%0 Journal Article
%~ PubMed
%A Abraham, Suzanne
%A Kellow, John E
%T Do the digestive tract symptoms in eating disorder patients represent functional gastrointestinal disorders?
%B BMC Gastroenterology
%D 2013
%C United Kingdom
%I BioMed Central Ltd.
%V 13
%N 
%P 38
%@ 1471-230X
%X 
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Quigley, Eamonn M M
%A Abdel-Hamid, Hussein
%A Barbara, Giovanni
%A Bhatia, Shobna J
%A Boeckxstaens, Guy
%A De Giorgio, Roberto
%A Delvaux, Michel
%A Drossman, Douglas A
%A Foxx-Orenstein, Amy E
%A Guarner, Francisco
%A Gwee, Kok-Ann
%A Harris, Lucinda A
%A Hungin, A Pali S
%A Hunt, Richard H
%A Kellow, John E
%A Khalif, Igor L
%A Kruis, Wolfgang
%A Lindberg, Greger
%A Olano, Carolina
%A Moraes-Filho, Joaquim P
%A Schiller, Lawrence R
%A Schmulson, Max
%A Simrén, Magnus
%A Tzeuton, Christian
%T A global perspective on irritable bowel syndrome: a consensus statement of the World Gastroenterology Organisation Summit Task Force on irritable bowel syndrome.
%B Journal of Clinical Gastroenterology
%D 2012
%C United States
%I Lippincott Williams & Wilkins
%V 46
%N 5
%P 356-366
%@ 1539-2031
%X 
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Shim, L
%A Hansen, R D
%A Prott, G M
%A Morris, L A I
%A Malcolm, A
%A Kellow, J E
%T Altered temporal characteristics of the rectoanal inhibitory reflex in patients with abdominal distension.
%B American journal of Physiology
%D 2012
%C United States
%I American Physiological Society
%V 302
%N 11
%P G1343-1346
%@ 1522-1547
%X The rectoanal inhibitory reflex (RAIR) is important in gas and stool evacuation. We examined RAIR features in patients with chronic constipation who exhibited bloating with and without abdominal distension, to determine whether alterations in RAIR may be a factor in the pathogenesis of abdominal distension. Seventy-five female patients with chronic constipation with or without abdominal distension were included in the study. The presence or absence of abdominal distension was assessed according to the Rome II questionnaire. All patients underwent both RAIR and rectal sensitivity testing, and specific RAIR parameters were analyzed. Patients were divided into two groups: abdominal bloating with distension (D, n = 55) and abdominal bloating without distension (ND, n = 20). D had a longer time to the onset of anal sphincter inhibition (latency of inhibition) (P = 0.03) compared with ND. In logistic regression analysis, a combination of age, latency of inhibition and the time measured from onset of inhibition to the point of maximum inhibition predicted abdominal distension (P = 0.002). There were no differences between groups for the time from point of maximum inhibition to recovery and for the percentage of internal anal sphincter relaxation. This is the first study to examine the role of RAIR in patients with abdominal distension. Female patients with constipation and abdominal distension exhibited differences in the temporal characteristics of, but not in the degree of, anal sphincter relaxation compared with patients without distension. Since this study was uncontrolled, further studies are necessary to determine the contribution of altered anorectal reflexes to abdominal distension.
%Z FOR Codes: 1103 1116


%0 Journal Article
%~ PubMed
%A Abraham, Suzanne
%A Luscombe, Georgina M
%A Kellow, John E
%T Pelvic floor dysfunction predicts abdominal bloating and distension in eating disorder patients.
