William L. Hasler's research while affiliated with Mayo Clinic - Scottsdale and other places

Publications (311)

Article
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Background An increasing number of studies have explored the clinical features, epidemiology, pathophysiology, and management of cyclic vomiting syndrome (CVS). CVS is common in adults and children and negatively impacts patients, families, and the healthcare system. A related condition, cannabinoid hyperemesis syndrome (CHS), has been a focus of i...
Article
Gastroparesis presents with nausea, early satiety, vomiting, bloating, distention, and abdominal pain and is diagnosed by documenting delayed passage of contents from the stomach to the intestines in the absence of mechanical obstruction. Several factors contribute to gastroparesis pathophysiology. Pylorospasm, or increased pyloric contractility, i...
Chapter
Cyclic vomiting syndrome (CVS) and marijuana-induced hyperemesis referred to as cannabinoid hyperemesis syndrome (CHS) are characterized by recurrent episodes of nausea and vomiting. This chapter addresses salient features of CVS, CHS, and abnormalities in gastric emptying/dumping syndrome. CHS is thought to be a subset of CVS and is related to chr...
Article
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Purposeof Review Migraine is a chronic and disabling disease affecting a significant proportion of the world’s population. There is evidence that gastroparesis, a gastrointestinal (GI) dysmotility disorder in which transit of gastric contents is delayed, can occur in the setting of migraine. This article aims to review recent literature on overlap...
Article
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Abnormalities of mast cell structure or function may play prominent roles in irritable bowel syndrome (IBS) symptom genesis. Mast cells show close apposition to sensory nerves and release bioactive substances in response to varied stimuli including infection, stress, and other neuroendocrine factors. Most studies focus on patients who develop IBS a...
Chapter
Cannabinoid hyperemesis syndrome (CHS) is defined by the Rome Foundation as stereotypical episodic vomiting resembling cyclic vomiting syndrome (CVS) that presents after a prolonged period of excessive cannabis use and is relieved by sustained cannabis cessation. It is uncertain if CHS is a subset of CVS or a distinct entity. Estimates of CHS preva...
Chapter
Cyclic vomiting syndrome (CVS) comprises four distinct phases. This chapter addresses especially challenging components of CVS care—aborting symptoms in the prodromal or early emetic phase and providing supportive treatment for patients with vomiting unresponsive to abortive therapy if needed. Available treatments which can be self-administered at...
Chapter
Cyclic vomiting syndrome (CVS) is a chronic disorder of recurrent episodes of repetitive vomiting, separated by periods of reduced or absent symptoms. A notable group of patients with moderate-to-severe CVS experience episodes that are frequent and/or severe enough to require daily preventive (or prophylactic) medications. The goal of this treatmen...
Chapter
Cannabinoid hyperemesis syndrome (CHS) was defined by the Rome Foundation as a functional nausea and vomiting disorder separated from cyclic vomiting syndrome (CVS) and chronic nausea vomiting syndrome. However, there is marked overlap with CVS and there is disagreement if CHS is a CVS subset instead of a distinct condition. Because of divergent di...
Article
Objective Although gastric per-oral endoscopic myotomy (G-POEM) is considered a promising technique for the management of refractory gastroparesis, high-quality evidence is limited. We prospectively investigated the efficacy and safety of G-POEM in unselected patients with refractory gastroparesis. Design In five tertiary centres, patients with sy...
Article
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Background Small intestinal bacterial overgrowth (SIBO) is defined by an increased number of bacteria measured via exhaled hydrogen and/or methane gas following the ingestion of glucose. This condition is prevalent following abdominal surgery, including Roux-en-Y gastric bypass (RYGB), and associated with a variety of non-specific abdominal symptom...
Article
Introduction: The North American Consensus guidelines for glucose breath testing (GBT) for small intestinal bacterial overgrowth (SIBO) incorporated changes in glucose dosing and diagnostic cutoffs. We compared GBT positivity based on hydrogen and methane excretion and quantified symptoms during performance of the North American vs older modified...
