Motility Evaluation in the Patient with Inflammatory Bowel Disease

Abdalla, Sherine M.; Kalra, Gorav; Moshiree, Baha

doi:10.1016/j.giec.2016.06.010

Cited by 12 publications

(7 citation statements)

References 90 publications

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“…The inflammation is not only limited to the mucosa, but may also involve deeper muscle layers and affect the enteric nervous system 3,18 . One may therefore hypothesize that gastrointestinal dysmotility, which is highly prevalent in patients with IBD 19 and possibly could explain symptoms in patients with inactive disease, could be present at distances from the mucosal lesions. The absence of differences in MI of jejunum does not affirm this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Volumetric analysis of small bowel motility in an unselected cohort of patients with Crohn’s disease

Dreja

Ekberg

Leander

et al. 2020

Neurogastroenterology Motil

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Background Quantified terminal ileal motility during magnetic resonance enterography (MRE) has been suggested to be used as a biomarker of Crohn's disease (CD). The aim of the present study was to evaluate this method in clinical practice. Methods Healthy volunteers and all consecutive patients referred to MRE during a 2‐year period were asked to participate and complete the Irritable Bowel Syndrome‐Symptom Severity Scale (IBS‐SSS) to assess gastrointestinal symptoms. Medical records were scrutinized, and motility indices (MIs) were calculated from MR images. Key Results Twenty‐two healthy controls and 134 examinations with CD were included (inclusion rate: 76.3%). Patients with CD had increased mural thickness of the terminal ileum, increased fecal calprotectin, and more symptoms than controls. Patients with active CD had increased mural thickness of ileum and terminal ileum, higher MR activity indices, and signs of inflammation in laboratory analyses, but similar symptoms, compared with inactive disease. After exclusion of sole colon disease (n = 13), MI inversely correlated with mural thickness in terminal ileum, and MI was lower in active disease versus controls in ileum (P = .019) and terminal ileum (P = .005), and versus inactive disease in terminal ileum (P = .044). The area under the curve of MI in terminal ileum was 0.736 for active CD against healthy controls (P = .002) and 0.682 for active against inactive CD (P = .001). MIs were similar in controls and inactive CD. Conclusions and Interferences MI reflects inflammatory activity in the intestine. Alterations in MI did not explain symptomatology in inactive CD, without measurable inflammatory parameters in morphology or laboratory analyses.

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Section: Discussionmentioning

confidence: 99%

Volumetric analysis of small bowel motility in an unselected cohort of patients with Crohn’s disease

Dreja

Ekberg

Leander

et al. 2020

Neurogastroenterology Motil

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“…[29][30][31] Gastrointestinal movement disturbance often happens in gut diseases, especially in certain inflammatory-related GI diseases. [32][33][34][35][36] Also, the GI motility disturbance in systemic inflammatory diseases is a well-recognized phenomenon. 37 A study provided that a disorder on colonic motion was found in colitis, with multiple stimulation likely involved.…”

