Comparative quantitative assessment of global small bowel motility using magnetic resonance imaging in chronic intestinal pseudo‐obstruction and healthy controls

Menys, Alex; Butt, Shamaila; Emmanuel, Anton; Plumb, Andrew; Fikree, Asma; Knowles, C H; Atkinson, David; Zárate, Natalia; Halligan, Steve; Taylor, Stuart A.

doi:10.1111/nmo.12735

Cited by 50 publications

(52 citation statements)

References 32 publications

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“…Contrast medium radiological tests have been recently superseded by dedicated enterography with high‐resolution CT or MRI, which more accurately detect mechanical obstruction and intestinal adhesions. Cine‐MRI is emerging as a non‐invasive, radiation‐free method for assessing and monitoring GI motility particularly in the pediatric population …”

Section: Diagnosismentioning

confidence: 99%

Chronic intestinal pseudo‐obstruction in children and adults: diagnosis and therapeutic options

Nardo¹,

Lorenzo

Lauro

et al. 2016

Neurogastroenterology Motil

109

139

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The present article aims to provide pediatric and adult gastroenterologists with an up to date review about clinical features, diagnosis and therapeutic options for CIPO. Although pediatric and adult CIPO share many clinical aspects distinctive features can be identified. There is no single diagnostic test or pathognomonic finding of CIPO, thus a stepwise approach including radiology, endoscopy, laboratory, manometry, and histopathology should be considered in the diagnostic work-up. Treatment of patients with CIPO is challenging and requires a multidisciplinary effort with participation of appropriately experienced gastroenterologists, pathologists, dieticians, surgeons, psychologists, and other subspecialists based on the presence of comorbidities. Current treatment options invariably involve surgery and specialized nutritional support, especially in children. Medical therapies are mainly aimed to avoid complications such as sepsis or intestinal bacterial overgrowth and, where possible, restore intestinal propulsion. More efficacious therapeutic options are eagerly awaited for such difficult patients.

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Section: Diagnosismentioning

confidence: 99%

Chronic intestinal pseudo‐obstruction in children and adults: diagnosis and therapeutic options

Nardo¹,

Lorenzo

Lauro

et al. 2016

Neurogastroenterology Motil

109

139

View full text Add to dashboard Cite

show abstract

“…Evidence for supporting the use of ACIs in GI dysmotility includes multiple small trials with neostigmine 15 and a recent metaanalysis by Valle and Godoy, 16 all revealing positive results. 17 -21 Furthermore, in a study by O'Dea et al, 22 7 adult patients with pseudoobstruction were treated successfully with pyridostigmine, with marked improvement in symptoms and a decrease in the use of laxatives for constipation, further supporting the notion that ACI therapy for CIPO is an effective medical approach, as was the case in our patient.…”

Section: Figurementioning

confidence: 99%

The Use of Pyridostigmine in a Child With Chronic Intestinal Pseudo-Obstruction

et al. 2018

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Chronic intestinal pseudo-obstruction is a rare disorder that affects the motility of the gastrointestinal tract. It results in acute or subacute intestinal obstruction symptoms in the absence of mechanical lesion. It can lead to intestinal failure in children with significant strain on nutrition, growth, and development. There is no universally agreed protocol for management of chronic intestinal pseudo-obstruction in children, and there is wide variation in clinical practice.

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“…This technique has been validated and shown to be repeatable and sensitive to drug-induced changes in motility 24 . It has previously been successfully applied in segmental CD 22 and Chronic Intestinal PseudoObstruction 28 .…”

Section: Motility Assessmentmentioning

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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Comparative quantitative assessment of global small bowel motility using magnetic resonance imaging in chronic intestinal pseudo‐obstruction and healthy controls

Cited by 50 publications

References 32 publications

Chronic intestinal pseudo‐obstruction in children and adults: diagnosis and therapeutic options

Chronic intestinal pseudo‐obstruction in children and adults: diagnosis and therapeutic options

The Use of Pyridostigmine in a Child With Chronic Intestinal Pseudo-Obstruction

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

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