Magnetic resonance imaging assessed enteric motility and luminal content analysis in patients with severe bloating and visible distension

Abstract

Background: Gastrointestinal symptoms in functional gut disorders occur without any discernible structural gut abnormality. Preliminary observations on enteric MRI suggest possible abnormal content and motility of the terminal ileum (TI) in constipationpredominant IBS (IBS-C) with severe bloating, and in functional bloating and distension (FABD) patients. We investigated whether MRI can quantify differences in small bowel (SB) content and motility between patients and healthy controls (HCs). Methods: 11 IBS-C (mean age 40 [21-52] years; 10 women) and 7 FABD (36 [21-56]; all women) patients with bloating and 20 HCs (28 [22-48]; 6 women) underwent enteric MRI, including dynamic motility and anatomical sequences. Three texture analysis (TA) parameters assessed the homogeneity of the luminal content, with ratios calculated between the TI and (1) the SB and (2) the ascending colon. Four TI motility metrics were derived. Ascending colon diameter (ACD) was measured. A comparison between HCs and patients was performed independently for: (1) three TA parameters, (2) four TI motility metrics, and (3) ACD. Key Results: Compared with HCs, patients had TI:colon ratios higher for TA contrast (p < 0.001), decreased TI motility (lower mean motility [p = 0.04], spatial motility variation [p = 0.03], and area of motile TI [p = 0.03]), and increased ACD (p = 0.001). Conclusions and Inferences: IBS-C and FABD patients show reduced TI motility and differences in luminal content compared with HCs. This potentially indicates reflux of colonic contents or delayed clearance of the TI, which alongside increased ACD may contribute to symptoms of constipation and bloating.

MRI-Based Quantification of Pan-Alimentary Function and Motility in Subjects with Diabetes and Gastrointestinal Symptoms

“…Using a novel multi-segmental MRI framework, we observed several differences between patients and a healthy volunteer population. While previous studies have reported MRI examinations of several segments of the gut, we added more structural and functional details with the multi-segmental gut examination resulting in a detailed panenteric characterization of the gut [ 10 , 34 , 35 ]. We observed significant differences in static parameters as diabetic patients showed lower stomach volumes at baseline, characterized by lower volumes in the fundus and antrum.…”

Editorial: eosinófilos en dispepsia funcional, mucoprotectores, motilidad del intestino delgado en el SII y estudios manométricos en pediatría

“…En años recientes, utilizando otras tecnologías, como por ejemplo la resonancia magnética, se ha demostrado una disminución de la motilidad del íleon terminal con un aumento de su contenido luminal, sugiriendo una reducción en su aclaramiento o un reflujo del contenido colónico, lo cual puede estar relacionado con los síntomas de estreñimiento y distensión abdominal subjetiva 32 . Con el uso de la cápsula SmartPill ® de pH/presión, y la prueba del aliento con lactulosa, DuPont et al 33 reportaron que el 76% de 46 pacientes con SII presentaron vaciamiento gástrico prolongado, y aquellos con predominio de estreñimiento mostraron tránsito intestinal retardado.…”