The association of coeliac disease and microscopic colitis: a large population-based study.

Background: An association between microscopic colitis and coeliac disease (CD) has been suggested in literature; however, population-based data are limited.

Aims: To estimate the degree of association between these two diseases and to identify possible risk factors for disease concomitance.

Methods: A population-based review of all patients diagnosed with CD and microscopic colitis in a large Canadian centre over a 5-year period.

Differential effects of salvinorin A on endotoxin-induced hypermotility and neurogenic ion transport in mouse ileum.

Background: Salvinorin A (SA) is the principal active ingredient of Salvia divinorum, with an established inhibitory action on gastrointestinal (GI) transit and colonic ion transport in mice. Under normal conditions, the effects of SA are mediated by kappa opioid (KOR) and cannabinoid (CB1 and CB2) receptors. However, the role of SA in pathophysiological conditions remains unresolved.

Effect of GABA-ergic mechanisms on synaptosomal NO synthesis and the nitrergic component of NANC relaxation in rat ileum.

Background: γ-Aminobutyric acid (GABA) acts on specific neural receptors [A, B and C(Aρ)] to modulate gastrointestinal function. The precise role of GABA receptor activation in the regulation of presynaptic nitric oxide (NO) synthesis in nerve terminals is unknown.

Methods: Rat ileal nerve terminals were isolated by differential centrifugation.

Percutaneous endoscopically assisted transenteric full-thickness gastric biopsy: initial experience in humans.

Background: GI neuromuscular diseases (GINMD) can cause severe dysmotility and symptoms. Full-thickness biopsy specimens may help diagnose these disorders histologically.

Objective: To assess a novel percutaneous endoscopically assisted transenteric (PEATE) biopsy method for obtaining full-thickness gastric tissue in patients with suspected GINMD.

What is nonacid reflux disease?

Proton pump inhibitors (PPIs) are the gold standard treatment for gastroesophageal reflux disease. In clinical practice, failure of PPIs occurs frequently, and may affect up to 30% of patients in a typical gastroenterology practice. Multichannel impedance monitoring combined with pH monitoring helps to detect nonacid reflux, and if symptoms correlate with these nonacid reflux episodes, nonacid reflux disease can be diagnosed.

Quantitative metabolomic profiling of serum and urine in DSS-induced ulcerative colitis of mice by (1)H NMR spectroscopy.

Quantitative profiling of a large number of metabolic compounds is a promising method to detect biomarkers in inflammatory bowel diseases (IBD), such as ulcerative colitis (UC). We induced an experimental form of UC in mice by treatment with dextran sulfate sodium (DSS) and characterized 53 serum and 69 urine metabolites by use of (1)H NMR spectroscopy and quantitative ("targeted") analysis to distinguish between diseased and healthy animals. Hierarchical multivariate orthogonal partial least-squares (OPLS) models were developed to detect and predict separation of control and DSS-treated mice.

Juvenile polyposis of the stomach--a novel cause of hypergastrinemia.

Background: A 38-year-old female presented with a 3-year history of postprandial abdominal pain, refractory nausea, vomiting and hematemesis. She appeared malnourished and her symptoms were refractory to previous treatment with acid-suppressive drugs, prokinetics and antiemetics. Her medical history was significant for a diagnosis of juvenile polyposis syndrome at the age of 14 resulting in a transverse colectomy, and a diagnosis of Crohn's disease in her residual colon at the age of 35 resulting in a total colectomy.

Botulinum toxin in the treatment of diffuse esophageal spasm.

Diffuse esophageal spasm is a primary esophageal motility disorder. The prevalence is 3-10% in patients with dysphagia and treatment options are limited. This review summarizes the treatment of diffuse esophageal spasm, including pharmacotherapy, endoscopic treatment, and surgical treatment with a special focus on botulinum toxin injection.

The novel endomorphin degradation blockers Tyr-Pro-DClPhe-Phe-NH (EMDB-1) and Tyr-Pro-Ala-NH (EMDB-2) prolong endomorphin-2 action in rat ileum in vitro.