%B Scandinavian Journal of Gastroenterology
%D 2012
%C Norway
%I Informa Healthcare
%V 47
%N 6
%P 625-631
%@ 1502-7708
%X Abstract Objective. Little is known about the symptoms of abdominal bloating and distension in women with eating disorders (EDs). This study aimed to explore the prevalence and predictors of these symptoms in patients with EDs, by examining correlations with functional gastrointestinal disorders (FGIDs) including pelvic floor symptoms and other clinical features. Material and methods. 184 ED inpatients, 16-55 years, completed on admission to hospital the ROME II symptom questionnaire, additional questions about abdominal bloating and distension, and psychological questionnaires. Prediction of abdominal bloating and distension was modeled using logistic regression analyses with individual FGIDs, psychological variables, ED type, and clinical features as the potential predictors. Results. Bloating (78%) was more common than distension (58%) in each ED type. In the final multivariate models, after controlling for BMI, the number of Rome II symptoms of pelvic floor dyssynergia (i.e., having to strain to pass a stool, feeling unable to empty the rectum, and having difficulty relaxing to evacuate the stool) was a significant predictor of both abdominal distension (p < 0.001) and bloating (p < 0.005). The presence of irritable bowel syndrome (IBS, 46%) was a significant predictor of bloating (p < 0.001) but not distension. Conclusions. Symptoms of pelvic floor dysfunction, but not IBS, appear to be especially important in the genesis of abdominal distension in patients with ED.
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Abraham, Suzanne
%A Kellow, John
%T Exploring eating disorder quality of life and functional gastrointestinal disorders among eating disorder patients.
%B Journal of Psychosomatic Research
%D 2011
%C United States
%I Elsevier Inc.
%V 70
%N 4
%P 372-377
%@ 1879-1360
%X Functional gastrointestinal-like disorders (FGIDs) are prevalent among eating disorder (ED) patients. The aims are to explore the relationship between quality of life related to eating disorders (QOL ED) and FGIDs.
%Z FOR Codes: 110319


%0 Journal Article
%~ PubMed
%A Shim, L S E
%A Jones, M
%A Prott, G M
%A Morris, L I
%A Kellow, J E
%A Malcolm, A
%T Predictors of outcome of anorectal biofeedback therapy in patients with constipation.
%B Alimentary pharmacology & therapeutics
%D 2011
%C United Kingdom
%I Wiley-Blackwell Publishing Ltd.
%V 33
%N 11
%P 1245-51
%@ 1365-2036
%X BaCKGROUND: Anorectal biofeedback therapy (BFT) is a safe and effective treatment in patients with constipation. Given the high prevalence of constipation and therefore high demand for BFT, there is a need to prioritise patients.
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Boyd, Catherine
%A Abraham, Suzanne
%A Kellow, John
%T Appearance and disappearance of functional gastrointestinal disorders in patients with eating disorders.
%B Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
%D 2010
%C United Kingdom, Neth
%I Wiley-Blackwell Publishing Ltd.
%V 22
%N 
%P 1279-83
%@ 1365-2982
%X Functional gastrointestinal disorders or ''functional gastrointestinal disorder-like'' symptoms (FGIDs) occur commonly in eating disorders (ED), but it is not known if these disorders are stable over time. The aims were to evaluate the turnover of FGIDs in patients with ED, and to relate this turnover to changes in body mass index (BMI), ED behaviors, and psychological variables.
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Suttor, V P
%A Prott, G M
%A Hansen, R D
%A Kellow, J E
%A Malcolm, A
%T Evidence for pelvic floor dyssynergia in patients with irritable bowel syndrome.
