Peroral endoscopic myotomy: is it better to perform it in naive patients or as second-line therapy? Results of an open-label-controlled study in 105 patients.

Background: Whether Peroral Endoscopic Myotomy (POEM) can be proposed as a second-line treatment in patients with achalasia remains to be confirmed in real-life series.

Objective: This study aimed to compare the efficacy, feasibility and safety of POEM between treatment-naïve patients and patients who had prior endoscopic or surgical therapies for achalasia.

Methods: All consecutive patients who underwent a POEM procedure for achalasia in our centre from June 2015 to September 2018 were included in this retrospective study.

Altered epithelial barrier functions in the colon of patients with spina bifida.

Our objectives were to better characterize the colorectal function of patients with Spina Bifida (SB). Patients with SB and healthy volunteers (HVs) completed prospectively a standardized questionnaire, clinical evaluation, rectal barostat, colonoscopy with biopsies and faecal collection. The data from 36 adults with SB (age: 38.

Solitary rectal ulcer syndrome in 102 patients: Do different phenotypes make sense?

Background: Little is known about the pathophysiological mechanisms of solitary rectal ulcer syndrome (SRUS).

Aims: We aim to identify the different phenotypes, taking into account complaints, anatomy and anorectal physiology.

Methods: Complaints, endoscopy results, and physiology data of patients with histologically proven SRUS were collected and analysed.

Impact of Gastric Electrical Stimulation on Economic Burden of Refractory Vomiting: A French Nationwide Multicentre Study.

Background & Aims: Medico-economic data of patients suffering from chronic nausea and vomiting are lacking. In these patients, gastric electrical stimulation (GES) is an effective, but costly treatment. The aim of this study was to assess the efficacy, safety and medico-economic impact of Enterra therapy in patients with chronic medically refractory nausea and vomiting.

Management of solitary rectal ulcer syndome: Results of a french national survey: Société Nationale Française de Coloproctologie SNFCP, France.

There is no consensus on the treatment for solitary rectal ulcer syndrome (SRUS). This study aimed to obtain information from physicians treating patients with SRUS in a French medical surgical society to facilitate management plans and to develop a support algorithm. Members of the French National Society of Coloproctology (SNFCP) were invited to complete a survey that included twenty items about therapeutic management and healing criteria.

Jackhammer esophagus: Clinical presentation, manometric diagnosis, and therapeutic results-Results from a multicenter French cohort.

Background/aims: Jackhammer esophagus (JE) is a hypercontractile esophageal motor disorder defined by at least two swallows with a distal contractile integral (DCI) >8000 mm Hg.s.cm during high-resolution manometry (HRM).

Gastric Electrical Stimulation Reduces Refractory Vomiting in a Randomized Crossover Trial.

Background & Aims: There have been conflicting results from trials of gastric electrical stimulation (GES) for treatment of refractory vomiting, associated or not with gastroparesis. We performed a large, multicenter, randomized, double-blind trial with crossover to study the efficacy of GES in patients with refractory vomiting, with or without gastroparesis.

Methods: For 4 months, we assessed symptoms in 172 patients (66% women; mean age ± standard deviation, 45 ± 12 years; 133 with gastroparesis) with chronic (>12 months) of refractory vomiting (idiopathic, associated with a type 1 or 2 diabetes, or postsurgical).

Quality of life in 1870 patients with constipation and/or fecal incontinence: Constipation should not be underestimated.

Background: Quality of life is increasingly seen as important, but remains difficult to assess in patients with functional anorectal complaints.

Objective: We aimed to quantify quality of life and to analyse the symptomatic descriptors associated with a poor outcome in patients with faecal incontinence (FI) and/or constipation.

Methods: The characteristics of the patients, data from self-administered questionnaires and from physical examinations were evaluated prospectively for all cases of functional anorectal disease over a period of thirteen years.

Defecation disorders in Spina Bifida: Realistic goals and best therapeutic approaches.

Aims: Spina Bifida (SB) is a rare congenital condition that frequently impairs the neurological control of both fecal continence and defecation. Several therapeutic strategies have been proposed but impact assessment is lacking. Our objectives were to quantify the symptomatic improvement and to determine the optimal strategy in this rare condition where randomized controlled trials are difficult to conduct.

A systematic literature review on solitary rectal ulcer syndrome: is there a therapeutic consensus in 2018?

Purpose: To screen all treatments tested for solitary rectal ulcer syndrome (SRUS) without rectal prolapse and to assess their efficacy.

Method: A systematic review was performed according to the PRISMA guidelines, focusing on the treatment of SRUS without rectal prolapse. The types of treatment and their efficacy were collected and critically assessed.

Clinical practice guidelines from the French National Society of Coloproctology in treating chronic constipation.

