Gastrointestinal Transit Times in Health as Determined Using Ingestible Capsule Systems: A Systematic Review

Abstract

Background: Ingestible capsule (IC) systems can assess gastrointestinal (GI) transit times as a surrogate for gut motility for extended periods of time within a minimally invasive, radiation-free and ambulatory setting. Methods: A literature review of IC systems and a systematic review of studies utilizing IC systems to measure GI transit times in healthy volunteers was performed. Screening for eligible studies, data extraction and bias assessments was performed by two reviewers. A narrative synthesis of the results was performed. Results: The literature review identified 23 different IC systems. The systematic review found 6892 records, of which 22 studies were eligible. GI transit time data were available from a total of 1885 healthy volunteers. Overall, seventeen included studies reported gastric emptying time (GET) and small intestinal transit time (SITT). Colonic transit time (CTT) was reported in nine studies and whole gut transit time (WGTT) was reported in eleven studies. GI transit times in the included studies ranged between 0.4 and 15.3 h for GET, 3.3–7 h for SITT, 15.9–28.9 h for CTT and 23.0–37.4 h for WGTT. GI transit times, notably GET, were influenced by the study protocol. Conclusions: This review provides an up-to-date overview of IC systems and reference ranges for GI transit times. It also highlights the need to standardise protocols to differentiate between normal and pathological function.

Can we rely on the orocecal transit time measured by the lactulose breath test? Simultaneous measurement of Tc99m colloid scintigraphy and lactulose breath hydrogen test in asymptomatic volunteers

“…The reproducibility of scintigraphy for measuring colonic transit is good and allows evaluation of the stomach, small intestine, and large intestine, even in the pediatric population. It is useful for monitoring cases with intractable constipation using a technique with two radiopharmaceuticals with different half-lives; unfortunately, In 111 is not available in our setting (7).…”

Dietary impact on fasting and stimulated GLP-1 secretion in different metabolic conditions – a narrative review

“…Experimental studies have shown that the proximal part of the gut is responsible for most early GLP-1 responses to meal ingestion [ 135 ]. Multiple studies showing a gastric emptying time of <1 h [ 138 ] underline the possibility that nutrients, especially after a fast transit of liquid meals or glucose solutions, can reach the duodenum in a short time, leading to GLP-1 release from L cells. This could explain the observed peaks in GLP-1 concentrations, even in short-term postprandial protocols with a duration of ∼3 h. As summarized in the same review, the shortest small intestine transit time reported was 3.3 h, leaving a short time for the luminal content to come in contact with L cells located in the jejunum or even the ileum and stimulate the chemo-sensing machinery, leading to the modulation of GLP-1 release.…”

“…As it is undisputable that liquids empty from the stomach more quickly than solid meals, the physical state of the test meal applied in the reviewed studies had a decisive effect on L cell-mediated GLP-1 secretion [ 138 ]. In addition, the size of the meal seemed to matter; the late GLP-1 response (30–180 min) to a large meal (520 kcal) was shown to be more pronounced than that to a small meal (260 kcal), possibly due to lower exposure of stimulatory nutrients to the L cells following the small meal [ 56 ].…”

Using a human colonoid-derived monolayer to study bacteriophage translocation

“…While we observed translocation occurring within 2 hours in our disease models, it is possible that it may occur even faster, within 10–15 minutes as has been reported previously. 13 This is ample time for phage translocation in the colon, where colonic transit time ranges from ~ 16–29 h. 73 , 74 …”