%B Diseases of the Colon and Rectum
%D 2010
%C United States
%I Lippincott Williams & Wilkins
%V 53
%N 2
%P 156-160
%@ 0012-3706
%X PURPOSE: Although functional constipation is known to often manifest concomitant features of pelvic floor dyssynergia, the nature of pelvic floor symptoms and anorectal dysfunction in non-diarrhea predominant irritable bowel syndrome is less clear. This study aims to compare anorectal sensorimotor function and symptoms of patients who have non-diarrhea predominant irritable bowel syndrome with those who have functional constipation. METHODS: We studied 50 consecutive female patients referred with constipation and 2 or more symptoms of pelvic floor dyssynergia, who also satisfied Rome II criteria for either non-diarrhea predominant irritable bowel syndrome (n = 25; mean age, 47 +/- 3 y) or functional constipation (n = 25; 49 +/- 3 y). Assessments included the Rome II Integrative Questionnaire, a validated constipation questionnaire, Hospital Anxiety and Depression scale, visual analog scores for satisfaction with bowel habit and for impact on quality of life, and a comprehensive anorectal physiology study. RESULTS: Both groups displayed physiological evidence of pelvic floor dyssynergia; but patients with non-diarrhea predominant irritable bowel syndrome exhibited a higher prevalence of abnormal balloon expulsion (P < .01) and less paradoxical anal contraction with strain (P = .045) than patients with functional constipation. These patients with irritable bowel syndrome also reported more straining to defecate (P = .04), a higher total constipation score (P = .02), lower stool frequency (P = .02), a trend toward harder stools (P = .06), and less satisfaction with bowel habit (P = .03) than patients with functional constipation. CONCLUSION: Patients with non-diarrhea predominant irritable bowel syndrome with symptoms of pelvic floor dyssynergia exhibit overall pelvic floor dyssynergia physiology similar to that of patients with functional constipation. Certain features, however, such as abnormal balloon expulsion, may be more prominent in the patients with irritable bowel syndrome. Therapeutic modalities, such as biofeedback, that are effective in patients with functional constipation with pelvic floor dyssynergia should therefore be considered in selected patients with irritable bowel syndrome with pelvic floor dyssynergia.
%Z FOR Codes: 1116


%0 Journal Article
%~ PubMed
%A Kellow, John E
%T IBS: Do we need to exclude exocrine pancreatic insufficiency in IBS?
%B Nature Reviews. Gastroenterology & Hepatology
%D 2010
%C United Kingdom
%I Nature Publishing Group
%V 7
%N 9
%P 479-480
%@ 1759-5053
%X 
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Kellow, John E
%T Introduction: a practical evidence-based approach to the diagnosis of the functional gastrointestinal disorders.
%B American Journal of Gastroenterology
%D 2010
%C United States
%I Nature Publishing Group
%V 105
%N 4
%P 743-746
%@ 1572-0241
%X 
%Z FOR Codes: 1103


%0 Journal Article
%~ PubMed
%A Shim, L
%A Prott, G
%A Hansen, R D
%A Simmons, L E
%A Kellow, J E
%A Malcolm, Allison
%T Prolonged balloon expulsion is predictive of abdominal distension in bloating.
%B American journal of Gastroenterology
%D 2010
%C United States
%I Nature Publishing Group
%V 105
%N 4
%P 883-887
%@ 1572-0241
%X OBJECTIVES: Abdominal bloating and distension are common in patients with constipation. The precise mechanism of abdominal distension remains uncertain. We hypothesized that constipated patients with bloating plus distension exhibit a greater degree of anorectal dysfunction, potentially affecting gas evacuation, than those without distension. Therefore, our aim was to evaluate anorectal function and other clinical features in patients with constipation who exhibit bloating with and without distension. METHODS: In all, 88 female patients with abdominal bloating and either non-diarrhea irritable bowel syndrome (IBS) or functional constipation were included in the study. The presence or absence of abdominal distension was assessed according to the Rome II questionnaire, and all patients underwent comprehensive clinical assessment and anorectal function studies. RESULTS: Patients were divided into two groups: abdominal bloating with distension (D; n=53) and abdominal bloating without distension (ND; n=35). D featured a prolonged balloon expulsion time (P=0.005), a higher resting anal sphincter pressure (P=0.002), and a higher maximum anal sphincter squeeze pressure (P=0.015) than ND. They also experienced more bloating (P<0.001), more abdominal pain (P=0.004), harder stools (P=0.01), and more incomplete emptying (P=0.005). In logistic regression modeling, prolonged balloon expulsion time was a significant predictor of abdominal distension (P=0.018). CONCLUSIONS: This is the first study to show that prolonged balloon expulsion time predicts abdominal distension in patients with bloating and constipation. Hence, ineffective evacuation of gas and stool associated with prolonged balloon expulsion may be an important mechanism underlying abdominal distension.