Chronic constipation is a common symptom that regularly affects the quality of life of adult patients. Its treatment is mainly based on dietary rules, laxative drugs, perineal rehabilitation and surgical treatment. The French National Society of Coloproctology offers clinical practice recommendations on the basis of the data in the current literature, including those on recently developed treatments.

Bowel Dysfunction Related to Spina Bifida: Keep It Simple.

Background: Although care of urological disorders in spina bifida is well established, there is yet no agreement on a standardized approach to bowel dysfunction in this population.

Objective: The purpose of this study was to assess bowel dysfunction using validated instruments and the risk factors in adults with spina bifida.

Design: A multidisciplinary team prospectively collected patient data, focusing on anorectal and urological symptoms.

Fecal incontinence in patients with spina bifida: The target is the rectum.

Aims: The prevalence rate of severe fecal incontinence (FI) in adults with spina bifida (SB) is high. The physiological basis of FI in SB has not been clearly established, which contributes to inadequate care. The aim was to better characterize a large cohort of adults with special consideration of anorectal physiology.

Factors Associated with Fecal Incontinence in Women of Childbearing Age with Crohn's Disease.

Background: Fecal incontinence is common in women with Crohn's disease, but little is known about the impact of childbirth, perianal Crohn's disease, and past surgical history on fecal incontinence.

Methods: Self-administered questionnaires were mailed to consecutive women referred to a tertiary gastroenterology centre with a focus on fecal incontinence and childbirth. These data were cross-referenced with a prospective database of the same patients' own Crohn's disease histories.

[Factors and clinical forms of gastroesophageal reflux disease in adults].

Factors and clinical forms of gastroesophageal reflux disease in adults. Gastro-oesophageal reflux (GERD) is a common complaint. Factors involved in GERD are the antireflux barrier dysfunction, the oesophageal sensitivity disorders, impaired oesophageal clearance, the acid component of the refluxate, and impaired gastric emptying.

High-Resolution Manometry Improves the Diagnosis of Esophageal Motility Disorders in Patients With Dysphagia: A Randomized Multicenter Study.

Objectives: High-resolution manometry (HRM) might be superior to conventional manometry (CM) to diagnose esophageal motility disorders. We aimed to compare the diagnosis performed with HRM and CM and confirmed at 6 months in a multicenter randomized trial.

Methods: Patients with unexplained dysphagia were randomized to undergo either CM or HRM.

Pharyngeal pH alone is not reliable for the detection of pharyngeal reflux events: A study with oesophageal and pharyngeal pH-impedance monitoring.

Background: Pharyngeal pH probes and pH-impedance catheters have been developed for the diagnosis of laryngo-pharyngeal reflux.

Objective: To determine the reliability of pharyngeal pH alone for the detection of pharyngeal reflux events.

Methods: 24-h pH-impedance recordings performed in 45 healthy subjects with a bifurcated probe for detection of pharyngeal and oesophageal reflux events were reviewed.

Long-term results of pneumatic dilatation for relapsing symptoms of achalasia after Heller myotomy.

Background: The aim of this study was to assess the efficacy and safety of pneumatic dilatation (PD) to treat symptom recurrence after Heller myotomy (HM).

Methods: Consecutive patients receiving PD for relapsing symptoms following prior HM were included in this retrospective single-center study. Eckardt score ≤3 and/or ∆ Eckardt (difference between Eckardt score before and after dilatation) ≥3 defined the success of initial dilatation.

Normal values of pharyngeal and esophageal 24-hour pH impedance in individuals on and off therapy and interobserver reproducibility.

Background & Aims: Combined pH and impedance monitoring can detect all types of reflux episodes within the esophageal lumen and the pharynx. We performed a multicenter study to establish normal values of pharyngeal and esophageal pH-impedance monitoring in individuals on and off therapy and to determine the interobserver reproducibility of this technique.

Methods: We collected ambulatory 24-hour pH-impedance recordings from 46 healthy subjects by using a bifurcated probe that allowed for detection of reflux events in the distal and proximal esophagus and pharynx.

Overt rectal prolapse and fecal incontinence.

Purpose: Rectal prolapse is frequently associated with fecal incontinence; however, the relationship is questionable. The study was designed to evaluate fecal incontinence in a large consecutive series of patients who suffered from rectal prolapse, focusing on both past history, anal physiology, and imaging.

Methods: Eighty-eight consecutive patients who suffered from an overt rectal prolapse (72 women, 16 men; mean age, 51.

Esophageal pH-impedance monitoring and symptom analysis in GERD: a study in patients off and on therapy.

Introduction: Combined esophageal pH-impedance monitoring allows detection of nearly all gastroesophageal reflux episodes, acid as well as nonacid. However, the role of nonacid reflux in the pathogenesis of symptoms is poorly known. The aim of this study was to evaluate the diagnostic yield of this technique in patients with suspected reflux symptoms while on or off PPI therapy.