Chapter
Gastroparesis presents with cardinal symptoms suggesting a gastroduodenal origin and is diagnosed by demonstrating delayed gastric emptying. However, most patients with gastroparesis symptoms exhibit normal emptying and alternatively are given diagnoses of functional gastroduodenal disorders. This observation along with poor correlation of gastric...
Article
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Objective The gastrointestinal environment in which drug products need to disintegrate before the drug can dissolve and be absorbed has not been studied in detail due to limitations, especially invasiveness of existing techniques. Minimal in vivo data is available on undisturbed gastrointestinal motility to improve relevance of predictive dissoluti...
Article
Background & Aims Constipation can be an important symptom in some patients with gastroparesis. The aims were to: 1) Determine prevalence of constipation and delayed colonic transit in patients with symptoms of gastroparesis; 2) Correlate severity of constipation to severity of symptoms of gastroparesis; and 3) Relate severity of constipation to GI...
Article
Background and aims: Whether gastric emptying tests predict longitudinal outcomes in patients with symptoms of gastroparesis is unclear. We aimed to determine whether baseline gastric emptying tests and gut motility parameters could impact longitudinal symptom(s) and quality of life (QOL) in a prospective, observational cohort study of patients wi...
Article
Gastroparesis presents with nausea, vomiting, and other upper gut symptoms, and is diagnosed by confirming delayed gastric emptying. A related condition, chronic unexplained nausea and vomiting, has similar symptoms but with normal emptying. Both conditions are managed using therapies with diverse mechanisms of action. Even though prokinetic treatm...
Article
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Background Marijuana may be used by some patients with gastroparesis (Gp) for its potential antiemetic, orexigenic, and pain-relieving effects. Aims The aim of this study was to describe the use of marijuana by patients for symptoms of Gp, assessing prevalence of use, patient characteristics, and patients’ perceived benefit on their symptoms of Gp...
Article
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Fluid sampling from the gastrointestinal (GI) tract has been applied as a valuable tool to gain more insight into the fluids present in the human GI tract and to explore the dynamic interplay of drug release, dissolution, precipitation and absorption after drug product administration to healthy subjects. In the last twenty years, collaborative init...
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LINKED CONTENT This article is linked to Camilleri et al and Camilleri papers. To view these articles, visit https://doi.org/10.1111/apt.15711 and https://doi.org/10.1111/apt.15866.
Article
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Background Functional Lumen Imaging Probe (EndoFLIP) tests typically measure static pyloric parameters, but the pylorus exhibits phasic variations on manometry. Dynamic changes in pyloric function have not been quantified using EndoFLIP, and the impact of Gastric Per‐Oral Endoscopic Myotomy (G‐POEM) on static and dynamic pyloric activity in gastrop...
Article
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Background Autonomic dysfunction can be present in patients with idiopathic and diabetic gastroparesis. The role of autonomic dysfunction relating to gastric emptying and upper gastrointestinal symptoms in patients with gastroparesis and chronic unexplained nausea and vomiting (CUNV) remains unclear. The aim of our study is to evaluate autonomic fu...
Article
The community prevalence of dyspepsia ranges from 20% to 40%, and dyspepsia accounts for 3% to 5% of primary care visits. Dyspepsia symptoms include epigastric pain, epigastric burning, postprandial fullness, early satiety, epigastric bloating, nausea, and belching. Functional dyspepsia is diagnosed when an organic etiology for the symptoms is not...
Article
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Background and aims: Endoluminal functional luminal imaging probe (EndoFLIP) is an imaging tool that measures physiological characteristics of gastrointestinal sphincters. In this study we used EndoFLIP to evaluate the association between the pyloric physiological measurements with clinical outcomes of gastric peroral endoscopic myotomy (G-POEM) i...
