Brian E. Lacy’s research while affiliated with Mayo Clinic and other places

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Publications (488)


Diagnosing and managing gastroparesis - where are we now?
  • Article

November 2024

Caroline G Olson

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Brian E Lacy






Ranking of the most bothersome symptoms of IBS‐C (n = 885) and IBS‐D (n = 653). IBS‐C, irritable bowel syndrome with constipation; IBS‐D, irritable bowel syndrome with diarrhea.
Treatments currently taken for symptoms of (A) IBS‐C and (B) IBS‐D. IBS‐C, irritable bowel syndrome with constipation; IBS‐D, irritable bowel syndrome with diarrhea; SD, standard deviation.
Burden of illness and treatment attitudes among participants meeting Rome IV criteria for irritable bowel syndrome: A nationwide survey in the United States
  • Article
  • Full-text available

September 2024

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29 Reads

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2 Citations

Background Irritable bowel syndrome (IBS) is a disorder of gut–brain interaction characterized by abdominal pain and altered bowel habits, with patient‐perceived dissatisfaction of treatment symptom control. We assessed disease burden, satisfaction with medication use, and impact on activities, in participants with IBS with constipation (IBS‐C) and diarrhea (IBS‐D). Methods This study assessed data from a large, United States survey of adults querying demographics, comorbid conditions, quality of life, medication use, satisfaction with symptom control, and work productivity. Participants were grouped into the IBS‐C or IBS‐D cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self‐reported. Key Results Nine hundred and ten participants with IBS‐C and 669 with IBS‐D were matched to controls. The most reported symptoms were abdominal discomfort for IBS‐C and abdominal pain and abdominal discomfort for IBS‐D. Among the IBS‐C and IBS‐D cohorts, 74.2% and 65.9%, respectively, took prescription and/or over‐the‐counter medication for their symptoms. Respondents were more dissatisfied than satisfied with control of their symptoms. Respondents taking prescription medication(s) with or without over‐the‐counter medication(s) reported better symptom control than respondents only taking over‐the‐counter medications (p < 0.001). There was significantly higher mean presenteeism, work productivity loss, and daily activity impairment (p < 0.001 for all) in respondents with IBS compared with controls. Conclusions and Inferences This study provides insight into respondents' experiences of IBS symptoms, including the impact on daily activity, as well as satisfaction with control of symptoms and prescription and over‐the‐counter medications.

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Overall survey and IBS/CIC module relationship diagram. CIC, chronic idiopathic constipation; HCP, healthcare provider; HRQoL, health‐related quality of life; IBS, irritable bowel syndrome.
(A) Ranking of the most bothersome symptoms in the past week, symptoms leading to medication use in the past year, and (B) medications currently taken for symptom control. †2413 respondents answered the question. Respondents reported and ranked their top five most bothersome symptoms experienced in the past 7 days; ‡2302 respondents answered the question; all percentages are calculated from that number. CIC, chronic idiopathic constipation; OTC, over the counter.
Satisfaction with symptom control in respondents with CIC. †Includes respondents who responded “extremely dissatisfied,” “very dissatisfied,” or “dissatisfied;” ‡Includes respondents who responded “extremely satisfied,” “very satisfied,” or “satisfied.” CIC, chronic idiopathic constipation; OTC, over the counter.
Treatment for chronic idiopathic constipation: Use and satisfaction from a nationwide survey of US participants

August 2024

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24 Reads

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3 Citations

Background Chronic idiopathic constipation (CIC) is a disorder of gut–brain interaction characterized by a variety of bowel movement‐related and abdominal symptoms. A greater understanding of medication use and satisfaction with symptom control may provide insights to optimize patient care. Therefore, we explored these aspects of the disorder in adults with CIC. Methods This study assessed data collected from a large nationwide survey of adult participants in the United States, querying demographics, clinical characteristics, and comorbid conditions, as well as medication use, care‐seeking behaviors, and satisfaction with symptom control. Participants were grouped into the CIC cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self‐reported. Key Results Two thousand five hundred and thirty‐three participants with CIC were matched 1:1 to controls. In the CIC cohort, abdominal pain was the most reported symptom leading to medication use: 15.9% of respondents were receiving a prescription medication in addition to an over‐the‐counter medication, while 26.3% were taking neither. In addition, only one‐third were satisfied with the control of their symptoms; however, satisfaction was significantly higher in respondents taking a prescription medication (p < 0.001). The proportion of reported comorbidities was significantly higher in the CIC cohort versus the control cohort, with chronic pain, anxiety, and depression among the highest (p < 0.001 for all). Conclusions and Inferences This study emphasizes the need for better communication regarding prescription medications and their benefits, with the goal of further improving CIC patients' overall symptoms.




Citations (47)


... AHRI data and survey methodology have been described in multiple publications. 13,[15][16][17] The study protocol was reviewed by the Sterling Institutional Review Board and classified as exempt because responses were deidentified in accordance with 45 CFR §46. Participants electronically signed informed consent. ...

