nicotinic Receptor in Intestinal Mucosal Macrophages: Evidence for a Neuron-Macrophage Interplay to Modulate Gut Inflammation
L. Spagnol, P. Brun, M. Scarpa, M. Scarpa, G. C. Sturniolo, F. Galeazzi, I. Castagliuolo
10. OP305 (t) Gut Microbiota Depletion Alters the Structure and Function of the Eneric Nervous System in Adolescent Mice
V. Caputi, I. Marsilio, F. Marinelli, V. Filpa, I. Lante, F. Galuppini, S. Dall'Acqua, P. Debetto, M. Rugge, G. Orso, C. Giaroni, M. C. Giron
1st nEUROgastro Tandem Young Investigator Meeting was held June 1-3, 2015 in Koç University, Turkey. The aim was to bring together scientists with clinical and basic background and to produce a long-lasting collaboration within a European network, resulting in a scientific output.
The participants came from 13 different countries, and worked more than two months together to compose a research project. The final results were presented at the NeuroGASTRO 2015 in Istanbul.
To watch the interviews with the winners click here
29 May 2015: World Digestive Health Day
Every year on May 29, patients and healthcare professionals around the globe mark World Digestive Health Day (WDHD) to show their respect for and raise awareness of the many patients who suffer from digestive disorders.
This year’s theme focuses on “Heartburn: A Global Challenge”. Chronic heartburn is often underestimated as a symptom for an underlying chronic condition: gastro-oesophageal reflux disease (GORD). Although it affects 20% of Europeans, patients often do not know how to address this condition, although effective self-management measures and medication can often already help.
To this end, United European Gastroenterology (UEG), the European Society of Neurology and Motility (ESNM) and the European Society of Gastrointestinal Endoscopy (ESGE), who produced this video: goo.gl/TQ3ude
About World Digestive Health Day
Launched in 2005 by the World Gastroenterology Organisation (WGO), the WDHD is held each year to raise awareness of different health issues related to the gastrointestinal tract. The theme for this year’s edition is “Heartburn: A Global Challenge”.
Gastroenterology developed in Romania as a specialty by itself, from the internal medicine, in the 60s of the 20th century, but the Romanian Society of Gastroenterology was found in 1958, thus being one of the 25 national societies founding the World Gastroenterology Organization.
Obviously, some of the gastroenterologists were impressed by the importance of the pathology linked to motility disorders or was simply unexplained. Hence, a group of interested physicians dedicated to the functional and motility disorders met in 2005 during an international meeting on neurogastroenterology in Brasov, in the center of Romania. It was a seminal meeting, largely supported by the Humboldt Foundation. Many specialists and their fellows met there, including participants from neighbour countries and keynote speakers were Douglas Drossman and Paul Enck. This was a moment when the awareness on functional disorders increased in this country and the need of a specialized society became obvious. Therefore, the Romanian Society of Neurogastroenterology (http://www.neurogastro.ro/) was created the same year, celebrating now its first decade. The society, was affiliated to ESNM since 2010. It organizes every second year meetings with international participation, called NeurogastRO and special sessions with international guests at the annual meetings of the Romanian Society of Gastroenterology and Hepatology. This year, NeurogastRO 2015 is held 27-30 May in Cluj-Napoca, in association with the Annual Scientific Meeting of the European Society of Clinical Investigation.
The main objectives of the society are: increasing the awareness on functional digestive disorders and on motility disorders, including their investigation and therapy, among clinicians and general practitioners; Topics related to this pathology in the training of students and residents (this policy was successful, as most students and doctors are now familiar with the management and therapy of these conditions); Stimulating research (an increasing number of papers is issued by the members of our society). Of course, progress is not easy and funding of research insufficient. However, as a group of enthusiasts, the Romanian Society of Neurogastroenterology has established its place in the Romanian gastroenterology and our members give frequently lectures in neighbor countries, where increasingly, emphasis is put on functional gastrointestinal disorders. We are confident that our activity will develop in the future.