Article
Multiple approaches such as mathematical deconvolution and mechanistic oral absorption models have been used to predict in vivo drug dissolution in the gastrointestinal (GI) tract. However, these approaches are often validated by plasma pharmacokinetic profiles, but not by in vivo drug dissolution due to the limited data available regarding the loc...
Article
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https://deepblue.lib.umich.edu/bitstream/2027.42/153273/1/nmo13715_am.pdf
Article
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Background Gastric electrical stimulation (GES) for treating gastroparesis symptoms is controversial. Methods We studied 319 idiopathic or diabetic gastroparesis symptom patients from the Gastroparesis Clinical Research Consortium (GpCRC) observational studies: 238 without GES and 81 with GES. We assessed the effects of GES using change in GCSI to...
Article
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Introduction: Gastric emptying scintigraphy (GES) or wireless motility capsules (WMCs) can evaluate upper gastrointestinal symptoms in suspected gastroparesis; WMC tests can also investigate lower gut symptoms. We aimed to determine whether these tests impact treatment plans and needs for additional diagnostic evaluation. Methods: In a prospecti...
Article
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Background Symptoms induced by caloric or non‐caloric satiety test meals and gastric myoelectrical activity (GMA) have not been studied in patients with diabetic gastroparesis (DGP) before and after intense glucose management. Aims We determined the effects of continuous subcutaneous insulin infusion (CSII) with continuous glucose monitoring (CGM)...
Article
Objectives: Diabetic gastroparesis (Gp) occurs more often in type 1 diabetes mellitus (T1DM) than in type 2 diabetes mellitus (T2DM). Other diabetic end-organ complications include peripheral neuropathy, nephropathy, and retinopathy (together termed triopathy). This study determines the prevalence of diabetic complications (retinopathy, nephropath...
Article
INTRODUCTION We previously reported a positive impact of gastroparesis diet recommendations on overall and individual symptoms in patients with suspected gastroparesis who show gastric emptying delays. In contrast, those with non-delayed gastric emptying showed only minimal benefits on this diet. The impact of gastroparesis diet recommendations in...
Article
INTRODUCTION Diarrhea-predominant irritable bowel syndrome (IBS-D) is a chronic, disabling condition. Treatments for IBS-D, including rifaximin, a nonabsorbable antibiotic, and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP), improve symptoms in ≤50% of patients. We hypothesized that changes in the g...
Article
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Abdominal pain can be an important symptom in some patients with gastroparesis (Gp). Aims (1) To describe characteristics of abdominal pain in Gp; (2) describe Gp patients reporting abdominal pain. Methods Patients with idiopathic gastroparesis (IG) and diabetic gastroparesis (DG) were studied with gastric emptying scintigraphy, water load test,...
Article
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Cyclic vomiting syndrome (CVS) is characterized by severe episodic emesis in adults and children. Cannabinoid hyperemesis syndrome is an increasingly recognized CVS‐like illness that has been associated with chronic cannabis use. There are significant gaps in our understanding of the pathophysiology, clinical features, comorbidities, and effective...
Article
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Cannabis is commonly used in cyclic vomiting syndrome (CVS) due to its antiemetic and anxiolytic properties. Paradoxically, chronic cannabis use in the context of cyclic vomiting has led to the recognition of a putative new disorder called cannabinoid hyperemesis syndrome (CHS). Since its first description in 2004, numerous case series and case rep...
Article
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The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence‐based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessmen...
Article
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Background This evidence review was conducted to inform the accompanying clinical practice guideline on the management of cyclic vomiting syndrome (CVS) in adults. Methods We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and focused on interventions aimed at prophylactic management and abortive t...
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Linked Content This article is linked to Navas et al paper. To view this article, visit https://doi.org/10.1111/apt.15112.
