Assessment of whole gut motility in adolescents using the wireless motility capsule test

AbstractFunctional gastrointestinal (GI) disorders are often associated with intestinal dysmotility representing a diagnostic challenge. A relatively new method is the wireless motility capsule (WMC) test, which continuously measures pH, pressure, temperature and regional transit times as it passes through the GI tract. In adults, the WMC test was approved for use in the diagnosis of gastroparesis and constipation by assessing GI transit and contractility. We performed the WMC test in nine adolescent patients aged 12–17 years with functional GI symptoms from July 2017 until February 2019. Abnormal transit times were detected in four patients. Three patients showed abnormal transit times of the upper GI tract: in two cases, contractility analysis revealed prolonged gastric retention, and in one patient, abnormal colonic transit was detected.Conclusion: The WMC test is a minimally invasive procedure with potential to expand future diagnostic opportunities for paediatric patients with functional GI disorders and suspected motility disturbances. What is Known:• The assessment of GI transit and contractility of the whole gut is possible with the WMC test which is approved for use in the diagnosis of gastroparesis and constipation in adults. What is New:• The WMC test is a non-invasive diagnostic tool with the potential to expand diagnostic opportunities in paediatric patients by assessing regional and whole gut motility.• In paediatric patients with functional GI disorders, the WMC test could help to make an adequate diagnosis and initiate appropriate therapy.

Download Full-text

Assessment of Whole Gut Motility in Adolescents Using the Wireless Motility Capsule Test

10.21203/rs.3.rs-749533/v1 ◽

2021 ◽

Author(s):

Tanja Fritz ◽

Christoph Huenseler ◽

Ilse Broekaert

Keyword(s):

Invasive Procedure ◽

Colonic Transit ◽

Gi Tract ◽

Diagnostic Challenge ◽

Upper Gi ◽

Functional Gi Disorders ◽

Transit Times ◽

Intestinal Dysmotility ◽

Gi Symptoms ◽

Wireless Motility Capsule

Download Full-text

Assessment of the Variation Associated with Repeated Measurement of Gastrointestinal Transit Times and Assessment of the Effect of Oral Ranitidine on Gastrointestinal Transit Times Using a Wireless Motility Capsule System in Dogs

Veterinary Medicine International ◽

10.1155/2012/938417 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Jonathan A. Lidbury ◽

Jan S. Suchodolski ◽

Renata Ivanek ◽

Jörg M. Steiner

Keyword(s):

Transit Time ◽

Gastrointestinal Transit ◽

Repeated Measurement ◽

Experimental Conditions ◽

Transit Times ◽

Coefficients Of Variation ◽

Wireless Motility Capsule ◽

Gastric Emptying Time ◽

Gi Transit ◽

Privately Owned

This study aimed to evaluate the variation associated with repeated measurement of gastrointestinal (GI) transit times and the effect of oral ranitidine on GI transit times in healthy dogs using a wireless motility capsule (WMC) system. Eight privately owned healthy adult dogs were enrolled, and one developed diarrhea and was removed from the study. For the first 3 repetitions, each dog was fed a standard meal followed by oral administration of a WMC. For the 4th repetition, each dog was given ranitidine hydrochloride (75 mg PO every 12 hours) prior to and during assessment of GI transit times. Mean between-subject coefficients of variation for gastric emptying time (GET), small and large bowel transit time (SLBTT), and total transit time (TTT) were 26.9%, 32.3%, and 19.6%, respectively. Mean within-subject coefficients of variation for GET, SLBTT, and TTT were 9.3%, 19.6%, and 15.9%, respectively. Median GET, SLBTT, and TTT without ranitidine were 719, 1,636, and 2,735 minutes, respectively. Median GET, SLBTT, and TTT with ranitidine were 757, 1,227, and 2,083 minutes, respectively. No significant differences in GI transit times were found between any of the 4 repetitions. Under these experimental conditions, no significant effects of oral ranitidine on GI transit times were observed.

Download Full-text

The impact of opioid treatment on regional gastrointestinal transit

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2016.05.029 ◽

2016 ◽

Vol 12 (1) ◽

pp. 126

Author(s):

D. Jørgensen ◽

J.L. Poulsen ◽

A.E. Olesen ◽

C. Brock ◽

T.H. Sandberg ◽

...

