Demonstration of differences in colonic volumes, transit, chyme consistency, and response to psyllium between healthy and constipated subjects using magnetic resonance imaging

被引：48
作者：
Major, G. [1 ,2 ,3 ]
Murray, K. [1 ,2 ,3 ,4 ]
Singh, G. [1 ,2 ,3 ]
Nowak, A. [1 ,2 ,3 ]
Hoad, C. L. [1 ,2 ,3 ,4 ]
Marciani, L. [1 ,2 ,3 ]
Silos-Santiago, A. [5 ]
Kurtz, C. B. [5 ]
Johnston, J. M. [5 ]
Gowland, P. [1 ,2 ,3 ,4 ]
Spiller, R. [1 ,2 ,3 ]
机构：
[1] Nottingham Univ Hosp NHS Trust, Nottingham Digest Dis Ctr, Nottingham, England
[2] Nottingham Univ Hosp NHS Trust, NIHR, Nottingham Biomed Res Ctr, Nottingham, England
[3] Univ Nottingham, Nottingham, England
[4] Univ Nottingham, Sir Peter Mansfield Imaging Ctr, Nottingham, England
[5] Ironwood Pharmaceut Inc, Cambridge, MA USA
来源：
NEUROGASTROENTEROLOGY AND MOTILITY | 2018年 / 30卷 / 09期
基金：
英国医学研究理事会;
关键词：
ispaghula; laxative; relaxometry; IRRITABLE-BOWEL-SYNDROME; CHRONIC IDIOPATHIC CONSTIPATION; CHLORIDE CHANNEL ACTIVATOR; GASTROINTESTINAL TRANSIT; WATER-CONTENT; STOOL CHARACTERISTICS; MOTOR FUNCTIONS; MRI; VOLUNTEERS; MOTILITY;
D O I：
10.1111/nmo.13400
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
BackgroundIn functional gastrointestinal disorders a lack of objective biomarkers limits evaluation of underlying mechanisms. We aimed to demonstrate the utility of magnetic resonance imaging for this task using psyllium, an effective constipation treatment, in patients and controls. MethodsTwo crossover studies: (i) adults without constipation (controls, n=9) took three treatments in randomized order for 6days - maltodextrin (placebo), psyllium 3.5g t.d.s and 7g t.d.s., (ii) adults with chronic constipation (patients, n=20) took placebo and psyllium 7g t.d.s. for 6days. MRI was performed fasting and postprandially on day 6. Measurements included small bowel and ascending colon water content, colonic volume, transit time, and MR relaxometry (T1, T2) to assess colonic chyme. Stool water percentage was measured. Results7g psyllium t.d.s. increased fasting colonic volumes in controls from median 372mL (IQR 284-601) to 578mL (IQR 510-882), and in patients from median 831mL (IQR 745-934) to 1104mL (847-1316), P<.05. Mean postprandial small bowel water was higher in controls and patients after 7g psyllium t.d.s. vs placebo. Whole gut transit was slower in patients than controls (P<.05). T1 of the descending colon chyme (fasting) was lower in patients (213ms, 176-420) than controls (440ms, 352-884, P<.05) on placebo, but increased by 7g psyllium t.d.s. (590ms, 446-1338), P<.001. Descending colon T1 correlated with baseline stool water content and stool frequency on treatment. Conclusions and InferencesMRI measurements can objectively demonstrate the mode of action of therapy targeting intestinal fluid content in constipation.
引用
收藏
页数：11
相关论文
共 33 条
  • [11] Performance characteristics of scintigraphic colon transit measurement in health and irritable bowel syndrome and relationship to bowel functions
    Deiteren, A.
    Camilleri, M.
    Bharucha, A. E.
    Burton, D.
    McKinzie, S.
    Rao, A. S.
    Zinsmeister, A. R.
    [J]. NEUROGASTROENTEROLOGY AND MOTILITY, 2010, 22 (04) : 413 - +
  • [12] Feldman M, 2015, GASTROENTEROLOGY, V149, P506
  • [13] Non-invasive quantification of small bowel water content by MRI: a validation study
    Hoad, C. L.
    Marciani, L.
    Foley, S.
    Totman, J. J.
    Wright, J.
    Bush, D.
    Cox, E. F.
    Campbell, E.
    Spiller, R. C.
    Gowland, P. A.
    [J]. PHYSICS IN MEDICINE AND BIOLOGY, 2007, 52 (23) : 6909 - 6922
  • [14] Colon wall motility: comparison of novel quantitative semi-automatic measurements using cine MRI
    Hoad, C. L.
    Menys, A.
    Garsed, K.
    Marciani, L.
    Hamy, V.
    Murray, K.
    Costigan, C.
    Atkinson, D.
    Major, G.
    Spiller, R. C.
    Taylor, S. A.
    Gowland, P. A.
    [J]. NEUROGASTROENTEROLOGY AND MOTILITY, 2016, 28 (03) : 327 - 335
  • [15] Bowel Disorders
    Lacy, Brian E.
    Mearin, Fermin
    Chang, Lin
    Chey, William D.
    Lembo, Anthony J.
    Simren, Magnus
    Spiller, Robin
    [J]. GASTROENTEROLOGY, 2016, 150 (06) : 1393 - +
  • [16] Colonic response to laxative ingestion as assessed by MRI differs in constipated irritable bowel syndrome compared to functional constipation
    Lam, C.
    Chaddock, G.
    Marciani, L.
    Costigan, C.
    Paul, J.
    Cox, E.
    Hoad, C.
    Menys, A.
    Pritchard, S.
    Garsed, K.
    Taylor, S.
    Atkinson, D.
    Gowland, P.
    Spiller, R.
    [J]. NEUROGASTROENTEROLOGY AND MOTILITY, 2016, 28 (06) : 861 - 870
  • [17] Colon Hypersensitivity to Distension, Rather Than Excessive Gas Production, Produces Carbohydrate-Related Symptoms in Individuals With Irritable Bowel Syndrome
    Major, Giles
    Pritchard, Sue
    Murray, Kathryn
    Alappadan, Jan Paul
    Hoad, Caroline L.
    Marciani, Luca
    Gowland, Penny
    Spiller, Robin
    [J]. GASTROENTEROLOGY, 2017, 152 (01) : 124 - +
  • [18] Classification of functional bowel disorders by objective physiological criteria based on endoluminal image analysis
    Malagelada, Carolina
    Drozdzal, Michal
    Segui, Santi
    Mendez, Sara
    Vitria, Jordi
    Radeva, Petia
    Santos, Javier
    Accarino, Anna
    Malagelada, Juan-R
    Azpiroz, Fernando
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY, 2015, 309 (06): : G413 - G419
  • [19] Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers
    Manabe, N.
    Cremonini, F.
    Camilleri, M.
    Sandborn, W. J.
    Burton, D. D.
    [J]. ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2009, 30 (09) : 930 - 936
  • [20] Stimulation of colonic motility by oral PEG electrolyte bowel preparation assessed by MRI: comparison of split vs single dose
    Marciani, L.
    Garsed, K. C.
    Hoad, C. L.
    Fields, A.
    Fordham, I.
    Pritchard, S. E.
    Placidi, E.
    Murray, K.
    Chaddock, G.
    Costigan, C.
    Lam, C.
    Jalanka-Tuovinen, J.
    De Vos, W. M.
    Gowland, P. A.
    Spiller, R. C.
    [J]. NEUROGASTROENTEROLOGY AND MOTILITY, 2014, 26 (10) : 1426 - 1436
1234