Increased physical activity improves GI symptoms in IBS. Physically active patients with IBS will face less symptom deterioration compared with physically inactive patients. Physical activity should be used as a primary treatment modality in IBS.

Total and segmental colonic transit alterations are of importance for the abnormal bowel habit seen in men and women with IBS, but of no or minor importance for other IBS symptoms.

This procedure meets most of the requirements of the ideal bowel transit test and is easily performed at one visit. Small-bowel transit as well as gastric emptying and colonic transit were significantly slower for women.

An intervention to increase physical activity has positive long-term effects on IBS symptoms and psychological symptoms.

Accelerated small bowel and distal colonic transit as well as overweight are probably involved in the pathophysiology of IBAM.

The GAGES-UE and GAGES-C are easy to administer and consistent and meet high standards of reliability and validity. They can be used to measure the effectiveness of simulator training and to provide specific feedback. The GAGES results can be generalized to North American and European endoscopists and may contribute to the definition of technical proficiency in endoscopy.

Background and Aims: Certain appearances of the major duodenal papilla have been claimed to make cannulation more difficult during ERCP. This study uses a validated classification of the endoscopic appearance of the major duodenal papilla to determine if certain types of papilla predisposes to difficult cannulation. Methods: Patients, with a naïve papilla, scheduled for ERCP, were included. The papilla was classified into one of 4 papilla types before cannulation started. Time to successful bile duct cannulation, attempts and number of pancreatic duct passages were recorded. Difficult cannulation was defined as, after 5 minutes, 5 attempts, or 2 pancreatic guide-wire passages. Results: One thousand four hundred one patients were included from 9 different centers in the Nordic countries. The overall frequency of difficult cannulation was 42% (95% CI, 39%-44%). Type 2, small papilla, (52%; 95% CI, 45%-59%) and Type 3 protruding or pendulous papilla (48%; 95% CI, 42%-53%) were more frequently difficult to cannulate compared with Type 1, regular papilla (36%; 95% CI, 33%-40%, both p<0.001). If an inexperienced endoscopist started cannulation, the frequency of failed cannulation increased from 1.9% to 6.3% (p<0.0001), even though they were replaced by a senior endoscopist after 5 minutes. Conclusion: The endoscopic appearance of the major duodenal papilla influences bile duct cannulation. Small, Type 2, and protruding or pendulous Type 3 papillae are more frequently

The aim of this prospective study was to analyse the yield and utility of a gastrointestinal (GI) transit measurement procedure in clinical practice. Patients referred by gastroenterologists to a tertiary centre for detailed transit measurements were prospectively included. All together 243 patients were enrolled. Body mass index was recorded. The patients were categorized according to the predominant symptom into five groups: diarrhoea, constipation, nausea, vomiting and abdominal pain. The patients recorded their bowel movements and GI symptoms daily during the week before the transit measurement. Percentiles 5 and 95 of the transit values in 83 healthy subjects served as reference values. Widespread abnormalities were found in the five patient groups and 63% of the patients had at least one transit abnormality. The abnormalities were more frequent in men compared with women. Patients with underweight had more motility disturbances compared with other patients. In male and female patients with vomiting a significant delay of transit in the ascending colon was observed compared with healthy subjects. Large-scale transit measurements frequently detect transit abnormalities in clinical practice and may elucidate the relationship between some GI symptoms and abnormal motility.