Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract

Keller, Jutta; Beglinger, Christoph; Holst, Jens J.; Andresen, Viola; Layer, Peter

doi:10.1152/ajpgi.00145.2009

Cited by 49 publications

(56 citation statements)

References 56 publications

(59 reference statements)

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“…Our results show that patients with inactive Crohn's disease had significantly prolonged gastric emptying half time and lag time measured by 13 C-OABT compared with healthy controls, which is in accordance with results published elsewhere [6,8]. Annese et al demonstrated that gastric emptying, measured by a scintigraphic study, was slowed in patients with nonobstructive Crohn's disease [6].…”

Section: Discussionsupporting

confidence: 93%

“…Disorders in gastrointestinal motility have been observed in patients and in experimental models of Crohn's diseases [4][5][6][7][8]. However, the association between gastric dysmotility and the presence of dyspeptic symptoms in these patients had not been previously investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Annese et al demonstrated that gastric emptying, measured by a scintigraphic study, was slowed in patients with nonobstructive Crohn's disease [6]. In addition, Keller et al demonstrated that patients with Crohn's disease had delayed gastric emptying, measured by a standardized 13 C-octanoic acid breath test, and suggested that this disorder might partly be caused by excessive cholecystokinin (CCK) release [8]. The delayed gastric emptying in inactive Crohn's disease could be due to a decrease in the antroduodenal contraction rate, as described by Annese et al in 1997, which showed that in the fed state, the inactive Crohn's disease patients had antrum hypomotility characterized by a decrease in the number of contractions [4].…”

Section: Discussionmentioning

confidence: 99%

“…Although not primarily a motility disorder, some of the symptoms of Crohn's disease could be explained by the presence of inflammatory mucosal changes, tissue swelling and occasional obstruction, which may have important effects on gastrointestinal motility [3]. Disordered motility patterns, including delayed gastric emptying, visceral hypersensitivity and upper intestinal hypomotility, have been observed in patients and animals with inflammatory bowel diseases [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Nóbrega¹,

Ferreira²,

Oliveira³

et al. 2011

Gastroenterology

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Background: Patients with Crohn's disease (CD) have been shown to present dyspeptic symptoms more frequently than the general population. Some of these symptoms could be related to motility disorders to some degree. Then, we propose to investigate whether gastric emptying of solids in patients with inactive CD is delayed and to determine the relationships between gastric emptying and dyspeptic symptoms in inactive CD. Methods: Twenty-six patients with inactive Crohn's disease, as defined by a Crohn's Disease Activity Index (CDAI) < 150, underwent a gastric emptying test by breath test using 13 C octanoic acid coupled to a solid meal and answered a validated questionnaire (The Porto Alegre Dyspeptic Symptoms Questionnaire) to assess dyspeptic symptoms. Patients with scores ≥ 6 were considered to have dyspepsia. The control group was composed by 19 age-and sex-matched healthy volunteers. Results: Patients with CD had a significantly longer t 1/2 and t lag (p<0.05) than the controls. CD patients with dyspepsia had significantly (p<0.05) prolonged gastric emptying when compared to patients without dyspeptic symptoms. When the individual symptom patterns were analyzed, only vomiting was significantly associated with delayed gastric emptying (p<0.05). There was no difference between the subgroups of patients with respect to gender, CDAI scores, disease location, clinical behavior (obstructive/obstructive) or previous gastrointestinal surgery. Conclusion: Delayed gastric emptying in inactive Crohn's disease patients seems to be associated with dyspeptic symptoms, particularly vomiting, even without any evidence of gastrointestinal obstruction.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Nóbrega¹,

Ferreira²,

Oliveira³

et al. 2011

Gastroenterology

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“…These changes lead to abnormal secretion, sensation and motility of the gut which could precipitate functional symptoms including abdominal pain and diarrhea [11][12][13] . Oro-cecal transit time for example has been shown to be reduced in active CD 14 whilst gastric emptying is apparently attenuated 15,16 . Furthermore, irritable bowel syndrome type symptoms are more common in Crohn's patients with raised calprotectin even when clinically otherwise in remission 17 .…”

Section: Introductionmentioning

confidence: 99%

Aberrant Motility in Unaffected Small Bowel is Linked to Inflammatory Burden and Patient Symptoms in Crohnʼs Disease

Menys¹,

Makanyanga²,

Plumb³

et al. 2016

Inflammatory Bowel Diseases

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Objectives: Inflammation related enteric dysmotility has been postulated as a cause for abdominal symptoms in Crohn's disease (CD). We investigated the relationship between MRI-quantified small bowel (SB) motility, inflammatory activity and patient symptom burden.Methods: The Harvey Bradshaw Index (HBI) and fecal calprotectin were prospectively measured in 53 CD patients (median age 35, range 18-78) the day before MRI enterography which included a dynamic (cine), breath-hold motility sequence, repeated to encompass the whole SB volume. A validated registration based motility quantitation technique produced motility maps and regions of interest were drawn to include all morphologically normal SB (i.e. excluding diseased bowel). Global SB motility was correlated with calprotectin, HBI and symptom components (wellbeing, pain, diarrhea). Adjustment for age, sex, smoking and surgical history was made using multivariate linear regression.Results: Median calprotectin was 336 (range 0-1280). Mean HBI, motility mean and motility variance were 3 (range 0-16), 0.33 (0.18 to 0.51) and 0.01 (0.0014 to 0.034) respectively. Motility variance was significantly negatively correlated with calprotectin (Rho = -0.33, P = 0.015), total HBI (rho = -0.45, P <0.001), wellbeing (rho= -0.4, p=0.003), pain (rho = -0.27, p =0.05) and diarrhea (rho= -0.4, p=0.0025). The associations remained highly significant after adjusting for covariates. There was no association between mean motility and calprotectin or HBI (p>0.05).Conclusions: Reduced motility variance in morphologically normal small bowel is associated with patient symptoms and fecal calprotectin levels, supporting the hypothesis that inflammation related enteric dysmotility may explain refractory abdominal symptoms in CD.

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Gastrointestinal tract and appetite control

Cegla

Bloom

2014

Advanced Nutrition and Dietetics in Gastroenterology

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Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract

Abstract: Keller J, Beglinger C, Holst JJ, Andresen V, Layer P. Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract.

Cited by 49 publications

References 56 publications

Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Aberrant Motility in Unaffected Small Bowel is Linked to Inflammatory Burden and Patient Symptoms in Crohnʼs Disease

Gastrointestinal tract and appetite control

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