The endogenous opioid system is involved in the control of gastrointestinal (GI) motility. The potential use of endogenous MOR ligands, endomorphins (EMs), as therapeutics is limited because of their rapid enzymatic degradation and short duration of action. Targeting enzymatic degradation is an approach to prolong EM activity.

Synthesis and biological evaluation of novel peripherally active morphiceptin analogs.

Morphiceptin (Tyr-Pro-Phe-Pro-NH(2)), a tetrapeptide present in the enzymatic digest of bovine beta-casein, is a selective ligand of the mu-opioid receptor. In the present study, we describe the synthesis of a series of novel morphiceptin analogs modified in positions 1-3. Two of the obtained analogs, [Dmt(1), D-Ala(2), D-1-Nal(3)]morphiceptin and [Dmt(1), D-NMeAla(2), D-1-Nal(3)]morphiceptin (Dmt-2',6'-dimethyltyrosine and d-1-Nal-3-(1-naphthyl)-D-alanine)) displayed very high mu-receptor affinity, resistance to enzymatic degradation, and remarkable supraspinally mediated analgesia, as shown in the hot-plate test after intracerebroventricular but not intravenous administration, which indicated that they could not cross the blood-brain barrier.

Synthesis and opioid activity of novel 6-substituted-6-demethoxy-ethenomorphinans.

A set of novel 6-substituted orvinols was synthesized and pharmacologically characterized in order to explore the effect of the polarity and steric effects of these new moieties on the opioid activity. It was revealed that longer 6-O-alkyl chains led to increased agonistic activities, while the lack of C6-etheral oxygen gave rise to an antagonistic profile at the opioid receptors in the mouse ileum.

A case of Conn's syndrome revealed after oral sodium phosphate (Fleet) preparation for colonoscopy.

Oral sodium phosphate solutions (Fleet Mcneil Consumer Healthcare, Guelph, Ontario, Canada) are commonly used as bowel cleansing agents in preparation for colonoscopic exams; however, serious electrolyte disorders associated with oral sodium phosphate use have been described in case reports including hyperphosphatemia, hypocalcemia, hypomagnesemia, hypernatremia, and hypokalemia. We describe a 57-year-old patient with a past history of resistant hypertension who experienced severe symptomatic hypokalemia following colonic cleansing with an oral sodium phosphate solution. Further investigations revealed a serum aldosterone of 691 pmol/L and a serum renin level of 0.

A novel method of full-thickness gastric biopsy via a percutaneous, endoscopically assisted, transenteric approach.

Background: Pathologic changes of the enteric nervous system of the stomach have been described in gastroparesis. Because the enteric nervous system lies within the myenteric plexus between the muscle layers of the stomach, it is not accessible by standard biopsy forceps. Thus, tissue must be obtained by laparoscopy or laparotomy.

The cannabinoid 1 receptor (CNR1) 1359 G/A polymorphism modulates susceptibility to ulcerative colitis and the phenotype in Crohn's disease.

Background: Recent evidence suggests a crucial role of the endocannabinoid system, including the cannabinoid 1 receptor (CNR1), in intestinal inflammation. We therefore investigated the influence of the CNR1 1359 G/A (p.Thr453Thr; rs1049353) single nucleotide polymorphism (SNP) on disease susceptibility and phenotype in patients with ulcerative colitis (UC) and Crohn's disease (CD).

Targeting the endocannabinoid system for gastrointestinal diseases: future therapeutic strategies.

Cannabinoids extracted from the marijuana plant (Cannabis sativa) and synthetic cannabinoids have numerous effects on gastrointestinal (GI) functions. Recent experimental data support an important role for cannabinoids in GI diseases. Genetic studies in humans have proven that defects in endocannabinoid metabolism underlie functional GI disorders.

Differential effects of CB(1) neutral antagonists and inverse agonists on gastrointestinal motility in mice.

