Tessera

Rajan Singh

@rajansingh.bsky.social

Asst Prof (R) #unrmed 🇺🇸 #DGBIs #Microbiome #Gut-Brain-Microbiome #NeuroGastro #DGBIs #MetabolicHealth #SoMe ✍️ #NGMJournal #INMAssociation #GutBrainScience Alumnus #Gastro #SGPGIMS 🇮🇳 https://scholar.google.com/citations?hl=en&user=TBjcHp8AAAAJ

31 Posts834 Follower 1822 Folgt

@ngmjournal.bsky.social · 6mo ago

🆕🔥Medically Refractory Constipation With #ColonicHypercompliance: Comparison With #Megacolon and Healthy Colon‼️ 🎯Medically-refractory chronic constipation has colonic compliance similar to that of patients with megacolon👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM @mayoclinic.org

$Key Points: Patients with chronic megacolon typically have increased colonic diameter and compliance. We have identified a subset of patients with treatment-refractory constipation who have intraluminal motility findings of chronic hypercompliance without increased colonic diameters on cross-sectional imaging. We refer to this as refractory constipation with colonic hypercompliance (RCCH). The increased compliance differs from compliance reported in chronic constipation alone. Further examination of myenteric and smooth muscle structure and function is required to advance management.$

@ngmjournal.bsky.social · 6mo ago

🆕🔥Brain changes underlying #IrritableBowelSyndrome symptom improvement in response to #Mindfulness‐Based Stress Reduction‼️ 🎯Improves #IBS symptoms by changing communication between brain regions at rest👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM #Gut-Brain 🧠Axis

Key Points

In participants with irritable bowel syndrome (IBS) who show decreased symptom severity after mindfulness-based stress reduction, brain regions communicate differently with each other when at rest.
These changes in brain communication are consistent with a shift from inward and overthinking to paying more attention and noticing things happening in the body and environment.
The study suggests MBSR improves IBS symptoms by changing communication between brain regions at rest.

Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 6mo ago

New online! The critical role of gut–brain signalling in eating behaviour and obesity

The critical role of gut–brain signalling in eating behaviour and obesity

Nature Reviews Gastroenterology & Hepatology, Published online: 21 April 2026; doi:10.1038/s41575-026-01203-xThis Review outlines the role of gut–brain signalling in eating behaviour and obesity, highlighting gut-derived signals and cues relevant during eating phases. Underlying mechanisms of this gut–brain communication are discussed alongside the key role of the vagus nerve in this process.

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Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 6mo ago

ICYMI: New online! What do we mean by gut health?

What do we mean by gut health?

Nature Reviews Gastroenterology & Hepatology, Published online: 15 April 2026; doi:10.1038/s41575-026-01208-6A new Consensus Statement puts forward a definition of ‘gut health’ in an attempt to bring some clarity and consistency to a term that is widely used but often ill-defined and vague.

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@ngmjournal.bsky.social · 6mo ago

🆕🔥#AdverseChildhoodExperiences due to #maltreatment are associated with #AbdominalPain intensity, poorer health-related quality of life, greater anxiety, and greater depressive symptoms, #Pediatric patients with #DGBI‼️ 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM #PEARLS

Key Points

In this sample of 120 children with pain-predominant Disorders of Gut-Brain Interaction (DGBI) and their caregivers, 102 of the 120 caregivers (85%) indicated that their child had experienced at least one adverse childhood experience (ACE).
ACEs due to maltreatment were significantly correlated with greater 7 day average abdominal pain intensity, poorer health-related quality of life (HRQoL), greater anxiety, and greater depression, while ACEs due to household challenges and social context were not significantly correlated.
The experience of maltreatment accounted for significant portions of variance in 7-day average abdominal pain intensity and HRQoL, respectively, even after controlling for anxiety and depression.

Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 7mo ago

ICYMI: New online! Therapeutic targets for metabolic dysfunction-associated steatohepatitis: a personalized approach to disease management

Therapeutic targets for metabolic dysfunction-associated steatohepatitis: a personalized approach to disease management

Nature Reviews Gastroenterology & Hepatology, Published online: 18 March 2026; doi:10.1038/s41575-026-01187-8Current drug approvals reshape metabolic dysfunction-associated steatohepatitis (MASH) therapeutic strategies. This Review highlights current and emerging therapeutic targets and discusses a mechanism-based framework for personalized, combination-oriented management in MASH.