Article
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The gut microbiota are linked to a variety of gastrointestinal diseases, including inflammatory bowel disease. Despite this importance, microbiota dynamics in the upper gastrointestinal tract are understudied. Our article seeks to understand what factors impact microbiota dynamics in the healthy human upper gut. We found that the upper gastrointest...
Article
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OBJECTIVES/SPECIFIC AIMS: Objectives and goals of this study are to (i) determine whether IBS-D patients randomized to either rifaximin or low FODMAP diet show improvement in IBS-related symptoms; and (2) identify using longitudinal analyses how SIBO status and fecal microbiota features associate with response to either rifaximin or low FODMAP diet...
Article
Symptoms of abdominal pain, nausea, vomiting, bloating, abdominal distention, diarrhea, and constipation are common and may relate to abnormalities in gastrointestinal motility. There are a number of different options to study gastrointestinal motility. This article reviews novel and standard motility tests available in the stomach, small bowel, an...
Article
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Background/Aims High-resolution methods have advanced esophageal and anorectal manometry interpretation but are incompletely established for intestinal manometry. We characterized normal fasting duodeno-jejunal manometry parameters not measurable by standard techniques using clustered closely-spaced recordings. Methods Ten fasting recordings were...
Chapter
Based on recent consensus documents, dyspepsia is defined as predominant epigastric pain lasting at least 1 month. Patients with dyspepsia commonly report associated symptoms including epigastric burning, early satiety, postprandial fullness, and nausea. The differential diagnosis for dyspepsia is broad, which warrants a focused diagnostic evaluati...
Article
Background & aims: It is a challenge to make a diagnosis of gastroparesis. There is good agreement in results from wireless motility capsule (WMC) analysis and gastric emptying scintigraphy (GES), but the diagnostic yield of WMC is unclear and the accuracy of this method has not been validated. We compared the performance characteristics of WMC vs...
Article
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Exploring the intraluminal behavior of an oral drug product in the human gastrointestinal (GI) tract remains challenging. Many in vivo techniques are available to investigate the impact of GI physiology on oral drug behavior in fasting state conditions. However, little is known about the intraluminal behavior of a drug in postprandial conditions. I...
Article
Background & aims: Gastroparesis is a chronic disorder of the stomach characterized by nausea, vomiting, early satiety, postprandial fullness, and abdominal pain. There is limited information on gastroparesis in minority populations. We assessed ethnic, racial, and sex variations in the etiology, symptoms, quality of life, gastric emptying, treatm...
Article
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The goal of this project was to explore and to statistically evaluate the responsible gastrointestinal (GI) factors that are significant factors in explaining the systemic exposure of ibuprofen, between and within human subjects. In a previous study, we determined solution and total concentrations of ibuprofen as a function of time in aspirated GI...
Preprint
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Although the microbiota in the proximal gastrointestinal (GI) tract has been implicated in health and disease, much of these microbes remains understudied compared to the distal GI tract. This study characterized the microbiota across multiple proximal GI sites over time in healthy individuals. As part of a study of the pharmacokinetics of oral mes...
Article
Background & aims: Many patients with gastroparesis are prescribed opioids for pain control, but indications for opioid prescriptions and the relationship of opioid use to gastroparesis manifestations are undefined. We characterized associations of use of potent vs weaker opioids and presentations of diabetic and idiopathic gastroparesis. Methods...
Article
Over the past decade, formulation predictive dissolution (fPD) testing has gained increasing attention. Another mindset is pushed forward where scientists in our field are more confident to explore the in vivo behavior of an oral drug product by performing predictive in vitro dissolution studies. Similarly, there is an increasing interest in the ap...

Citations

... Robust quantitative data on CVS episode characteristics were provided by a preliminary study of the natural history of the disorder in adults. 21 In this study, 61/88 (69.3%) reported at least 1 CVS episode over 6 months of observation, with a mean episode duration of 7.1 ± 12.0 days. However, 26.7% of episodes were >7 days long exceeding the limit proposed by the Rome criteria. ...