Keyword(s):

Transit Time ◽

Rating Scale ◽

Gastrointestinal Transit ◽

Transit System ◽

Opioid Treatment ◽

Gastrointestinal Symptom Rating Scale ◽

Transit Times ◽

Gi Symptoms ◽

Gi Transit ◽

The Impact

AbstractAimsTo employ a human experimental model of opioid-induced bowel dysfunction (OIBD) in healthy volunteers, and evaluate the impact of opioid treatment compared to placebo on gastrointestinal (GI) symptoms and motility, assessed by questionnaires and regional GI transit times.MethodsTwenty-five healthy males were randomly assigned to oxycodone or placebo for five days in a double-blind, crossover design. Adverse GI effects were measured with bowel function index, gastrointestinal symptom rating scale, patient assessment of constipation symptoms questionnaire, and bristol stool form scale. Regional GI transit times were determined using the 3D-Transit system and segmental colonic transit times were determined using a custom Matlab® graphical user interface.ResultsGI symptom scores increased significantly across all applied questionnaires during opioid treatment. Oxycodone increased median total GI transit time from 22.2 to 43.9 h (P< 0.01), segmental transit times in the cecum and ascending colon from 5.7 to 9.9 h (P<0.05), rectosigmoid transit time from 2.7 to 9.0 h (P<0.05), and colorectal transit time from 18.6 to 38.6 h (P<0.01). No association between questionnaire scores and segmental transit times were detected.ConclusionsSelf-assessed adverse GI effects and increased GI transit times in different segments were induced during oxycodone treatment. This detailed information about segmental changes in motility has great potential for future interventional head-to-head trials of different laxative regimes for prevention and treatment of OIBD.

Download Full-text

Investigation of oral, gastric, and duodenal microbiota in patients with upper gastrointestinal symptoms

Journal of Investigative Medicine ◽

10.1136/jim-2020-001642 ◽

2020 ◽

Vol 69 (4) ◽

pp. 870-877

Author(s):

Jorge Cervantes ◽

Majd Michael ◽

Bo-Young Hong ◽

Aden Springer ◽

Hua Guo ◽

...

Keyword(s):

Gastrointestinal Symptoms ◽

Microbiota Composition ◽

Gi Tract ◽

Upper Gi ◽

Functional Gi Disorders ◽

Gi Symptoms ◽

Dyspeptic Symptoms ◽

Upper Gastrointestinal Symptoms ◽

Upper Gastrointestinal ◽

Gastric Microbiota

Disease-associated alterations of the intestinal microbiota composition, known as dysbiosis, have been well described in several functional gastrointestinal (GI) disorders. Several studies have described alterations in the gastric microbiota in functional dyspepsia, but very few have looked at the duodenum.Here, we explored the upper GI tract microbiota of inpatients with upper GI dyspeptic symptoms, and compared them to achalasia controls, as there is no indication for an esophagogastroduodenoscopy in healthy individuals.We found differences in the microbiota composition at the three sites evaluated (ie, saliva, stomach and duodenum). Changes observed in patients with dyspepsia included an increase in Veillonella in saliva, an oral shift in the composition of the gastric microbiota, and to some degree in the duodenum as well, where an important abundance of anaerobes was observed. Metabolic function prediction identified greater anaerobic metabolism in the stomach microbial community of patients with dyspepsia. Proton pump inhibitor use was not associated with any particular genus. Co-abundance analysis revealed Rothia as the main hub in the duodenum, a genus that significantly correlated with the relative abundance of Clostridium, Haemophilus, and Actinobacillus.We conclude that patients with upper GI symptoms consistent with dyspepsia have alterations in the microbiota of saliva, the stomach, and duodenum, which could contribute to symptoms of functional GI disorders.

Download Full-text

Evaluation of regional and whole gut motility using the wireless motility capsule: relevance in clinical practice

Therapeutic Advances in Gastroenterology ◽

10.1177/1756283x12437874 ◽

2012 ◽

Vol 5 (4) ◽

pp. 249-260 ◽

Cited By ~ 57

Author(s):

Khoa Tran ◽

Rita Brun ◽

Braden Kuo

Keyword(s):

Clinical Practice ◽

Gut Motility ◽

Wireless Motility Capsule

Download Full-text

Error analysis of classic colonic transit time estimates

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.2000.279.3.g520 ◽

2000 ◽

Vol 279 (3) ◽

pp. G520-G527 ◽

Cited By ~ 35

Author(s):

Michel Bouchoucha ◽

S. Randall Thomas

Keyword(s):

