Kyle Staller's research while affiliated with Harvard Medical School and other places

Publications (169)

Article
Background: Little is known about the impact of psychiatric comorbidity on pharmacologic treatment outcomes, including neuromodulators (medications targeting the gut-brain axis), among adult patients with disorders of gut-brain interaction (DGBI). Accordingly, we aimed to examine associations between psychiatric comorbidity and DGBI pharmacologic...
Article
Disruption of normal gastrointestinal (GI) function in critical illness is linked to increased morbidity and mortality, and GI dysmotility is frequently observed in patients who are critically ill. Despite its high prevalence, the diagnosis and management of GI motility problems in the intensive care unit remain very challenging, given that critica...
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Health care providers are likely to encounter patients with recurrent unexplained abdominal pain. Because hereditary angioedema (HAE) is a rare disease, it may not be part of the differential diagnosis, especially for patients who do not have concurrent skin swelling in addition to abdominal symptoms. Abdominal pain is very common in patients with...
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Purpose of Review Colonic motility disorders may be influenced by the gut microbiota, which plays a role in modulating sensory and motor function. However, existing data are inconsistent, possibly due to complex disease pathophysiology, fluctuation in symptoms, and difficulty characterizing high-resolution taxonomic composition and function of the...
Article
Background: Satisfaction with current treatment options for irritable bowel syndrome with constipation (IBS-C) is low, with many patients turning to complementary treatments. Tai Chi is a mind-body medicine practice with proven efficacy in other functional disorders. As a proof-of-concept, we tested the feasibility and preliminary clinical outcome...
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Objective Normal elective outpatient care has been impacted during the COVID-19 pandemic, due to limitations imposed by healthcare systems. Clear communication is necessary to address patient concerns as resumption of elective care gains pace. Methods Thirty patients who had diagnostic gastrointestinal (GI) testing within our motility lab during t...
Article
Fecal incontinence (FI) is a debilitating gastrointestinal disorder with a devastating impact on quality of life,1,2 particularly on older women, partly because of unique risk factors including parity and menopause.2,3 Therefore, identifying modifiable factors, such as diet, are crucial for developing effective prevention strategies for FI among th...
Chapter
Although rarely requiring surgery, irritable bowel syndrome (IBS), chronic abdominal pain, and chronic pelvic pain are a sizeable subset of patients referred to a colorectal specialist. This group of patients suffer from frequent misdiagnoses and are at increased likelihood of undergoing inappropriate surgical procedures. Having a rational diagnost...
Article
Recent reports document avoidant/restrictive food intake disorder (ARFID) symptoms among 24-43% of adults presenting to neurogastroenterology clinics, but ARFID in pediatrics is understudied. We conducted a retrospective review of charts from 129 consecutive referrals (ages 6-18 y; 57% female) for pediatric neurogastroenterology examination, from J...
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Background Prescription drug costs exert profound effects on commercial insurance coverage and access to effective therapy. Aims We aimed to assess threshold pricing to achieve budget neutrality of FDA-approved drugs treating irritable bowel syndrome from an insurance perspective, based on cost-savings resulting in decreased healthcare utilization...
Article
Background Functional gastrointestinal disorders are a common but challenging set of conditions to treat. Gastroenterology practices often struggle to meet the needs of patients with functional disorders given the need for careful monitoring, frequent communication, and management of stressors that occur outside of the clinical setting. In recent y...
Article
Background and aims: Prolonged colon transit times may increase contact time between potential carcinogens in the stool and the colonic mucosa. Nonetheless, previous studies have yielded conflicting results connecting chronic constipation with risk of CRC. We examined the association between chronic constipation and later CRC. Methods: In this n...
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The first coronavirus disease 2019 (COVID-19) pandemic surge harshly impacted the medically underserved populations of the urbanized northeastern United States. Severe acute respiratory syndrome coronavirus 2 virions infect the gastrointestinal (GI) tract, and GI symptoms are common during acute infection.1 Post-COVID syndromes increasingly are rec...
Article
Background Previous studies show some patients with functional gastrointestinal disorders (disorders of gut-brain interaction) may be at risk for or already have an eating disorder (ED). Avoidant/restrictive food intake disorder (ARFID) (ED not primarily motivated by body shape/weight concerns) may be particularly relevant but previous studies have...
Article
Introduction: This post hoc analysis evaluated the effect of prucalopride on abdominal bloating in participants with chronic idiopathic constipation (CIC) who had moderate to very severe bloating at baseline. Methods: Data from 6 phase 3/4 studies of prucalopride in participants with CIC were pooled. Abdominal bloating was assessed weekly using...