Reference:

Gout Flare Burden in the United States: A Multiyear Cross‐Sectional Survey Study
Burden of illness and treatment attitudes among participants meeting Rome IV criteria for irritable bowel syndrome: A nationwide survey in the United States

... 9 Seseorang dengan leaky gut mengeluh diare kronis, kembung, ketidaknyamanan di daerah perut, mual, masalah kulit seperti jerawat atau eksim dan nyeri sendi. 10 Berbagai marker penanda masih terus dilakukan penelitian. Beberapa marker yang telah diketahui antara lain penurunan eskpresi protein adesi zonulin dan okludin, peningkatan inflamasi dan penuruan bakteri Laktobasilus. ...

Leaky Gut Syndrome: Myths and Management
  • Citing Article
  • August 2024

Gastroenterology and Hepatology

... AHRI data and survey methodology have been described in multiple publications. 13,[15][16][17] The study protocol was reviewed by the Sterling Institutional Review Board and classified as exempt because responses were deidentified in accordance with 45 CFR §46. Participants electronically signed informed consent. ...

Treatment for chronic idiopathic constipation: Use and satisfaction from a nationwide survey of US participants

... Recently, PAMORA, including naldemedine, has become part of clinical practice and is recommended for patients with OIC refractory to traditional laxative [11,12]. Several studies have demonstrated the effectiveness of PAMORA in treating OIC [26,27], but few studies have investigated the preventive effects of prophylactic laxatives on OIC. Ozaki et al. compared prophylactic naldemedine with prophylactic magnesium oxide in terms of the incidence of OIC. ...

Opioids and the Gastrointestinal Tract: The Role of Peripherally Active µ-Opioid Receptor Antagonists in Modulating Intestinal Permeability

The American Journal of Gastroenterology

... On the other, the increased permeability at intestinal barrier associated with IBS (with some genetic association to IBS-D) may promote reactions to toxins, microbial excretory/secretory products or food allergens gaining access from lumen to mucosal intestinal compartments thus interacting with lymphocytes and mast cells [10,11]. In fact, tenapanor, an inhibitor of Sodium-Proton ex-changer NHE3 that promotes permeability restoration is currently approved for use in IBS-C [12]. In line with these facts, serotonin produced in the gut by Enterochromaffin Cells (ECCs) is a wellknown general regulator of membrane permeability [13]. ...

Intestinal Permeability, Irritable Bowel Syndrome with Constipation, and the Role of Sodium-Hydrogen Exchanger Isoform 3 (NHE3)

... Chronic N/V syndrome and gastroparesis are usually treated with prokinetics. Domperidone and Metoclopramide are often used, but unfortunately, both drugs can have serious side effects and their long-term use is restricted [18]. Erythromycin stimulates contractions of the stomach and small intestine. ...

Prokinetics‐safety and efficacy: The European Society of Neurogastroenterology and Motility/The American Neurogastroenterology and Motility Society expert review

... It is important to exclude secondary causes of CC, evaluate the presence of comorbidities and, in some instances (i.e., in refractory cases), explore the underlying pathophysiological mechanisms in order to improve management and therapeutic appropriateness [7,23,24]. In recent years, several surveys have been published regarding the management of CC [2,8,[25][26][27][28]. These surveys were mainly directed at patients and addressed prevalence and risk factors [2,25,26] or treatment strategies [8,27,28] for patients with chronic constipation. ...

Prevalence and patterns of laxative use in subjects with self-reported constipation: results from a multinational digestive health survey

... In contrast, the etiology of DGBI is less well defined and responses to gut-brain psychological therapy 5 and pharmacotherapy 6 are arguably more variable, partly due to the lack of objective biomarkers detectable using routine clinical evaluation, which could help guide management. 7 Indeed, the management of DGBI relies to a greater extent on the biopsychosocial model; uniform and streamlined care can challenge healthcare systems when biological, psychological and social interventions must be delivered in nuanced, balanced measures. 8 Treatment of DGBI is further complicated by the greater stigma that patients with such conditions face compared to those with organic gastrointestinal (GI) disease. ...

Patient-Reported Outcomes in Disorders of Gut–Brain Interaction
  • Citing Article
  • February 2024

Gastroenterology

... Tenapanor also alleviated other abdominal symptoms experienced by patients with IBS-C such as bloating, discomfort, cramping, and fullness. 63 Consistent with tenapanor's action to increase water retention in the intestinal lumen and improve gastrointestinal motility, most treatment-emergent adverse events in the phase 3 studies were gastrointestinal in nature. The most common adverse event reported among tenapanor-treated patients was diarrhea (14.6% in T3MPO-1, 16.0% in T3MPO-2, and 11.1% in T3MPO-3) ( Table 2). ...

Abdominal Symptom Improvement During Clinical Trials of Tenapanor in Patients With Irritable Bowel Syndrome With Constipation: A Post Hoc Analysis

The American Journal of Gastroenterology

... Overall, the gastroenterologists who were most affected by burnout were women and younger members of the profession, and this occurred as a result of the stressors from both the change in work from the virus and its effect on home life and financial uncertainty. Both family and patients were seen for shorter periods, and care for patients was more complicated, involving increased administration that concomitantly expanded the litigiousness of the environment [51]. ...

Burnout in GI Providers
  • Citing Article
  • January 2024

The American Journal of Gastroenterology