%Z FOR Codes: 1103


%0 Journal Article
%~ PubMed
%A Prott, G
%A Shim, L
%A Hansen, R
%A Kellow, J
%A Malcolm, A
%T Relationships between pelvic floor symptoms and function in irritable bowel syndrome.
%B Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
%D 2010
%C United Kingdom, Neth
%I Wiley-Blackwell Publishing Ltd.
%V 22
%N 7
%P 764-9
%@ 1365-2982
%X Pelvic floor dyssynergia (PFD) within irritable bowel syndrome (IBS) is often overlooked and the relationship between symptoms and physiology is relatively unexplored. Our aims were to determine relationships between clinical features and anorectal function in non-diarrhea predominant IBS (non-D IBS) patients and whether certain clinical or physiological features predict PFD in IBS.
%Z FOR Codes: 1116 1103


%0 Journal Article
%~ PubMed
%A Suttor, V P
%A Ng, C
%A Rutkowski, S
%A Hansen, R D
%A Kellow, J E
%A Malcolm, A
%T Colorectal responses to distension and feeding in patients with spinal cord injury.
%B American Journal of Physiology: Gastrointestinal and Liver Physiology
%D 2009
%C United States
%I American Physiological Society
%V 296
%N 6
%P G1344-G1349
%@ 0193-1857
%X The role of the central nervous system in enteroenteric motor reflexes remains controversial. Our aims were as follows: 1) to evaluate colorectal, rectocolic, gastrocolonic, and gastrorectal reflex responses in patients with cervical spinal cord injury (SCI) and 2) to compare these responses with those in healthy subjects. In six patients with SCI (5 male, 42 +/- 4 yr) and six healthy control subjects (5 male, 36 +/- 5 yr), 2-min phasic distensions were performed randomly via dual-barostat balloons in the colon and rectum. Continuous colonic and rectal balloon volumes were recorded during distensions and after a 1,000-kcal liquid meal. Mean balloon volumes were recorded before, during, and after phasic distensions and over 60 min postprandially. The colorectal response was similar in control subjects and SCI patients (rectal volume reduction = 28 +/- 11% and 15 +/- 5% in SCI patients and healthy subjects, respectively); the rectocolic response was variable. The gastrocolonic response was present in all subjects (colonic volume reduction = 49 +/- 4% and 44 +/- 3% in SCI patients and healthy subjects, respectively), with a time effect in the first 30 min (P < 0.0001) and a group effect in the second 30 min (P < 0.004). The gastrorectal response was present in four SCI patients and five healthy subjects (rectal volume reduction = 38 +/- 4% and 41 +/- 3% in SCI patients and healthy subjects, respectively), with a time effect in the first 30 min (P < 0.0001) but no group effect in the second 30 min. Intact neural transmission between the spinal cord and higher centers is not essential for normal colorectal motor responses to feeding and distension; however, a degree of central nervous system and neurohormonal modulation of these responses is likely.
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Friesen, Noel
%A Hansen, Ross D
%A Abraham, Suzanne F
%A Kellow, John E
%T Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders.
