Assessment of colonic contents in patients with chronic constipation using MRI

Abstract

Although chronic constipation is common, colonic functional evaluating tests are uncommon. This study examines whether chronic constipation and gastrointestinal symptoms are correlated with the lateral diameter of the colon measured from MRI images. We included chronic constipation patients in a prospective, cross-sectional study using MRI at three centers. We divided 3D MRI colorectal images into 6 segments using with specified sequences and selected the maximum luminal diameter from each segment. We used the GSRS questionnaire to evaluate gastrointestinal symptoms. We evaluated the correlation between luminal diameters and GSRS scores. We found the following positive correlations: descending colon and unsatisfactory defecation symptoms; sigmoid colon and diarrhea; and rectum and constipation. The sum and ratio of the ascending and sigmoid colon diameters correlated with nausea and diarrhea. The sum of the transvers to the sigmoid colon diameter also correlated with nausea and diarrhea. The sum of all segment diameters correlated with nausea and constipation. In conclusion, we showed cross-sectional study of colonic MRI correlate with gastrointestinal symptoms. MRI might be useful for colonic motility evaluations to determine appropriate constipation treatments (Clinical trial registry number UMIN 000021274).

Correlation between Constipation Symptoms and Abdominal CT Imaging: A Cross-Sectional Pilot Study

“…It has been reported that the dilatation of the descending colon causes bloating and abdominal distention [22]. MRI evaluation of the colon for chronic constipation showed a correlation between the sensation of residual stool and the diameter of the descending colon [9]. In this study, the stool volume in the left hemi-colon was also correlated with the total CSS.…”

Correlation between Constipation Symptoms and Abdominal CT Imaging: A Cross-Sectional Pilot Study

“…It has been reported that the dilatation of the descending colon causes bloating and abdominal distention [22]. MRI evaluation of the colon for chronic constipation showed a correlation between the sensation of residual stool and the diameter of the descending colon [9]. In this study, the stool volume in the left hemi-colon was also correlated with the total CSS.…”

Evaluation of the Effect of Rectal Dilatation on Bowel Function by Sagittal CT Imaging

“…In previous reports, measurement points for the diameter or dimension of the rectum were unclear ( 1 - 3 , 10 , 11 ). Since the axial cross-sectional images obtained by CT, magnetic resonance imaging (MRI), and ultra-sonography were not parallel to the line between the superior border of the pubis and the inferior border of the third sacral vertebra, the diameters of the axial cross-sectional images do not reveal true rectal diameters.…”

“…An increased rectal sensory threshold (loss of the urge to defecate) is involved in the pathophysiology of chronic constipation ( 8 , 9 ). There is a strong relationship between rectal dilation and chronic constipation ( 1 - 3 ).…”

Elobixibat Improves Stool/Gas Distribution and Fecal Bile Acids in Older Adults With Chronic Constipation

“…Volumetric assessment of S/G distribution in the colon and rectum is a more precise method, and thus the optimal approach, because it would enable the identification of more substantial variation in S/G distribution between CC patients and healthy subjects. Recently, several studies have evaluated the pathophysiology of CC by measuring the transverse diameter of the colon and rectum using MRI; moreover, a relationship between symptoms and transverse diameter has been observed [ 13 , 20 ]. In our study, we used a simpler, noninvasive evaluation method that is more suited to real‐world clinical settings.…”

Correlation between Constipation Symptoms and Abdominal CT Imaging: A Cross-Sectional Pilot Study

“…It has been reported that the dilatation of the descending colon causes bloating and abdominal distention [22]. MRI evaluation of the colon for chronic constipation showed a correlation between the sensation of residual stool and the diameter of the descending colon [9]. In this study, the stool volume in the left hemi-colon was also correlated with the total CSS.…”

Evaluation of the Effect of Rectal Dilatation on Bowel Function by Sagittal CT Imaging

“…In previous reports, measurement points for the diameter or dimension of the rectum were unclear ( 1 - 3 , 10 , 11 ). Since the axial cross-sectional images obtained by CT, magnetic resonance imaging (MRI), and ultra-sonography were not parallel to the line between the superior border of the pubis and the inferior border of the third sacral vertebra, the diameters of the axial cross-sectional images do not reveal true rectal diameters.…”

“…An increased rectal sensory threshold (loss of the urge to defecate) is involved in the pathophysiology of chronic constipation ( 8 , 9 ). There is a strong relationship between rectal dilation and chronic constipation ( 1 - 3 ).…”

Elobixibat Improves Stool/Gas Distribution and Fecal Bile Acids in Older Adults With Chronic Constipation

“…Volumetric assessment of S/G distribution in the colon and rectum is a more precise method, and thus the optimal approach, because it would enable the identification of more substantial variation in S/G distribution between CC patients and healthy subjects. Recently, several studies have evaluated the pathophysiology of CC by measuring the transverse diameter of the colon and rectum using MRI; moreover, a relationship between symptoms and transverse diameter has been observed [ 13 , 20 ]. In our study, we used a simpler, noninvasive evaluation method that is more suited to real‐world clinical settings.…”

Correlation between Constipation Symptoms and Abdominal CT Imaging: A Cross-Sectional Pilot Study

“…It has been reported that the dilatation of the descending colon causes bloating and abdominal distention [22]. MRI evaluation of the colon for chronic constipation showed a correlation between the sensation of residual stool and the diameter of the descending colon [9]. In this study, the stool volume in the left hemi-colon was also correlated with the total CSS.…”

Evaluation of the Effect of Rectal Dilatation on Bowel Function by Sagittal CT Imaging

“…In previous reports, measurement points for the diameter or dimension of the rectum were unclear ( 1 - 3 , 10 , 11 ). Since the axial cross-sectional images obtained by CT, magnetic resonance imaging (MRI), and ultra-sonography were not parallel to the line between the superior border of the pubis and the inferior border of the third sacral vertebra, the diameters of the axial cross-sectional images do not reveal true rectal diameters.…”

“…An increased rectal sensory threshold (loss of the urge to defecate) is involved in the pathophysiology of chronic constipation ( 8 , 9 ). There is a strong relationship between rectal dilation and chronic constipation ( 1 - 3 ).…”

Elobixibat Improves Stool/Gas Distribution and Fecal Bile Acids in Older Adults With Chronic Constipation

“…Volumetric assessment of S/G distribution in the colon and rectum is a more precise method, and thus the optimal approach, because it would enable the identification of more substantial variation in S/G distribution between CC patients and healthy subjects. Recently, several studies have evaluated the pathophysiology of CC by measuring the transverse diameter of the colon and rectum using MRI; moreover, a relationship between symptoms and transverse diameter has been observed [ 13 , 20 ]. In our study, we used a simpler, noninvasive evaluation method that is more suited to real‐world clinical settings.…”