Colonic Transit ◽

X Rays ◽

Control Subjects ◽

Time Estimates ◽

Transit Times ◽

Daily Ingestion ◽

Kinetic Coefficients ◽

Classic Approach ◽

Healthy Control ◽

Irritable Bowel

Estimates of colonic transit times (CTT) through the three colonic segments, right colon, left colon, and rectosigmoid, are commonly based on radiopaque markers. For a given segment, CTT is usually calculated from just the number of markers visible in that segment on abdominal X-rays. This procedure is only strictly valid for the theoretical, but unrealistic, case of continuous marker ingestion (i.e., not for a single or once-daily ingestion). CTT was analyzed using the usual estimate of the mean CTT of one marker and also using a new, more realistic estimate based on the kinetic coefficients of a three-compartment colonic model. We directly compared our compartmental approach to classic CTT estimates by double-marker studies in six patients. We also retrospectively studied CTT in 148 healthy control subjects (83 males, 65 females) and 1,309 subjects with functional bowel disorders (irritable bowel syndrome or constipation). Compared with the compartmental estimates, the classic approach systematically underestimates CTT in both populations, i.e., in patients and in healthy control subjects. The relative error could easily reach 100% independent of the site of colonic transit delay. The normal values of total CTT are then 44.3 ± 29.3 instead of 30.1 ± 23.6 h for males and 68.2 ± 54.4 instead of 47.1 ± 28.2 h for females.

Download Full-text

The impact of naloxegol treatment on gastrointestinal transit and colonic volume

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2017.04.024 ◽

2017 ◽

Vol 16 (1) ◽

pp. 172-172

Author(s):

D. Grønlund ◽

A.E. Olesen ◽

J.L. Poulsen ◽

C. Brock ◽

A.M. Drewes

Keyword(s):

Experimental Model ◽

Transit Time ◽

Gastrointestinal Transit ◽

Receptor Activation ◽

Opioid Antagonist ◽

Imaging Method ◽

Transit System ◽

Gi Symptoms ◽

Gi Transit ◽

The Impact

Abstract Aims Opioid treatment is associated with gastrointestinal (GI) side effects, known as opioid-induced bowel dysfunction (OIBD). Symptoms of OIBD are caused by opioid receptor activation in the enteric nervous system, which results in increased GI transit time and increased faecal volume in the colon. OIBD can be experimentally induced in healthy participants through oral oxycodone treatment. The aim of this study was to investigate whether administration of naloxegol, a peripherally restricted opioid antagonist, could reduce GI symptoms, GI transit time, and colorectal volume, using an experimental model of OIBD. Methods In a double blind crossover trial, twenty-five healthy males were randomly assigned to a six day treatment of oral oxycodone in combination with either oral naloxegol or placebo. At baseline and at day six, participants filled in the Patient Assessment of Constipation Symptom questionnaire, and colorectal volume was quantified with a magnetic resonance imaging method. Participants swallowed a small electromagnetic capsule, which allowed determination of total and segmental GI transit times, using the 3D-Transit system. Results In the established model of oxycodone induced OIBD, fewer GI symptoms were observed during naloxegol treatment, compared to placebo (P <0.01). Naloxegol decreased median total transit time by 27% (56 vs 71 h, P < 0.05) and decreased colorectal transit time by 33% (45 vs 59 h, P < 0.01), compared to placebo. No difference in colorectal volume was found between the two treatments. Conclusions In an experimental model of OIBD, GI symptoms and GI transit time were reduced during treatment with naloxegol, compared to placebo. However, naloxegol treatment did not reduce colorectal volume. These findings add information on the potential of naloxegol to be used in prevention and treatment of OIBD.

Download Full-text

A118 GUT MICROBIOTA TRANSPLANTATION FROM A PATIENT WITH SEVERE CONSTIPATION INDUCED CHANGES IN COLONIC FUNCTION AND STRUCTUR OF GNOTOBIOTIC MICE

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.117 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 137-138

Author(s):

X Bai ◽

G De Palma ◽

J Lu ◽

S M Collins ◽

P Bercik

Keyword(s):

