Assessment of colonic contents in patients with chronic constipation using MRI

Inoh, Yumi; Kanoshima, Kenji; Ohkuma, Kanji; Fuyuki, Akiko; Uchiyama, S.; Ohkubo, Hidenori; Higurashi, Takuma; Iida, Hiroshi; Nonaka, Takashi; Fujita, Koji; Kusakabe, Akihiko; Inamori, Masahiko; Hiroishi, Kazumasa; Nagase, Hajime; Nakajima, Atushi; Takahara, Taro

doi:10.3164/jcbn.17-104

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…For most adult subjects, colonic volume is determined by many factors other than whole gut transit time. In a recent, prospective MRI study in 20 adult patients with constipation, the maximum luminal colon diameter was measured from the images in different colonic segments [29]. The measurements were then correlated with gastrointestinal symptom rating scales.…”

Section: Discussionmentioning

confidence: 99%

Colonic Volume Changes in Paediatric Constipation Compared to Normal Values Measured Using MRI

et al. 2021

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Background: Functional constipation in children is common. Management of this condition can be challenging and is often based on symptom reports. Increased, objective knowledge of colonic volume changes in constipation compared to health could provide additional information. However, very little data on paediatric colonic volume is available except from methods that are invasive or require unphysiological colonic preparations. Objectives: (1) To measure volumes of the undisturbed colon in children with functional constipation (FC) using magnetic resonance imaging (MRI) and provide initial normal range values for healthy controls, and (2) to investigate possible correlation of colonic volume with whole gut transit time (WGTT). Methods: Total and regional (ascending, transverse, descending, sigmoid, and rectum) colon volumes were measured from MRI images of 35 participants aged 7–18 years (16 with FC and 19 healthy controls), and corrected for body surface area. Linear regression was used to explore the relationship between total colon volume and WGTT. Results: Total colonic volume was significantly higher, with a median (interquartile range) of 309 mL (243–384 mL) for the FC group than for the healthy controls of 227 mL (180–263 mL). The largest increase between patients and controls was in the sigmoid colon–rectum region. In a linear regression model, there was a positive significant correlation between total colonic volume and WGTT (R = 0.56, p = 0.0005). Conclusions: This initial study shows increased volumes of the colon in children with FC, in a physiological state, without use of any bowel preparation. Increased knowledge of colonic morphology may improve understanding of FC in this age group and help to direct treatment.

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Section: Discussionmentioning

confidence: 99%

Colonic Volume Changes in Paediatric Constipation Compared to Normal Values Measured Using MRI

et al. 2021

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“…Inoh et al . evaluated the relationship between colonic diameter and gastrointestinal symptoms in 20 patients with self-reported chronic constipation by using abdominal MRI 49 . Ascending colon diameter correlated with a sense of incomplete evacuation, and rectal diameter correlated with constipation scores 49 .…”

Section: Normal and Abnormal Colonic And Anal Structure And Functionmentioning

confidence: 99%

“…evaluated the relationship between colonic diameter and gastrointestinal symptoms in 20 patients with self-reported chronic constipation by using abdominal MRI 49 . Ascending colon diameter correlated with a sense of incomplete evacuation, and rectal diameter correlated with constipation scores 49 . However, although the sum of all the segmental diameters (cecum, ascending, transverse, descending, sigmoid colon, and rectum) correlated with an increasing severity of constipation, the sum of certain segmental diameters also positively correlated with diarrhea.…”

Section: Normal and Abnormal Colonic And Anal Structure And Functionmentioning

confidence: 99%

Recent advances in understanding and managing chronic constipation

Prichard

Bharucha

2018

F1000Res

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Constipation, a condition characterized by heterogeneous symptoms, is common in Western society. It is associated with reduced physical health, mental health, and social functioning. Because constipation is rarely due to a life-threatening disease (for example, colon cancer), current guidelines recommend empiric therapy. Limited surveys suggest that fewer than half of treated individuals are satisfied with treatment, perhaps because the efficacy of drugs is limited, they are associated with undesirable side effects, or they may not target the underlying pathophysiology. For example, although a substantial proportion of constipated patients have a defecatory disorder that is more appropriately treated with pelvic floor biofeedback therapy than with laxatives, virtually no pharmacological trials formally assessed for anorectal dysfunction. Recent advances in investigational tools have improved our understanding of the physiology and pathophysiology of colonic and defecatory functions. In particular, colonic and anorectal high-resolution manometry are now available. High-resolution anorectal manometry, which is increasingly used in clinical practice, at least in the United States, provides a refined assessment of anorectal pressures and may uncover structural abnormalities. Advances in our understanding of colonic molecular physiology have led to the development of new therapeutic agents (such as secretagogues, pro-kinetics, inhibitors of bile acid transporters and ion exchangers). However, because clinical trials compare these newer agents with placebo, their efficacy relative to traditional laxatives is unknown. This article reviews these physiologic, diagnostic, and therapeutic advances and focuses particularly on newer therapeutic agents.

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