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@ngmjournal.bsky.social · 7mo ago

🆕🔥Colonic motility #mapping reveals a meal-induced #RectosigmoidBrake in healthy individuals that is disrupted, disorganized, or exaggerated following #surgery & in #MotilityDisorders‼️ #ileus #PseudoObstruction #FecalIncontinence 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Key Points

The distal colon has a natural “brake” (the rectosigmoid brake) that controls how quickly stool enters the rectum, helping prevent urgency and maintain continence.
When this brake misfires, different problems can result: after colorectal surgery it may become overactive and delay recovery; when weakened or removed it can lead to urgency or incontinence.
This brake is a promising, measurable sign to guide care: it can be boosted by sacral nerve stimulation, and new non-invasive tests may help doctors track it to predict recovery and tailor treatment.

@ngmjournal.bsky.social · 7mo ago

🆕🔥 #HeartRateVariability & #Sleep among Girls & Boys with #AbdominalPain‐related #DisordersofGutBrainInteraction‼️ 🎯Sleep-disordered breathing is associated with lower #HRV in both sexes #snoring #gasping 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM @drvantilburg.bsky.social 👏

Key Points
Children with chronic abdominal pain often have trouble sleeping and we found that indicators of parasympathetic activity may be linked to nighttime sleep.
Girls and boys showed different patterns of associations between heart rate variability and sleep.
Sleep-disordered breathing, including snoring or gasping, was associated with lower heart rate variability in both sexes.

Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 7mo ago

New online! Defining ‘gut health’: a leap forward, but still some road to travel

Defining ‘gut health’: a leap forward, but still some road to travel

Nature Reviews Gastroenterology & Hepatology, Published online: 17 March 2026; doi:10.1038/s41575-026-01189-6‘Gut health’ is a widely used term, but there is much uncertainty and inconsistency related to its use. An international panel has now provided a definition that includes consideration of both gastrointestinal function and symptom burden. While advancing the field, the definition also prompts a number of areas of debate.

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Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 7mo ago

New online! Therapeutic targets for metabolic dysfunction-associated steatohepatitis: a personalized approach to disease management

Therapeutic targets for metabolic dysfunction-associated steatohepatitis: a personalized approach to disease management

dlvr.it

@ngmjournal.bsky.social · 7mo ago

🚨Fascinating Review🆕🔥 ⏩Intestinal α-Syn Oligomers as a Novel Pharmacological Target for #Parkinson'sDisease‼️ 🎯Novel insights into pathogenetic mechanisms👏 🎯Therapeutic feasibility of targeting gut-derived α-Syn oligomers💡 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Highlights
1. α-Syn Oligomers Are the Most Neurotoxic Species
β-sheet-rich α-synuclein (α-Syn) oligomers are key drivers of neurodegeneration in Parkinson's disease (PD), exhibiting greater neurotoxicity than monomers or fibrils.
2. Gut as the Origin of Pathology
The intestine serves as a critical initiation site for α-Syn oligomer formation, modulated by intestinal inflammation, microbiota dysbiosis, environmental toxins, and genetic mutations.
3. Gut-to-Brain Transmission Pathways
Gut-derived α-Syn oligomers propagate to the brain via multiple routes: the vagus nerve, spinal cord, systemic circulation (including exosomes), and immune cells such as CD11c⁺ phagocytes.
4. Mechanisms of Neurotoxicity
α-Syn oligomers induce neuronal injury through oxidative stress, neuroinflammation, mitochondrial dysfunction, cytoskeletal disruption, and synaptic impairment.
5. Therapeutic Strategies Targeting α-Syn Oligomers
Promising interventions include: inhibiting oligomer formation (e.g., Anle138b, baicalein, doxycycline); promoting α-Syn degradation via autophagy (e.g., icariin, nilotinib); blocking pathological propagation (e.g., antibodies BIIB054, MEDI1341).
6. Clinical and Translational Potential
Targeting gut-derived α-Syn oligomers provides a novel early-stage strategy for PD, capable of modifying disease progression rather than merely alleviating symptoms.