%B World Journal of Gastroenterology
%D 2009
%C China
%I WJG Press
%V 15
%N 42
%P 5295-5299
%@ 1007-9327
%X AIM: To evaluate gastrointestinal (GI) symptoms and breath hydrogen responses to oral fructose-sorbitol (F-S) and glucose challenges in eating disorder (ED) patients. METHODS: GI symptoms and hydrogen breath concentration were monitored in 26 female ED inpatients for 3 h, following ingestion of 50 g glucose on one day, and 25 g fructose/5 g sorbitol on the next day, after an overnight fast on each occasion. Responses to F-S were compared to those of 20 asymptomatic healthy females. RESULTS: F-S provoked GI symptoms in 15 ED patients and one healthy control (P<0.05 ED vs control). Only one ED patient displayed symptom provocation to glucose (P<0.01 vs F-S response). A greater symptom response was observed in ED patients with a body mass index (BMI)<or=17.5 kg/m2 compared to those with a BMI>17.5 kg/m2 (P<0.01). There were no differences in psychological scores, prevalence of functional GI disorders or breath hydrogen responses between patients with and without an F-S response. CONCLUSION: F-S, but not glucose, provokes GI symptoms in ED patients, predominantly those with low BMI. These findings are important in the dietary management of ED patients.
%Z FOR Codes: 111103 110319 110307


%0 Journal Article
%~ PubMed
%A Kellow, John E
%T Myenteric plexitis in enteric dysmotility: what are the implications for clinical practice?
%B Gut
%D 2009
%C United Kingdom
%I BMJ Group
%V 58
%N 8
%P 1042-1043
%@ 0017-5749
%X 
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Bennett, Ethelle
%A Evans, Peter
%A Dowsett, John
%A Kellow, John
%T Sphincter of Oddi dysfunction: psychosocial distress correlates with manometric dyskinesia but not stenosis.
%B World Journal of Gastroenterology
%D 2009
%C China
%I WJG Press
%V 15
%N 48
%P 6080-6085
%@ 1007-9327
%X AIM: To compare postcholecystectomy patients with Sphincter of Oddi (SO) dyskinesia and those with normal SO motility to determine the psychosocial distress, gender and objective clinical correlates of dyskinesia, and contrast these findings with comparisons between SO stenosis and normal SO motility. METHODS: Within a cohort of seventy-two consecutive postcholecystectomy patients with suspected SO dysfunction, manometric assessment identified subgroups with SO dyskinesia (n = 33), SO stenosis (n = 18) and normal SO motility (n = 21). Each patient was categorized in terms of Milwaukee Type, sociodemographic status and the severity of stress-coping experiences. RESULTS: Logistic regression revealed that in combination certain psychological, sociodemographic and clinical variables significantly differentiated SO dyskinesia, but not SO stenosis, from normal SO function. Levels of psychosocial stress and of coping with this stress (i.e. anger suppressed more frequently and the use of significantly more psychological coping strategies) were highest among patients with SO dyskinesia, especially women. Higher levels of neuroticism (the tendency to stress-proneness) further increased the likelihood of SO dyskinesia. CONCLUSION: A motility disturbance related to psychosocial distress may help to explain the finding of SO dyskinesia in some postcholecystectomy patients.
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Haack, Horst-Gunter
%A Hansen, Ross-David
%A Malcolm, Allison
%A Kellow, John-Edward
%T Ineffective oesophageal motility: manometric subsets exhibit different symptom profiles.
%B World journal of gastroenterology
%D 2008
%C China
%I WJG Press
%V 14
%N 23
%P 3719-3724
%@ 1007-9327
%X AIM: To compare the demographic and clinical features of different manometric subsets of ineffective oesophageal motility (IOM; defined as > or = 30% wet swallows with distal contractile amplitude < 30 mmHg), and to determine whether the prevalence of gastro-oesophageal reflux differs between IOM subsets. METHODS: Clinical characteristics of manometric subsets were determined in 100 IOM patients (73 female, median age 58 years) and compared to those of 100 age-and gender-matched patient controls with oesophageal symptoms, but normal manometry. Supine oesophageal manometry was performed with an eight-channel DentSleeve water-perfused catheter, and an ambulatory pH study assessed gastro-oesophageal reflux. RESULTS: Patients in the IOM subset featuring a majority of low-amplitude simultaneous contractions (LASC) experienced less heartburn (prevalence 26%), but more dysphagia (57%) than those in the IOM subset featuring low-amplitude propagated contractions (LAP; heartburn 70%, dysphagia 24%; both P < or = 0.01). LASC patients also experienced less heartburn and more dysphagia than patient controls (heartburn 68%, dysphagia 11%; both P < 0.001). The prevalence of heartburn and dysphagia in IOM patients featuring a majority of non-transmitted sequences (NT) was 54% (P = 0.04 vs LASC) and 36% (P < 0.01 vs controls), respectively. No differences in age and gender distribution, chest pain prevalence, acid exposure time (AET) and symptom/reflux association existed between IOM subsets, or between subsets and controls. CONCLUSION: IOM patients with LASC exhibit a different symptom profile to those with LAP, but do not differ in gastro-oesophageal reflux prevalence. These findings raise the possibility of different pathophysiological mechanisms in IOM subsets, which warrants further investigation.