Gut Microbiota ◽

Fecal Microbiota Transplantation ◽

Fecal Microbiota ◽

Colonic Transit ◽

Slow Transit Constipation ◽

Antibiotic Exposure ◽

Ach Release ◽

Germ Free ◽

Gi Transit

Abstract Background Increasing evidence suggests that gut microbiota play a key role in gastrointestinal (GI) tract function. We have previously shown that fecal microbiota transplantation diarrhea predominant IBS patients into germ-free mice induces faster GI transit, increased permeability and innate immune activation. However, it is unknown whether gut dysfunction is induced by microbiota from patients with chronic constipation. Aims Here, we investigated the role of the intestinal microbiota in the expression of severe slow transit constipation in a patient with previous C difficile infection and extensive antibiotic exposure. Methods Germ-free (GF) mice (14 weeks old) were gavaged with diluted fecal content from the patient with constipation (PA) or a sex and age-matched healthy control (HC). 12 weeks later, we assessed gut motility and GI transit using videofluoroscopy and a bead expulsion test.. We then investigated intestinal and colonic smooth muscle isometric contraction in vitro using electric field stimulation (EFS), and acetylcholine (Ach) release was assessed by superfusion using [3H] choline. Histological changes were evaluated by H&E and immunohistochemistry. Results Mice with PA microbiota had faster whole GI transit (score 18.9 ± 0.9 (N=9) than mice with HC microbiota (15.4 ± 1.0, N=10, p=0.032), with markers located mainly in the distal small bowel and cecum. However, bead expulsion from the colon was significantly longer in PA mice (420.8 s ± 124.6 s, N=9) than in HC mice (82.6 s ± 20.0 s, N=10, p=0.026). This delayed colonic transit was likely due to colonic retroperistalsis visualized videofluoroscopically by retrograde flow of barium in the right colon of PA mice. There was no difference between the two groups in small intestinal or colonic tissues in Ach release or contractility induced by carbachol or KCl,. EFS caused transient biphasic relaxation and contraction in small intestine and colon, with the colonic contraction being stronger in the PA group. Microscopic tissue analysis showed disruption of the interstitial cells of Cajal (ICC) network and increased lymphocyte infiltration in colonic mucosa and submucosa in PA mice. Conclusions These results indicate that the microbiota is a driver of delayed colonic transit in a patient whose constipation started following extensive antibiotic exposure for C. difficile infection. The observed dysmotility pattern was not due to lower muscle contractility but likely caused by immune mediated changes in the ICC network. Funding Agencies CIHR

Download Full-text

Gastrointestinal Involvement in Mantle Cell Lymphoma (MCL). A Prospective Clinical, Endoscopical, Pathological and Molecular Study.

Blood ◽

10.1182/blood.v106.11.4665.4665 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4665-4665

Author(s):

Antonio Salar ◽

Nuria Juanpere ◽

Eva Gonzalez-Barca ◽

Beatriz Bellosillo ◽

Blanca Espinet ◽

...

Keyword(s):

Cyclin D1 ◽

Molecular Study ◽

Normal Mucosa ◽

Microscopic Level ◽

Gi Tract ◽

Upper Gi ◽

Multiple Biopsies ◽

Gi Symptoms ◽

Lower Endoscopy ◽

Almost All

Abstract Objective: to investigate the clinical, endoscopical, microscopical and molecular involvement of the GI tract in a prospective series of MCL. Methods: 13 patients with MCL have been prospectively and consecutively entered in a staging workup that included upper and lower endoscopy of the GI tract. Multiple biopsies of the stomach and colon were taken from pathologic mucosa and also from macroscopically normal mucosa. Specimens were assessed with immunohistochemistry (IHC), FISH and PCR. Results: Only 1 patient presented with GI symptoms at diagnosis. Endoscopy: Upper GI: abnormal mucosa in 5 cases (38%); Lower GI: abnormal mucosa in 6 cases (45%): mild colitis in 1, multiple micropolyps in 3, a large polyp and multiple micropolyps in 1 and three large polyps with normal mucosa in 1. As a whole, 9 patients (70%) had upper or lower endoscopic findings. Pathology: 10 cases (77%) had microscopic infiltration by MCL of the upper GI tract and 10 cases (77%) of the lower GI tract. As a whole, all but one patient (92%) were found to have microscopic infiltration of the GI tract. All positive cases for CD20 and CD5 were positive for cyclin D1. The PCR product showed a clear monoclonal peak in 12 out of 19 samples, giving a sensitivity of 63.5% compared with IHC. FISH was positive in 7 out of 11 samples (sensitivity of 64% compared with IHC). All but one case with endoscopic abnormalities had GI microscopic infiltration by MCL and 67% of cases with normal endoscopy were found to have GI tract infiltration by MCL. Conclusions: In our series, GI involvement by MCL was detected in almost all patients. All patients with endoscopic abnormalities had infiltration by MCL at the microscopic level. In 2/3 of the patients with normal endoscopy, GI tract involvement could be demonstrated at the microscopic level. IHC with cyclin D1 was more efficient than FISH and PCR as a diagnostic tool in this setting.

Download Full-text