@ngmjournal.bsky.social · 7mo ago

🆕🔥Predominant Symptom in Gastroparesis: #Cohort #Treatments #Outcomes‼️ 🎯Most common predominant symptoms⏩#Nausea, #Vomiting & #AbdominalPain and PrS can change over time👏 🎯Abdominal pain associated with poorer QOL🔥 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM #GpCRC

Key Points
In patients with gastroparesis, the most common predominant symptoms were nausea, vomiting, and abdominal pain.
Impaired QOL varied with the patient's predominant symptom, with abdominal pain associated with poorer QOL.
Over 48 weeks, GSCI improved ≥ 1 in a minority of patients, more often in patients with predominant symptoms of nausea and bloating, less often for fullness and abdominal pain.
The predominant symptom can change over time.

Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 7mo ago

ICYMI: New online! Physical activity and the gut

Physical activity and the gut

Nature Reviews Gastroenterology & Hepatology, Published online: 09 March 2026; doi:10.1038/s41575-026-01192-xPhysical activity and the gut

dlvr.it

@ngmjournal.bsky.social · 7mo ago

🆕🔥Adolescent normative intervals for #BodySurfaceGastricMapping‼️ 🎯BSGM normative reference intervals support test interpretation & allow specific phenotyping of gastric abnormalities & guide symptoms management👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

@ngmjournal.bsky.social · 7mo ago

🆕🔥Alternative Pathways of #Acetylcholine Release in Colon: Role of #HighAffinity Choline Transporters‼️ 🎯High-affinity choline transporters provide a novel pathway for acetylcholine release originating from neuronal sources👏 #ANMS #ESNM 👉 onlinelibrary.wiley.com/doi/10.1111/...

@ngmjournal.bsky.social · 7mo ago

🆕🔥#PercutaneousElectricalNerveFieldStimulation improves weight & other anthropometric outcomes in #Children & #Adolescents with #FunctionalDyspepsia who restrict their oral intake‼️ 🎯#PENFS can improve GI symptoms & #psychosocial outcomes #DGBIs👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 7mo ago

ICYMI: New online! Metabotherapy for intestinal disease: using metabolites to prevent and treat disorders of the gut

Metabotherapy for intestinal disease: using metabolites to prevent and treat disorders of the gut

Nature Reviews Gastroenterology & Hepatology, Published online: 02 March 2026; doi:10.1038/s41575-026-01178-9Metabolites are important mediators of metabolism at the cellular and organismal levels. This Review explores the concept of metabotherapy, harnessing metabolites to prevent and treat gastrointestinal disorders, providing insights into metabolite classifications and their pathophysiological mechanisms in health and disease and mapping their potential as therapeutic targets.

dlvr.it

@ngmjournal.bsky.social · 7mo ago

🆕🔥Central & peripheral #Neuromodulators in #FD & #Gastroparesis: Symptom-Based #ClinicalReview‼️ 🎯A pragmatic, symptom-oriented & mechanism-based approach facilitate individualized treatment selection & optimize clinical outcomes 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Key Points
• First-line therapies for functional dyspepsia, including proton pump inhibitors and Helicobacter pylori eradication, provide limited symptom relief in a substantial proportion of patients.
• Functional dyspepsia and gastroparesis share overlapping symptoms but differ in predominant pathophysiological mechanisms, requiring tailored therapeutic strategies.
• Predominantly central neuromodulators are most appropriate for epigastric pain syndrome, whereas predominantly peripheral neuromodulators are better suited for postprandial distress syndrome and gastroparesis-related nausea and vomiting.
• A pragmatic, symptom-oriented, and mechanism-based approach may facilitate individualized treatment selection and optimize clinical outcomes.

Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 7mo ago

New online! Metabotherapy for intestinal disease: using metabolites to prevent and treat disorders of the gut

Metabotherapy for intestinal disease: using metabolites to prevent and treat disorders of the gut

dlvr.it

@ngmjournal.bsky.social · 8mo ago

🆕🔥Preserved #AntralContractions measured by #WirelessMotilityCapsule are associated with 🔽Response Rates to G-POEM in #IdiopathicGastroparesis patients‼️ 🎯Diminished antral contractions & gastric emptying delay are more likely to respond to G-POEM👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS#ESNM

Key Points

Wireless motility capsule (WMC) contractile data can help guide patient selection for gastric per-oral endoscopic myotomy (G-POEM) by distinguishing physiologic phenotypes of gastroparesis—those driven by severe motor dysfunction versus sensory neuroenteric dysfunction.
Idiopathic gastroparesis patients with diminished antral contractions on WMC were more likely to respond to G-POEM, whereas those with preserved antral contractility were less likely to benefit.
Patients who demonstrate severe gastric emptying delay measured by both WMC and gastric emptying scintigraphy were more likely to respond to G-POEM.