Article
Introduction: Chronic idiopathic constipation (CIC) is a common and burdensome illness. We performed a cost-effectiveness analysis of the US Food and Drug Administration-approved CIC drugs to evaluate and quantify treatment preferences compared with usual care from insurer and patient perspectives. Methods: We evaluated the subset of patients wi...
Article
Introduction : Symptoms of irritable bowel syndrome (IBS) are common reasons for endoscopic procedures. We examined the yield of colonoscopy and upper endoscopy in IBS for several organic diseases. Methods : Matched population-based prevalence study in Sweden. We identified 21,944 participants diagnosed with IBS from 1987 to 2016 undergoing colono...
Article
Introduction: We evaluated factors that can predict the adequacy of bowel preparation in patients with chronic constipation undergoing colonoscopy. Materials and methods: We identified patients with chronic constipation who underwent anorectal manometry and at least 1 colonoscopy at 2 tertiary referral centers from 2003 to 2019. We also identifi...
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We extend previous studies on the impact of masks on COVID-19 outcomes by investigating an unprecedented breadth and depth of health outcomes, geographical resolutions, types of mask mandates, early versus later waves and controlling for other government interventions, mobility testing rate and weather. We show that mask mandates are associated wit...
Article
To the Editor In their Review about gastroesophageal reflux disease (GERD), Dr Maret-Ouda and colleagues¹ discussed risk factors and treatment options for GERD, including surgery and advanced endoscopic techniques. However, we believe they overlooked several recommendations that may benefit patients with heartburn.
Article
Background Chronic constipation is a common condition, and dyssynergic defecation underlies up to 40% of cases. Anorectal manometry is recommended to assess for dyssynergic defecation among chronically constipated patients but remains poorly standardized. We aimed to evaluate the diagnostic accuracy of anorectal manometry and determine optimal test...
Article
Background and Aims Early reports suggest significant difficulty with enteral feeding in critically ill COVID-19 patients. This study aimed to characterize the prevalence, clinical manifestations, and outcomes of feeding intolerance in critically ill patients with COVID-19. Methods We examined 323 adult patients with COVID-19 admitted to the inten...
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Background Examining the prevalence of irritable bowel syndrome (IBS) across regions has been challenging given significant methodological heterogeneity.AimsWe aimed to perform a uniform assessment of the global burden of IBS using data from Google Trends, a novel, online tool.Methods Google Trends measures popularity of a search term in a given we...
Article
Fecal incontinence can be a challenging and stigmatizing disease with a high prevalence in the elderly population. Despite effective treatment options, most patients do not receive care. Clues in the history and physical examination can assist the provider in establishing the diagnosis. Direct inquiry about the presence of incontinence is key. Bowe...
Preprint
Using publicly available data, we quantify the impact of mask adherence and mask mandates on COVID-19 outcomes. We show that mask mandates are associated with a statistically significant decrease in daily new cases (-3.24 per 100K), deaths (-0.19 per 100K), and the proportion of hospital admissions (-2.47%) due to COVID-19 between February 1 and Se...
Article
Objective The etiology of diverticulitis is poorly understood. The long-held belief that constipation and low-fiber diet are risk factors for diverticulosis has recently been challenged by studies that suggest that more frequent bowel movements predispose to diverticulosis. We aim to prospectively explore the association between bowel movement freq...
Article
Gastroesophageal reflux disease (GERD) affects nearly 30% of the US population.¹ Clinicians recommend dietary and lifestyle modifications to prevent GERD symptoms, but no prospective data are available to inform these recommendations. We evaluated the joint association of dietary and lifestyle factors with the risk of GERD symptoms.
Article
Background Racial disparity in healthcare is defined as differences in healthcare services received by racial groups not due to difference in needs or preferences. As irritable bowel syndrome (IBS) is highly correlated with social factors, healthcare disparities are important factors in the sociocultural model of IBS. We used healthcare utilization...
Article
Objective Little research exists on Rome IV disorders of gut–brain interaction (DGBI; formerly called functional gastrointestinal disorders) in outpatients with eating disorders (EDs). These data are particularly lacking for avoidant/restrictive food intake disorder (ARFID), which shares core features with DGBI. We aimed to identify the frequency a...
