Gastrointestinal motility disorders in inflammatory bowel diseases

The relationship between motility and inflammatory gastrointestinal disorders is at the same time complex and intriguing since these conditions might share some genetic, environmental, immunological and microbial predisposing factors. In addition, significant symptom overlapping may occur, muddling the waters within the clinical context. Although on one hand this represents a challenge for the clinician for a potential under- or over-treatment and diagnostic delay, on the other hand it possibly represents an opportunity for the researcher to better disclose the intimate relationship between chronic (often low-grade) inflammation, motor disorders and deranged sensory function. The best example is probably represented by Crohn’s disease and ulcerative colitis. In fact, a number of gastrointestinal motor disorders have been described in association with these diseases, disorders which span from the esophagus to the anorectum, and which will be extensively covered in this review. It is conceivable that at least part of this derangement is strictly related to inflammatory cytokine trafficking and neuromuscular changes; however, given the high prevalence of functional gastrointestinal disorders in the general population, this overlap might also be serendipitous. However, it is worth noting that literature data on this topic are relatively scarce, sometimes quite outdated, and mostly focused on the interplay between irritable bowel syndrome and inflammatory bowel disease. Nevertheless, both researchers and clinicians must be aware that symptoms related to gastrointestinal motility disorders may be highly prevalent in both active and inactive inflammatory bowel disease, correlate with greater psychological comorbidity and poorer quality of life, and may negatively influence the therapeutic approaches.

Clinical observation on functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor treated with electroacupuncture

Objective To observe the effects on functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor treated with electroacupuncture. Methods Twenty-nine cases of functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor were randomized into electroacupuncture group （19 cases） and control group （10 cases）. In electroacupuncture group, routine treatment after gastrointestinal operation and electroacupucture treatment were applied, Zusanli （足三里 ST 36）, Shangjuxu （上巨虚 ST 37）, Xiajuxu （下巨虚 ST 39） and Hegu （合谷 LI 4） were applied with electroacupuncture; in control group, the routine treatment after gastrointestinal operation was only applied. Anus exhaust, defecation, abdominal distension, stomachache, amount of gastrointestinal decompression drainage and changes of borborygmus were observed in two groups. Results Anus exhaust, defecation, abdominal distension, stomachache, amount of gastrointestinal decompression drainage and changes of borborygmus were relieved in two groups; and the effects of abdominal distension, anus exhaust, defecation, amount of gastrointestinal decompression drainage and borborygmus in electroacupuncture group were superior to those in control group （all P〈0.05）. Conclusion For the functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor, the theraputic effect of electroacupuncture combined with routine treatment after operation is better than the routine treatment after operation.

Long-pulse gastric electrical stimulation protects interstitial cells of Cajal in diabetic rats via IGF-1 signaling pathway

AIM: To investigate the effects of different parameters of gastric electrical stimulation (GES) on interstitial cells of Cajal (ICCs) and changes in the insulin-like growth factor 1 (IGF-1) signal pathway in streptozotocin-induced diabetic rats. METHODS: Male rats were randomized into control, diabetic (DM), diabetic with sham GES (DM + SGES), diabetic with GES1 (5.5 cpm, 100 ms, 4 mA) (DM + GES1), diabetic with GES2 (5.5 cpm, 300 ms, 4 mA) (DM + GES2) and diabetic with GES3 (5.5 cpm, 550 ms, 2 mA) (DM + GES3) groups. The expression levels of c-kit, M-SCF and IGF-1 receptors were evaluated in the gastric antrum using Western blot analysis. The distribution of ICCs was observed using immunolabeling for c-kit, while smooth muscle cells and IGF-1 receptors were identified using alpha-SMA and IGF-1R antibodies. Serum level of IGF-1 was tested using enzyme-linked immunosorbent assay. RESULTS: Gastric emptying was delayed in the DM group but improved in all GES groups, especially in the GES2 group. The expression levels of c-kit, M-SCF and IGF-1R were decreased in the DM group but increased in all GES groups. More ICCs (c-kit(+)) and smooth muscle cells (alpha-SMA(+)/IGF-1R(+)) were observed in all GES groups than in the DM group. The average level of IGF-1 in the DM group was markedly decreased, but it was up-regulated in all GES groups, especially in the GES2 group. CONCLUSION: The results suggest that long-pulse GES promotes the regeneration of ICCs. The IGF-1 signaling pathway might be involved in the mechanism underlying this process, which results in improved gastric emptying.