Dan L. Dumitarscu
UEG Week 2014 - the largest and most prestigious GI meeting in Europe - is also the most hi-tech, with 11 simultaneous live streams to a global audience. And afterwards all the content is available here online at UEG Education with our new 24/7 initiative.This page highlights the most recent recordings, and everything else can be found in the Library. Access is free for UEG Week attendees - simply login to your myUEG account for immediate online viewing. For non-attendees, instant access can be purchased online.
UEG Week Vienna 2014 in Numbers:
The Gut Microbiota and Health initiative of the ESNM is pleased to provide a first set of e-learning slides on gut microbiota dedicated to gastroenterologists. It contains a selection of scientific information about the human gut microbiota.
Neurogastroenterology involves several aspects of the most emerging mechanisms behind gastrointestinal diseases. This has resulted in better understanding on basic mechanisms such as motility and assessment of peripheral nerves, but the development within areas such as electrophysiology also deserves commenting. The revolution in electrophysiology is mainly related to better computer speed and collaboration between different specialities such as neurophysiology and physics. In human research complex information captured by the electroencephalogram (EEG) has previously been reduced to quantitative measures of brain rhythmicity. However, the phasic stimuli may not reflect clinical pain characterized by hyperalgesia and allodynia. New methods such as source analysis and graph theory have made it possible to utilise the resting stage EEG to a higher degree, especially when it is made more specific such as during tonic pain. Recently, we used these methods to investigate the effect of analgesics on the brain. The figure shows how the dominant electrical brain sources can be calculated with a method called s-LORETA, which estimates the most probable generators of the resting EEG. Then we showed that neurons in several brain areas including inferior frontal gyrus and insula at frontal lobe oscillated more strongly after remifentanil infusion and that this was associated with a cognitive decline (1). The data was later subjected to graph theory, which decomposes the complex information captured by multichannel EEG into a few composite measures of the overall brain network performance and functionality. Correspondingly remifentanil disrupts the functional connectivity network properties of the EEG (2).
In neurogastroenterology investigators have previously been dependent on methods such as magnetic resonance imaging (MRI) to explore the sensory system. Even though these methods give important information about the brain function they also have many limitations, among them the high costs, bad temporal resolution, less specificity for the neuronal activity and finally very limited possibilities for advanced and visceral stimulation. The above EEG methods will make it possible to use tonic stimulation, multimodal approaches and to sensitise the gut mucosa with e.g. acid or capsaicin - and in this way mimic clinical pain. As the resting EEG is not dependent on less physiologic phasic activation (such as evoked brain potentials), the methods may pave the road for a better understanding of gastrointestinal diseases and the effect of treatment.
1. Khodayari-Rostamabad A, Graversen C, Malver LP, Kurita GP, Christrup LL, Sjøgren P, Drewes AM. Source Localization of Resting EEG after Remifentanil Infusion: A Novel Approach to Identify Cognitive Decline. Clin Neurophysiol 2014 in press.
2. Khodayari-Rostamabad A, Olesen SS, Graversen C, Malver LP, Kurita GP, Christrup LL, Sjøgren P, Drewes AM. Disruption of cortical connectivity during remifentanil administration is associated with cognitive impairment but not with analgesia. Anesthesiol 2014 in press.
At the occasion of the World Digestive Health Day, on Thursday, May 29, the United European Gastroenterology (UEG) and European Society of Neurogastroenterology and Motility (ESNM) produced a short video on the importance of gut microbes in health and disease.
The cause of irritable bowel syndrome (IBS) remains a mystery for many patients; however, recent studies suggest that in around one-third of sufferers, the syndrome may have been caused by an acute gastrointestinal (GI) infection. Professor Paul Enck from the University of Tübingen in Germany, speaking on behalf of United European Gastroenterology (UEG), says people who develop IBS after a gut infection can experience symptoms for many years. "For most people, getting a GI infection is unpleasant, but the symptoms are self-limiting and require little treatment," he explains. "However, for up to 30% of infected patients, the symptoms can persist for anything up to 10 years, and these patients are frequently diagnosed as having IBS. Given that Europeans experience an episode of GI infection on average once every 5 years, it's not surprising that the prevalence of IBS is so high."
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