Article
Incorporating an APP into practice is an investment to improve and strengthen the care of shared patients and advance practice goals. The creation of a vigorous, yet practical orientation will set clear expectations to be followed throughout the APP’s time in the practice. Retention of APPs heavily depends on the motivation of both the APP and thei...
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Background/aims: CSP01 is a novel superabsorbent hydrogel that absorbs gastrointestinal fluids and maintains high viscoelastic properties into the colon, where these fluids are released. Methods: We conducted a 3 week-long single-center, randomized, double-blind, parallel-group, placebocontrolled pilot study comparing change in colonic transit t...
Article
Background Use of antibiotics in early life has been linked with childhood inflammatory bowel disease (IBD), but data for adults are mixed, and based on smaller investigations that did not compare risk among siblings with shared genetic or environmental risk factors. We aimed to investigate the association between antibiotic therapy and IBD in a la...
Article
Low-dose aspirin is recommended by the U.S. Preventive Services Task Force for primary prevention of colorectal cancer (CRC) in certain individuals. However, broader implementation will require improved precision prevention approaches to identify those most likely to benefit. The major urinary metabolite of PGE2, 11α-hydroxy-9,15-dioxo-2,3,4,5-tetr...
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Background: Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis. Methods: Our study population included participants in the Gastrointestinal Disease and...
Article
Google Trends is an online tool that allows measurement of search term popularity on Google, spatially and temporally. While not an epidemiological tool for determining incidence, it can estimate the popularity of a certain disease by search volume over time.1,2 It has previously correlated well with infectious disease incidence and has demonstrate...
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Rebecca Liu,1 Kyle Staller1,2 1Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; 2Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USACorrespondence: Kyle StallerMassachusetts General Hospital, 165 Cambridge St. 9th floor, B...
Article
Background Long-term colorectal cancer incidence and mortality after colorectal polyp removal remains unclear. We aimed to assess colorectal cancer incidence and mortality in individuals with removal of different histological subtypes of polyps relative to the general population. Methods We did a matched cohort study through prospective record lin...
Article
Objectives: Mortality concern is a frequent driver of care seeking in patients with irritable bowel syndrome (IBS). Data on mortality in IBS are scarce, and population-based studies have been limited in size. We examined mortality in IBS. Methods: A nationwide, matched, population-based cohort study was conducted in Sweden. We identified 45,524...
Preprint
Full-text available
Background: Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis. Methods: Our study population included participants in the Gastrointestinal Disease and E...
Preprint
Full-text available
Background: Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis. Methods: Our study population included participants in the Gastrointestinal Disease and E...
Article
Background aims: Individuals with eating disorders (EDs) frequently have constipation-related symptoms, although the mechanisms of this relationship are not clear. We examined the frequency of and relation between EDs and constipation in patients with chronic constipation referred for anorectal manometry. Methods: We analyzed data from 279 patie...
Article
Purpose: Urinary incontinence (UI) and fecal incontinence (FI) are common disorders in women that negatively impact quality of life. In addition to known health and lifestyle risk factors, genetics may play a role. Identification of genetic variants associated with UI and FI could result in better understanding of etiologic pathways and new interv...
Article
Objectives: Although the endogenous cannabinoid system modulates bowel function, our understanding of the impact of recreational marijuana (MJ) use on bowel motility is limited. This study examines the effect of MJ on self-reported bowel function among a large cohort of US adults. Methods: We identified adults (age: 20-59 years) who completed bo...
Article
Background & aims: Patients are frequently advised to eliminate coffee, tea, and/or soda to reduce symptoms of gastroesophageal reflux (GER), such as heartburn or regurgitation. However, there are no data from prospective studies to support these recommendations. Methods: We collected data from the prospective Nurses' Health Study II from 48,308...
Article
Background & aims: Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder that is characterized by avoidant or restrictive eating not primarily motivated by body shape or weight concerns. We aimed to determine the frequency of ARFID symptoms and study its characteristics and associated gastrointestinal symptoms. Method...
Article
Goals: We sought to determine the incidence of jackhammer esophagus (JE) after lung transplantation (LT) and identify potential risk factors for the development of JE after LT. Background: JE is a rare esophageal motility disorder, and its pathophysiology remains unclear. Lung transplantation has been implicated as a potential risk factor for JE...
Article
The critical role of the gut microbiome in microscopic colitis (MC) is evident by the observation that fecal diversion is associated with resolution of mucosal inflammation while restoration of fecal stream is associated with recurrence of disease.1 Characterization of the composition and function of the gut microbiome in MC therefore could provide...