Section: Discussionmentioning

confidence: 99%

Effects of O‐1602 and CBD on TNBS‐induced colonic disturbances

Wei

Wang

Yang

et al. 2019

Neurogastroenterology Motil

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Background This study attempted to provide the effects and mechanisms of two cannabinoids, O‐1602 and cannabidiol (CBD), on colonic motility of 2,4,6‐trinitro‐benzene sulfonic acid (TNBS) colitis. Methods TNBS was used to induce the model of motility disorder. G protein‐coupled receptor 55 (GPR55) expression was detected using real‐time PCR and immunohistochemistry in colon. Pro‐inflammatory cytokines and myeloperoxidase were also measured. The colonic motility was measured by upper GI transit in vivo and recorded using electrical stimulation organ bath technique in vitro. Freshly isolated smooth muscle from the rat colon were applied to determine the membrane potential and Ca2+‐ATPase activity, respectively. Key Results CBD or O‐1602 separately improved inflammatory conditions significantly in TNBS‐induced colitis rats. However, sole CBD pretreatment reduced GPR55 expression, which was up‐regulated in TNBS colitis. O‐1602 and CBD each lowered MPO and IL‐6 levels remarkably in TNBS colitis, while TNF‐α levels experienced no change. CBD rescued the downward colonic motility in TNBS colitis in vivo; however, it decreased the upward contraction of the smooth muscle strip under electrical stimulation in vitro. Pretreatment with CBD prevented against TNBS‐induced changes of Ca2+‐ATPase activity of smooth muscle cells. However, membrane potential of the smooth muscle cells decreased by TNBS experienced no change after O‐1602 or CBD import. Conclusions & Inferences The present study suggested that CBD participated in the regulation of colonic motility in rats, and the mechanisms may be involved in the regulation of inlammatory factors and Ca2+‐ATPase activity through GPR55.

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“…However, there was no difference in the MI between controls and the few dysmotility patients in the present study. Further, no difference was observed between healthy and patients with CD or UC, although dysmotility is often found in IBD[ 25 ]. The inverse associations between diarrhea and the MI of the jejunum and the positive association between constipation and the MI of the terminal ileum may be explained by effects on the mural thickness, e.g ., a bowel loaded with feces may lead to stretching of the bowel, resulting in thinner bowel walls, whereas an empty bowel may have thicker walls.…”

Section: Discussionmentioning

confidence: 99%

Motility index measured by magnetic resonance enterography is associated with sex and mural thickness

Månsson

Ekberg

Ohlsson

2020

WJG

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BACKGROUND Recently, a technique has been developed to use magnetic resonance enterography (MRE) for the evaluation of small bowel motility. The hypothesis was that assessment of the motility index (MI) should reflect differences in motility between clinical conditions. AIM To aim of the present observational, cross-sectional study was to evaluate the use of the MI in daily clinical practice. METHODS All consecutive patients aged 18-70 years who were referred for MRE at the Department of Radiology during a 2-year period were asked to participate. Healthy volunteers were included as controls. MRE was prepared and conducted in accordance with clinical routines. On the day of examination, all the participants had to complete the visual analog scale for irritable bowel syndrome (IBS) and IBS-symptom severity scale. Maps of MI were calculated from dynamic MR images. ANOVA was used to evaluate differences in MI between groups, classified as healthy, Crohn’s disease, ulcerative colitis, IBS, other assorted disorders and dysmotility. Logistic and linear regression were applied to the MI values. All medical records were scrutinized for medical history. RESULTS In all, 224 examinations were included (inclusion prevalence 76.3%), with 22 controls and 202 patients. There was a significant difference in the MI of the jejunum ( P = 0.021) and terminal ileum ( P = 0.007) between the different groups. The MI was inversely associated with the mural thickness of the terminal ileum in men ( P < 0.001) and women ( P = 0.063) after adjustments, and tended to be lower in men than in women ( P = 0.056). Subjectively observed reduction of motility on MRI was accomplished by reduced MI of terminal ileum in men ( P < 0.001) and women ( P = 0.030). In women, diarrhea was inversely associated with the MI of the jejunum ( P = 0.029), and constipation was positively associated with the MI of the terminal ileum ( P = 0.039). CONCLUSION Although MIs differ across diseases, a lower MI of the terminal ileum is mainly associated with male sex and an increased mural thickness. Symptoms are weakly associated with the MI.

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Motility Evaluation in the Patient with Inflammatory Bowel Disease

Cited by 12 publications

References 90 publications

Volumetric analysis of small bowel motility in an unselected cohort of patients with Crohn’s disease

Volumetric analysis of small bowel motility in an unselected cohort of patients with Crohn’s disease

Effects of O‐1602 and CBD on TNBS‐induced colonic disturbances

Motility index measured by magnetic resonance enterography is associated with sex and mural thickness

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