@ngmjournal.bsky.social · 8mo ago

🆕🔥 #Lactobacillus reuteri DSM 17938 improves #IntestinalMotility in 🐭 with #PostoperativeIleus by modulating #GutMicrobiota & #Macrophage‼️ 🎯L. reuteri DSM 17938 is a promising probiotic for the prevention of #POI👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Key points
1. POI is a common complication after abdominal sur-gery, prolonging the postoperative recovery time ofpatients.
2. POI will prolong the time for the intestines to empty,disrupt the intestinal flora balance, trigger related inflammatory responses, and cause disorder in the body's microenvironment.
3. Lactobacillus reuteri can alleviate intestinal metabolic disorders by promoting the expression of anti-inflammatory factors and inhibiting the expression of pro-inflammatory factors, thereby regulating the intestinal microbiota and facilitating the body's recovery.

Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 8mo ago

ICYMI: New online! The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of gut health

The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of gut health

Nature Reviews Gastroenterology & Hepatology, Published online: 18 February 2026; doi:10.1038/s41575-026-01176-xThis Consensus Statement provides a definition of the term ‘gut health’, as well as a discussion of the relevant domains that contribute to gut health and a framework for appropriate use of the term in the context of therapeutic interventions.

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@ngmjournal.bsky.social · 8mo ago

🆕🔥#WedgePillow vs. evening #ProtonPumpInhibitor for #NocturnalReflux symptoms‼️ 🎯Adding a wedge pillow was not inferior to evening PPI for nocturnal reflux symptoms ⏩Greater improvements in #sleep quality👏 👉https://onlinelibrary.wiley.com/doi/10.1111/nmo.70256 #ANMS #ESNM #GERD #PPI

Summary
• Guidelines recommend doubling the proton pump inhibitor (PPI) dosage for persistent nocturnal reflux symptoms, while wedge pillows are suggested as anon-pharmacological option. However, their efficacy compared with twice-daily PPI remains unstudied.
• A wedge pillow combined with a morning PPI was non-inferior to twice-daily PPI in alleviating nocturnal reflux symptoms and was associated with greater improvements in sleep quality, despite no significant changes in reflux parameters, suggesting that the observed benefit may be mediated by sleep-related factors.
• A wedge pillow can complement PPI therapy for man-aging nocturnal reflux symptoms, offering relief from night time symptoms and improving sleep quality inpatients not responding to morning PPI therapy.

Neckel Lab @neckellab.bsky.social · 9mo ago

📢 Remember those sleepless nights when you were kept awake from not knowing how the HSPG expression was in #ENS ganglia in #Hirschsprung 's disease?! 🤯 These days are over, as you can read all about it in our new paper @ngmjournal.bsky.social ! onlinelibrary.wiley.com/doi/10.1111/...

Perlecan, CollagenXVIII, and Agrin Expression in Normo‐, Hypo‐, and Aganglionic Segments in Hirschsprung's Disease

The secretory heparan sulphate proteoglycans perlecan, agrin, collagen18A1 are expressed in the periganglionic sheath of enteric ganglia in resectates of Hirschsprung's disease patients and non-Hirsc...

onlinelibrary.wiley.com

@ngmjournal.bsky.social · 8mo ago

🆕🔥Quantifying the Prevalence of #DisordersofGutBrainInteraction in #SystemicSclerosis‼️ 👉 onlinelibrary.wiley.com/doi/10.1111/... 🎯20% of patients with systemic sclerosis met diagnostic criteria for #IrritableBowelSyndrome or #FunctionalDyspepsia👏 #ANMS #ESNM

Key Points:
Twenty percent of patients with systemic sclerosis met diagnostic criteria for irritable bowel syndrome or functional dyspepsia, the two most common disorders of gut–brain interaction.
The presence of symptoms consistent with disorders of gut–brain interaction is associated with more severe systemic sclerosis gastrointestinal disease and poorer quality of life.
Effective management strategies have been used to treat disorders of gut brain interaction that could be tested in those patients with systemic sclerosis and co-morbid disorders of gut brain interaction to reduce symptom burden and improve quality of life.

