🌟Pearls on Managing Chronic Abd Pain #DDW2024 ▶️Judicious testing, consider other causes & treat from biopsychosocial framework ▶️Central neuromodulators w/ varying pain benefit, can augment, use 6-12 months after response ▶️+Diet, exercise, BGBT, acupuncture, electrostimulation

Total fan girl moment listening to #fernandoazpiroz talking about this beautiful research in abdominal bloating and APD in a packed house 👉Specify the symptom 😖APD is fr behavioral conditioning 🧘‍♀️Tx the sensation ➡️ fix the distension #DDW2024 Digestive Disease Week American Gastroenterological Association (AGA)

High-yield clinically-applicable talk by Kyle Staller, MD, MPH #DDW2024, see summary slides⬇️. Though data is overall sparse for treatments for #bloating (likely because there are many causes and varied sensory phenotypes), heed the call on "educate and neuromodulate"!

The best diet trial published in endometriosis so far.Ssingle blind crossover feeding trial of low FODMAP diet vs Australian diet in pple with endometriosis + GI symptoms - 70% response rate vs 32% - well done Jane Varney et al #DDW2024 👏🏼👏🏼👏🏼

We found most GI providers don’t screen for #endometriosis in pts w/ chronic GI symptoms bc they don’t know how. Need validated screening tools & large-scale prospective studies for GI pts, but agreed we have to start somewhere! Xiao Jing (Iris) Wang, M.D. Madison Simons, PsyD Laurie Keefer, PhD

🆕🔥Utilizing #TeleHealth in conjunction with in-person visits by skilled #PelvicHealth #PhysicalTherapists for addressing #PelvicFloorDisorders appears to be the preferred route of therapy for majority of patients‼️Stanford Div. of GI & Hepatology👏 👉onlinelibrary.wiley.com/doi/10.1111/nm… ANMS ESNM.eu

maura corsetti Daniel Keszthelyi MD PhD Chris Black Andrea Shin Michael Jones Lisa Vork Mohsin Butt Pierfrancesco Visaggi, MD Rajan Singh ANMS ESNM.eu Baha Moshiree MD, MSci, FACG, AGAF Miranda van Tilburg kara gross margolis Linda Ánh Vân Nguyễn MD Shanthi Srinivasan, MD Purna Kashyap M.B.B.S., AGAF BeyderLab Madhusudan (Madhu) Grover M.D., AGAF Emad El-Omar Melchior Chloé Jahnvi Dhar Zlatan Mujagic MD PhD Alejandra Mendoza Lumír Kunovský John E. Pandolfino Walter Chan, MD, MPH Luis Gerardo Alcala Gonzalez Dipesh Vasant Francisco Lajud Barquin Zubin Sharma MD Shima Ghavimi Faculty of Medical and Health Sciences Alimetry Dr Mikaela Law Gabe Schamberg Gabrielle Sebaratnam Chris Varghese Greg O'Grady Stefan Calder Neha Santucci MD Mayo Clinic Gastroenterology & Hepatology Mark Pimentel MD Eamonn Quigley Sean Spencer, MD, PhD John Damianos, M.D. Yuying Luo ✅Use of a #footstool improves #RectalBalloonExpulsion in some patients with #DefecatoryDisorders‼️🔥 Stanford Div. of GI & Hepatology👏 👉onlinelibrary.wiley.com/doi/10.1111/nm… ANMS ESNM.eu #GITwitter

maura corsetti Daniel Keszthelyi MD PhD Chris Black Andrea Shin Michael Jones Lisa Vork Mohsin Butt Pierfrancesco Visaggi, MD Rajan Singh ANMS ESNM.eu Baha Moshiree MD, MSci, FACG, AGAF Miranda van Tilburg kara gross margolis Linda Ánh Vân Nguyễn MD Shanthi Srinivasan, MD Purna Kashyap M.B.B.S., AGAF BeyderLab Madhusudan (Madhu) Grover M.D., AGAF Emad El-Omar Melchior Chloé Jahnvi Dhar Zlatan Mujagic MD PhD Alejandra Mendoza Lumír Kunovský John E. Pandolfino Walter Chan, MD, MPH Luis Gerardo Alcala Gonzalez Dipesh Vasant Francisco Lajud Barquin Zubin Sharma MD Shima Ghavimi Faculty of Medical and Health Sciences Alimetry Dr Mikaela Law Gabe Schamberg Gabrielle Sebaratnam Chris Varghese Greg O'Grady Stefan Calder Neha Santucci MD Mayo Clinic Gastroenterology & Hepatology Mark Pimentel MD Eamonn Quigley Sean Spencer, MD, PhD John Damianos, M.D. Yuying Luo Four groups of #FecalIncontinence patients based on #AnalPressure & #Electromyography🔥 1⃣ #Normal 2⃣ #CorticalApraxia 3⃣ #PudendalNerveDamage 4⃣ #MuscleDamage #AnalSphincter damage & #Clinical #Symptoms‼️ 👉onlinelibrary.wiley.com/doi/10.1111/nm… Neurogastro & Motil ANMS ESNM.eu #GITwitter

Insightful talk by Helen Burton Murray, Ph.D. on emerging 💨 entities: #ANMS2024: ▶️ Abelchia - UES botox may be helpful ▶️ Aerophagia - leads to bloating, does not equate belching ▶️ Excessive belching - diaphragmatic breathing may be more helpful for supragastric

IBS-M can be difficult to manage #ANMS2024 Scott Gabbard: ▶️ Counsel pts symptoms will fluctuate (~40%) ▶️ Bloating (r/o defecatory d/o early), pain & urgency can be bothersome ▶️ Guidelines lacking on therapies for specifically IBS-M, extrapolated from other #IBS subtypes

As expected, a tour-de-force presentation from Lin Chang ANMS #ANMS2024 on constipation. This should be required of every primary care/family medicine clinician.

Stellar lecture by Dr. Fletcher #ANMS2024 on crucial role of dynamic MRI in characterizing defecatory d/o: ▶️ Excessive perineal descent can give a false + BET ▶️ Clinically significant rectoceles usually >4cm ▶️ Evacuation of rectal gel may be difficult in supine position

Dr. Bharucha highlights utility of anorectal manometry, pitfalls & the 🛣️ ahead: ▶️ ARM can vary day-to-day in the same pt ▶️ How can we improve our evaluation - seated ARM? Fluid filled BET? Incorporating different approaches to analysis (looking at the rectoanal gradient)?

Always learning from Laurie Keefer, PhD on brain-gut therapies beyond IBS #ANM2024: ▶️ Think about specific targets for symptom generation to tailor techniques ▶️ Techniques can be personalized for specific GI symptoms ▶️ Nurse delivered interventions can help scale BGBTs

Excited to share some of what we’ve been working on over the last year at #ACG2024! Join me in Philadelphia for our research on appetite related factors, urogynecologic symptoms, provider screening for endometriosis, and IVIG treatment in gastroparesis.

William Chey: MC stabilizers may be helpful; H1 antagonists also reduce symptoms. TCA’s also exhibit anti-histaminic properties (ATLANTIS study Alexander Ford) #foodthemaincourse