... Migraine is a complicated genetic disorder characterized by episodes of moderate-to-severe headaches that are usually unilateral and are frequently accompanied by nausea and increased sensitivity to sound and light. A migraine attack can cause intense pain that affects a person from carrying on their daily activities and can last for hours or even days [2][3][4]. ...
... In IBS, alterations in lymphocyte populations, including changes in B and T lymphocyte counts and activation levels, have been documented. These immune changes are linked to increased eosinophil counts in the duodenum of patients with functional dyspepsia (FD) and elevated colonic mast cell numbers in those with IBS [14]. Additionally, elevated levels of α4+β7+ gut-homing T cells in the bloodstream are implicated in the pathophysiology of FD and IBS. ...
... Primary diseases such as pharyngeal trauma, severe pneumonia, and other injuries that cause vomiting disorders only require treatment, such as pharyngitis and cellulitis, which can be treated with oral broad-spectrum antibiotics, anti-inflammatory drugs, and analgesics [18]. For the above patients, if they have refractory vomiting symptoms, a rumen fistula can be established to alleviate long-term vomiting symptoms, and then diet and standing water treatment can be carried out through this method [19]. In valuable diseases, if the cause is in the abdomen, surgical treatment is necessary. ...
... 140 Gastric peroral endoscopic myotomy (G-POEM) is considered a safe and promising technique for the management of refractory DGP. 141 Several meta-analyses have shown that G-POEM treatment is effective in improving the clinical symptoms of patients with gastroparesis, and that GCSI scores and gastric emptying scintigraphy are significantly improved. 142,143 An evaluation of the longterm outcome of patients with refractory gastroparesis treated with GPOEM reveals a clinical success of 86.5% for DGP at 4 years of follow-up, with a significant improvement in patients' quality of life. ...
... Choice of substrate. The North American Consensus guidelines recommend a substrate dose of 75 g glucose (preferred over 50 g) or 10 g lactulose (30). However, European guidelines favor 50 g for glucose or 10-20 g of lactulose (15). ...
... While navigating through the gastrointestinal tract, the capsule continuously records various measurements and wirelessly transmits real-time data to a receiver worn by the patient on their waist throughout the study. While numerous studies have explored the utility of WMC in identifying multiregional dysmotility in various conditions (such as diabetes [18], chronic constipation [19] and gastroparesis [20]), no current data are available regarding the GI tract transit profile among patients with CD and other gluten-related disorders, such as NCGS. ...
... The intragastric defense barrier damage by acid suppression therapy makes it easier for upstream opportunistic pathogens to enter the small intestine [10][11][12]. Congenital or postoperative intestinal anatomical malformations increase local food residues and bacterial accumulation, like intestinal diverticulum, Roux-en-Y anastomosis, or small bowel resection [13,14]. Multiple pathophysiological mechanisms contribute to abdominal discomforts including carbohydrate fermentation and improper metabolites, GI chronic inflammation, mucosal immune deficiency, increased gut permeability, food intolerance, and antigenemia [15,16]. ...
... Until now, gastric motility has not been extensively studied with MRI; there exist only a few articles focusing on it. The study by Heissam et al. [59], based on fifteen healthy adults, compared the motility cine-MRI, performed with semi-automated techniques, with simultaneous water perfused manometry, using water as a contrast agent and demonstrating a strong correlation between the two methods. Another study, by Hosseini et al. [60] performed cine-MRI on four healthy volunteers, using pineapple juice as contrast and demonstrating the possibility of using MRI to measure and quantify gastric motility in human participants, even quantifying different motility patterns in different gastric portions. ...
... While in terms of treatment efficacy, the response of female FD patients was also lower than that of males [39]. Therefore, gender could be served as a robust predictor of FD symptoms and QoL improvements, which is similar to the results of Lee AA et al. [40]. Other than gender, the subtype of disease was also found to be another key predictor of acupuncture efficacy for FD. ...