Background: Cannabinoid type 1 (CB(1)) receptors are involved in the regulation of gastrointestinal (GI) motility and secretion. Our aim was to characterize the roles of the CB(1) receptor on GI motility and secretion in vitro and in vivo by using different classes of CB(1) receptor antagonists.

Methods: Immunohistochemistry was used to examine the localization of CB(1) receptor in the mouse ileum and colon.

Cannabinoid 1 receptors modulate intestinal sensory and motor function in rat.

Background: Cannabinoid receptors are involved in visceral pain perception and control of intestinal motility in vivo. The underlying mechanisms are not well characterized. We aimed to determine whether the cannabinoid-1 (CB(1)) receptor modulates intestinal afferent nerve discharge and the peristaltic reflex.

Novel endomorphin analogues with antagonist activity at the mu-opioid receptor in the gastrointestinal tract.

Opioid bowel dysfunction (OBD) summarizes common adverse side effects of opiate-based management of pain. A promising therapeutic approach to prevent OBD and other opioid-related disorders of the gastrointestinal (GI) tract is the co-administration of opiates with peripherally-restricted mu-opioid receptor (MOR)-selective antagonists. The aim of this study was to investigate the selectivity and efficacy of three novel peptide antagonists: antanal-1, antanal-2, and antanal-2A at MOR in the GI tract in vitro and in vivo.

Microscopic colitis -- a common cause of diarrhoea in older adults.

Diarrhoeal diseases are common in older populations and often markedly affect their quality of life. Although there are numerous potential causes, microscopic colitis (MC) is increasingly recognised as a major diagnostic entity in older individuals. MC is comprised of two distinct histological forms - collagenous colitis and lymphocytic colitis, both of which frequently occur in older populations.

Selective natural kappa opioid and cannabinoid receptor agonists with a potential role in the treatment of gastrointestinal dysfunction.

Salvinorin A is the major active ingredient of Salvia divinorum, a plant used by the Mazatec Indians of Mexico for spiritual and medical purposes. Different preparations from S. divinorum are also used in traditional healing practices to treat gastrointestinal disorders, including diarrhea.

Design, synthesis and pharmacological characterization of endomorphin analogues with non-cyclic amino acid residues in position 2.

A series of endomorphin-1 (EM-1) and endomorphin-2 (EM-2) analogues, containing non-cyclic amino acids (Ala, D-Ala, beta-Ala, NMeAla, D-NMeAla or Sar) instead of Pro in position 2 was synthesized, where NMeAla = N-methylalanine and Sar = N-methylglycine, sarcosine. The opioid activity profiles of these peptides were determined in mu and delta opioid receptor (MOR and DOR)-representative binding assays and bioassays in vitro, as well as in the mouse hot-plate test in vivo. Finally, the degradation rates of all analogues in the presence of either rat brain homogenate or selected proteolytic enzymes were determined.

Involvement of cannabinoid-1 and cannabinoid-2 receptors in septic ileus.

BACKGROUND Cannabinoid (CB) receptors are involved in the regulation of gastrointestinal (GI) motility under physiological and pathophysiological conditions. We aimed to characterize the possible influence of CB(1) and CB(2) receptors on motility impairment in a model of septic ileus. METHODS Lipopolysaccharide (LPS) injections were used to mimic pathophysiological features of septic ileus.

[Performance and interpretation of esophageal manometry: recommendations of the German Societies for Neurogastroenterology and Motility (DGNM), for Digestive and Metabolic Diseases (DGVS) and for General and Visceral Surgery (DGAV)].

Esophageal manometry examines the pressure profiles of the tubular esophagus and of the esophageal sphincters during resting conditions and in response to swallowing. It is regarded as the reference method for detection of esophageal motility disturbances but, up to date, performance of the procedure is not standardized among centers. This review depicts the recommendations of the German Societies for Neurogastroenterology and Motility, for Digestive and Metabolic Disturbances and for General and Visceral Surgery on indications, performance and analysis of conventional esophageal manometry.