Dyspeptic symptoms and delayed gastric emptying of solids in patients with inactive Crohn’s disease

Abstract

BackgroundPatients 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.MethodsTwenty-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 13C 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.ResultsPatients 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.ConclusionDelayed gastric emptying in inactive Crohn’s disease patients seems to be associated with dyspeptic symptoms, particularly vomiting, even without any evidence of gastrointestinal obstruction.

Gastric emptying and disease activity in inflammatory bowel disease

“…These new findings apparently contrast with earlier studies reporting delayed gastric emptying in patients with inactive IBD: Nobrega et al [5] reported a similar proportion of CD patients with delayed gastric emptying in remission as we only saw in active disease. This discrepancy is probably explained by the fact that Nobrega et al used the conventional CDAI threshold (> 150) for definition of active vs. inactive CD.…”

Magnetic resonance imaging‐quantified small bowel motility is a sensitive marker of response to medical therapy in Crohn's disease

“…The degree to which this dysmotility improves following treatment or remission of CD has been studied less, partly because of the relative difficulty and inconvenience of manometric measurements. Although the available literature suggests that there are detectable small bowel and gastric motility disturbances even in inactive CD, these studies compared motility in CD patients with healthy controls rather than within the same individual after treatment. We are not aware of any intra‐individual comparisons of motility pre‐ and post‐treatment in CD.…”

Morpho-functional evaluation of small bowel using wireless motility capsule and video capsule endoscopy in patients with known or suspected Crohn’s disease: pilot study

“…A previous study 11 , in which cine magnetic resonance enterography (MRE) was employed in addition to the regular MRI protocol, found that imaging areas of altered gut motility helped to detect more CD-specific findings. Other studies have shown that CD is associated with delayed gastric emptying, possibly due to inflammation 12 .…”