@ngmjournal.bsky.social · 8mo ago

🆕🔥#MuscularisMacrophage-derived #ApoE is dispensable for maintaining #GutMotility 🐭‼️ 🎯Global ApoE deficiency delays gut transit & promotes inflammation, while macrophage-specific ApoE deletion does not impair motility #POI👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Keypoints:
Muscularis macrophages express high levels of ApoE after intestinal manipulation, but macrophage-specific deletion of ApoE does not impair gut motility or tissue morphology.
While global ApoE deficiency mildly affects intestinal transit and promotes inflammation, macrophage-derived ApoE is dispensable for maintaining normal and postoperative gut motility.

@ngmjournal.bsky.social · 8mo ago

🆕🔥Combined utility of #CARS endoscopic score & #FLIP based on real‐time assessments‼️ 🎯Combination of CARS score ≥ 4 & reduced #EGJ opening on FLIP is highly predictive of an EGJ obstruction diagnosis #Achalasia #EGJOO👏 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Key Points:
Calculating the CARS endoscopic score and performing FLIP panometry during endoscopy can assess the likelihood of an esophageal motility disorder and potentially expedite its diagnosis.
A CARS score > 4 combined with FLIP-REO is highly predictive (100% specificity/100% positive predictive value) of an EGJ obstruction diagnosis (achalasia or confirmed EGJOO) on HRM.

@ngmjournal.bsky.social · 8mo ago

🆕🔥Pilot validation study of🌱plant‐based & allergy‐friendly alternative for testing #GastricEmptying #HealthyParticipants‼️ 🎯Tested #vegan egg meal appears to be a suitable alternative to standard egg meal for patients who are not able to eat eggs 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Key Points:
Validated options for assessing gastric emptying in patients with dietary restrictions that preclude eating the standard egg meal.
We developed and tested a vegan and allergy friendly meal using a vegan egg product for gastric emptying scintigraphy in 10 healthy volunteers after confirming in vitro stability/performance.
The tested vegan egg meal appears to be a suitable alternative to the standard egg meal for patients who are not able to eat eggs, though additional studies with larger sample sizes are needed for further validation.

@ngmjournal.bsky.social · 8mo ago

🆕🔥Loss of #Myofilaments in gastrointestinal smooth muscle represents a novel pathological mechanism in MELAS-associated chronic intestinal Pseudo-obstruction #CIPO‼️ 🎯 #Mitochondrial dysfunction directly impairs smooth muscle contractile apparatus 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Key Points:
This study reports the first documented case of myofilament loss in gastrointestinal smooth muscle cells in MELAS-associated chronic intestinal pseudo-obstruction (CIPO). Electron microscopic analysis demonstrated marked reduction of myofilaments accompanied by abundant abnormal mitochondria throughout the digestive tract, revealing that mitochondrial dysfunction may directly impair the smooth muscle contractile apparatus independent of previously described enteric nervous system abnormalities.
These findings suggest that apparent superior mesenteric artery syndrome in MELAS patients may represent underlying CIPO with inherent intestinal structural vulnerability, supporting early implementation of enteral nutrition strategies that bypass affected gastrointestinal segments. Future research should focus on quantitative assessment of contractile protein abnormalities and development of therapeutic interventions targeting smooth muscle function in mitochondrial disorders.

@ngmjournal.bsky.social · 8mo ago

🆕🔥Distinct Phenotypes of #RectalProlapse #RP in Women‼️ 🎯#Defecation-only RP represents an early stage of disease #preserved #AnalSphincter function ⬇️#PelvicFloorLaxity👏 🎯Patients with #Spontaneous RP are older & have⬆️ fecal incontinence severity 👉 onlinelibrary.wiley.com/doi/10.1111/... #ANMS #ESNM

Key Points
Patients with rectal prolapse only at defecation present a distinct, younger phenotype with more severe obstructive defecation symptoms, higher intrarectal push pressures, and better-preserved anal sphincter function. In contrast patients with spontaneous rectal prolapse are older and have higher fecal incontinence severity associated with lower resting anal tone and less sustained squeeze pressures.
MRI defecography shows greater pelvic floor laxity in spontaneous prolapse (larger levator hiatus length/width, bowl volume, and wider resting anorectal angle), whereas defecation-only prolapse demonstrates more preserved hiatus anatomy and less patulous anal canal.
Defecation-only prolapse may represent an early stage of disease. Identifying the phenotype of rectal prolapse can inform timing and type of intervention though surgical recurrence rates were similar between groups.