Prolonged Ambulant Recordings of Small Bowel Motility Demonstrate Abnormalities in the Irritable Bowel Syndrome

Kellow, John; Gill, Richard C.; Wingate, David

doi:10.1016/0016-5085(90)90335-x

Cited by 243 publications

(149 citation statements)

References 21 publications

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“…A possible explanation is that impaired coordination of bowel motility rather than changes in absolute levels leads to worsening of patient symptoms, particularly diarrhoea. Variation in small bowel motility is a normal finding in healthy individuals [20][21][22][23][24] and appears to be a marker of gut well-being. A reduction in this variability in turn may lead to abdominal symptoms.…”

Section: Discussionmentioning

confidence: 99%

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

Gollifer

Menys

Makanyanga

et al. 2018

BJR

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Section: Discussionmentioning

confidence: 99%

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

Gollifer

Menys

Makanyanga

et al. 2018

BJR

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“…It is well established that there is a wide range of contractile activity in healthy individuals [42][43][44][45][46][47] . Contractility is split broadly into the postprandial actions (peristalsis and segmentation) directed at mixing food and aiding absorption and the fasted contractility associated with maintaining bowel health and function 42 .…”

Section: Discussionmentioning

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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“…Physiological studies have shown diVerences in intestinal transit as well as contractile and myoelectrical activity, between IBS patients and controls. [2][3][4][5][6] Furthermore, distension of the bowel gives rise to sensations of desire to defaecate and pain at lower distending volumes compared with normal controls. [7][8][9][10] However, these studies fail to show convincingly any association between physiological disturbances and the experience of symptoms.…”

mentioning

confidence: 99%

The role of psychological and biological factors in postinfective gut dysfunction

Gwee¹,

Leong²,

Graham³

et al. 1999

European Journal of Gastroenterology & Hepatology

125

187

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Background-Both psychological and physiological disturbances have been implicated in the aetiopathogenesis of irritable bowel syndrome (IBS). Aims-To investigate how the psychological factors act, and the involvement of infective and physiological factors. Methods-Consecutive patients hospitalised for gastroenteritis reported life events for the previous 12 months, and past illness experiences on standardised questionnaires. They also completed psychometric questionnaires for anxiety, neuroticism, somatisation, and hypochondriasis. In some patients, rectal biopsy specimens were obtained during the acute illness and at three months postinfection. Results-Ninety four patients completed all questionnaires: 22 patients were diagnosed with IBS after their gastroenteritis (IBS+), and 72 patients returned to normal bowel habits (IBS−). IBS+ patients reported more life events and had higher hypochondriasis scores than IBS− patients. The predictive value of the life event and hypochondriasis measures was highly significant and independent of anxiety, neuroticism, and somatisation scores, which were also elevated in IBS+ patients. Rectal biopsy specimens from 29 patients showed a chronic inflammatory response in both IBS+ and IBS− patients. Three months later, specimens from IBS+ patients continued to show increased chronic inflammatory cell counts but those from IBS− patients had returned to normal levels. IBS+ and IBS− patients exhibited rectal hypersensitivity and hyper-reactivity and rapid colonic transit compared with normal controls, but there were no significant diVerences between IBS+ and IBS− patients for these physiological measurements. Conclusion-Psychological factors most clearly predict the development of IBS symptoms after gastroenteritis but biological mechanisms also contribute towards the expression of symptoms. (Gut 1999;44:400-406)

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Prolonged Ambulant Recordings of Small Bowel Motility Demonstrate Abnormalities in the Irritable Bowel Syndrome

Cited by 243 publications

References 21 publications

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

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

The role of psychological and biological factors in postinfective gut dysfunction

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