%Z FOR Codes: 110307


%0 Journal Article
%~ PubMed
%A Talley, Nicholas
%A Kellow, John
%A Boyce, Philip
%A Tennant, Christopher
%A Huskic, Sandy
%A Jones, Michael
%T Antidepressant Therapy (Imipramine and Citalopram) for Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Trial.
%B Digestive diseases and sciences
%D 2007
%C United States
%I Springer New York LLC
%V 53
%N 1
%P 108-15
%@ 0163-2116
%X The efficacy of antidepressants in irritable bowel syndrome (IBS) is controversial. No trials have directly compared a tricyclic with a selective serotonin reuptake inhibitor. Our aim was to determine whether imipramine and citalopram are efficacious in IBS.
%Z FOR Codes: 110307 110319


%0 Journal Article
%~ PubMed
%A Ng, Clinton
%A Malcolm, Allison
%A Hansen, Ross
%A Kellow, John
%T Feeding and colonic distension provoke altered autonomic responses in irritable bowel syndrome.
%B Scandinavian journal of gastroenterology
%D 2007
%C United Kingdom.
%I Informa Healthcare
%V 42
%N 4
%P 441-446
%@ 0036-5521
%X OBJECTIVE: Alterations in autonomic balance, detectable by heart rate variability (HRV) analysis, have been shown to occur after a meal in patients with irritable bowel syndrome (IBS). There are few data on changes in sympathovagal responses in IBS to other forms of enteric stimulation such as colonic distension. The aim of this study was to determine the effects of colonic balloon distension on HRV in the fasting and the postprandial state in healthy subjects and in IBS patients. MATERIAL AND METHODS: Eight IBS patients and 8 age- and gender-matched healthy subjects underwent unsedated descending colonic distension before and after a 1000 kcal liquid meal. Low- (LF) and high-frequency (HF) HRV band values obtained from 2-min ECG segments recorded before and during distension were compared between groups, and between fasting and postprandial states. A visual analogue scale was used to determine sensation during colonic distension. RESULTS: HF values decreased significantly with feeding in IBS patients (p=0.01), but not in healthy subjects. The low-to-high frequency (LF/HF) ratio was significantly higher postprandially in IBS patients (p=0.02) and, additionally, was decreased (p<0.01) with colonic distension in the fed state, independently of colonic sensitivity or distending volume. Moreover, changes in the LF/HF ratio with distension in the fed versus the fasting state were negatively correlated in IBS patients but positively correlated in healthy subjects (both p<0.05). CONCLUSIONS: IBS patients demonstrated altered autonomic responses to feeding and colonic distension. Further studies should determine whether these alterations could explain the postprandial exacerbation of symptoms in IBS.
%Z FOR Codes:


%0 Journal Article
%~ PubMed
%A Kellow, J E
%T The 'Pro' case. The Rome III criteria.
%B Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
%D 2007
%C United Kingdom, US.
%I Blackwell Publishing Ltd.
%V 19
%N 10
%P 787-792
%@ 1350-1925
%X 
%Z FOR Codes: