Normative values for region-specific colonic and gastrointestinal transit times in 111 healthy volunteers using the 3D-Transit electromagnet tracking system: Influence of age, gender, and body mass index.
colon
gastrointestinal
ingestible capsule
motility
transit time
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
18
04
2019
revised:
21
08
2019
accepted:
16
09
2019
pubmed:
1
10
2019
medline:
11
2
2021
entrez:
1
10
2019
Statut:
ppublish
Résumé
The 3D-Transit electromagnet tracking system (Motilis Medica, SA, Lausanne, Switzerland) is an emerging tool for the ambulatory assessment of gastrointestinal (GI) transit and motility. Using this tool, we aimed to derive normative values for region-specific colonic and GI transit times and to assess the influence of age, gender, and body mass index (BMI). Regional and total colonic transit times (CTT), gastric emptying (GET), small intestinal (SITT), and whole gut (WGTT) transit times were extracted from 111 healthy volunteers from the United Kingdom and Denmark (58 female; median age: 40 years [range: 21-88]). The effects of age, gender, and BMI were assessed using standard statistical methods. The ascending, transverse, descending, and rectosigmoid colon transit times accounted for 32%, 34%, 17%, and 17% of total CTT in females, and 33%, 25%, 14%, and 28% of total CTT in males. CTT and WGTT were seen to cluster at intervals separated by approximately 24 hours, providing further evidence of the non-continuous nature of these measurements. Increasing age was associated with longer CTT (P = .021), WGTT (P < .001) ascending (P = .004), transverse (P < .001), and total right (P < .001) colon transit times, but shorter rectosigmoid (P = .004) transit time. Female gender was significantly associated with longer transverse (P = .049) and descending (P < .001) colon transit times, but shorter rectosigmoid (P < .001) transit time. Increasing BMI was significantly associated with shorter WGTT (P = .012). For the first time, normative reference values for region-specific colonic transit have been presented. Age, gender, and BMI were seen to have an effect on transit times.
Sections du résumé
BACKGROUND
The 3D-Transit electromagnet tracking system (Motilis Medica, SA, Lausanne, Switzerland) is an emerging tool for the ambulatory assessment of gastrointestinal (GI) transit and motility. Using this tool, we aimed to derive normative values for region-specific colonic and GI transit times and to assess the influence of age, gender, and body mass index (BMI).
METHODS
Regional and total colonic transit times (CTT), gastric emptying (GET), small intestinal (SITT), and whole gut (WGTT) transit times were extracted from 111 healthy volunteers from the United Kingdom and Denmark (58 female; median age: 40 years [range: 21-88]). The effects of age, gender, and BMI were assessed using standard statistical methods.
KEY RESULTS
The ascending, transverse, descending, and rectosigmoid colon transit times accounted for 32%, 34%, 17%, and 17% of total CTT in females, and 33%, 25%, 14%, and 28% of total CTT in males. CTT and WGTT were seen to cluster at intervals separated by approximately 24 hours, providing further evidence of the non-continuous nature of these measurements. Increasing age was associated with longer CTT (P = .021), WGTT (P < .001) ascending (P = .004), transverse (P < .001), and total right (P < .001) colon transit times, but shorter rectosigmoid (P = .004) transit time. Female gender was significantly associated with longer transverse (P = .049) and descending (P < .001) colon transit times, but shorter rectosigmoid (P < .001) transit time. Increasing BMI was significantly associated with shorter WGTT (P = .012).
CONCLUSIONS AND INFERENCES
For the first time, normative reference values for region-specific colonic transit have been presented. Age, gender, and BMI were seen to have an effect on transit times.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13734Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71-80.
Sanchez MI, Bercik P. Epidemiology and burden of chronic constipation. Can J Gastroenterol. 2011;25(Suppl B):11B-15B.
Nellesen D, Yee K, Chawla A, Lewis BE, Carson RT. A systematic review of the economic and humanistic burden of illness in irritable bowel syndrome and chronic constipation. J Manag Care Pharm. 2013;19(9):755-764.
Carrington EV, Scott SM, Bharucha A, et al. Expert consensus document: Advances in the evaluation of anorectal function. Nat Rev Gastroenterol Hepatol. 2018;15(5):309-323.
Rao SS, Camilleri M, Hasler WL, et al. Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies. Neurogastroenterol Motil. 2011;23(1):8-23.
Keller J, Bassotti G, Clarke J, et al. Expert consensus document: Advances in the diagnosis and classification of gastric and intestinal motility disorders. Nat Rev Gastroenterol Hepatol. 2018;15(5):291-308.
Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG. Simplified assessment of segmental colonic transit. Gastroenterology. 1987;92(1):40-47.
Krevsky B, Malmud LS, D'Ercole F, Maurer AH, Fisher RS. Colonic transit scintigraphy. A physiologic approach to the quantitative measurement of colonic transit in humans. Gastroenterology. 1986;91(5):1102-1112.
Dinning PG, Smith TK, Scott SM. Pathophysiology of colonic causes of chronic constipation. Neurogastroenterol Motil. 2009;21(Suppl 2):20-30.
Maurer AH. Gastrointestinal motility, Part 2: Small-bowel and colon transit. J Nucl Med Technol. 2016;44(1):12-18.
Grønlund D, Poulsen JL, Sandberg TH, et al. Established and emerging methods for assessment of small and large intestinal motility. Neurogastroenterol Motil. 2017;29(7):e13008.
Zarate N, Mohammed SD, O'Shaughnessy E, et al. Accurate localization of a fall in pH within the ileocecal region: validation using a dual-scintigraphic technique. Am J Physiol Gastrointest Liver Physiol. 2010;299(6):G1276-1286.
Haase AM, Gregersen T, Schlageter V, et al. Pilot study trialling a new ambulatory method for the clinical assessment of regional gastrointestinal transit using multiple electromagnetic capsules. Neurogastroenterol Motil. 2014;26(12):1783-1791.
Gregersen T, Haase AM, Schlageter V, Gronbaek H, Krogh K. Regional gastrointestinal transit times in patients with carcinoid diarrhea: Assessment with the novel 3D-transit system. J Neurogastroenterol Motil. 2015;21(3):423-432.
Haase AM, Gregersen T, Christensen LA, et al. Regional gastrointestinal transit times in severe ulcerative colitis. Neurogastroenterol Motil. 2016;28(2):217-224.
Knudsen K, Haase AM, Fedorova TD, et al. Gastrointestinal transit time in Parkinson's disease using a magnetic tracking system. J Parkinsons Dis. 2017;7(3):471-479.
Poulsen JL, Nilsson M, Brock C, Sandberg TH, Krogh K, Drewes AM. The impact of opioid treatment on regional gastrointestinal transit. J Neurogastroenterol Motil. 2016;22(2):282-291.
Poulsen JL, Mark EB, Brock C, Frokjaer JB, Krogh K, Drewes AM. Colorectal transit and volume during treatment with prolonged-release oxycodone/naloxone versus oxycodone plus macrogol 3350. J Neurogastroenterol Motil. 2018;24(1):119-127.
Mark EB, Poulsen JL, Haase AM, et al. Assessment of colorectal length using the electromagnetic capsule tracking system: a comparative validation study in healthy subjects. Colorectal Dis. 2017;19(9):O350-o357.
Mark EB, Poulsen JL, Haase AM, et al. Ambulatory assessment of colonic motility using the electromagnetic capsule tracking system. Neurogastroenterol Motil. 2019;31(2):e13451.
Wang YT, Mohammed SD, Farmer AD, et al. Regional gastrointestinal transit and pH studied in 215 healthy volunteers using the wireless motility capsule: influence of age, gender, study country and testing protocol. Aliment Pharmacol Ther. 2015;42(6):761-772.
Christodoulides S. Multidimensional risk factor assessment in chronic idiopathic constipation, with a focus on fibre. London: St Bartholomew’s and the Royal London School of Medicine and Dentistry, Queen Mary University of London; 2019.
Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61-65.
Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum. 1996;39(6):681-685.
Kuo B, McCallum RW, Koch KL, et al. Comparison of gastric emptying of a nondigestible capsule to a radio-labelled meal in healthy and gastroparetic subjects. Aliment Pharmacol Ther. 2008;27(2):186-196.
Kalsi GK, Grønlund D, Martin J, Drewes AM, Scott SM, Birch MJ. Technical report: Inter- and intra-rater reliability of regional gastrointestinal transit times measured using the 3D-Transit electromagnet tracking system. Neurogastroenterol Motil. 2018;30(11):e13396.
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-163.
Heaton KW, Radvan J, Cripps H, Mountford RA, Braddon FE, Hughes AO. Defecation frequency and timing, and stool form in the general population: a prospective study. Gut. 1992;33(6):818-824.
Lubowski DZ, Meagher AP, Smart RC, Butler SP. Scintigraphic assessment of colonic function during defaecation. Int J Colorectal Dis. 1995;10(2):91-93.
Duthie HL. Colonic response to eating. Gastroenterology. 1978;75(3):527-528.
Rao SS, Sadeghi P, Beaty J, Kavlock R, Ackerson K. Ambulatory 24-h colonic manometry in healthy humans. Am J Physiol Gastrointest Liver Physiol. 2001;280(4):G629-639.
Madsen JL, Graff J. Effects of ageing on gastrointestinal motor function. Age Ageing. 2004;33(2):154-159.
Graff J, Brinch K, Madsen JL. Gastrointestinal mean transit times in young and middle-aged healthy subjects. Clin Physiol. 2001;21:253-259.
Saad RJ, Semler JR, Wilding GE, Chey WD. The effect of age on regional and whole gut transit times in healthy adults. Gastroenterology. 2010; 138:S-127. (Abstract)
Kim SE. Colonic slow transit can cause changes in the gut environment observed in the elderly. J Neurogastroenterol Motil. 2017;23(1):3-4.
Gomes OA, de Souza RR, Liberti EA. A preliminary investigation of the effects of aging on the nerve cell number in the myenteric ganglia of the human colon. Gerontology. 1997;43(4):210-217.
Salles N. Basic mechanisms of the aging gastrointestinal tract. Dig Dis. 2007;25(2):112-117.
Broad J, Kung V, Palmer A, et al. Changes in neuromuscular structure and functions of human colon during ageing are region-dependent. Gut. 2019;68(7):1210-1223.
Sadik R, Abrahamsson H, Stotzer PO. Gender differences in gut transit shown with a newly developed radiological procedure. Scand J Gastroenterol. 2003;38(1):36-42.
Abrahamsson H, Antov S, Bosaeus I. Gastrointestinal and colonic segmental transit time evaluated by a single abdominal x-ray in healthy subjects and constipated patients. Scand J Gastroenterol Suppl. 1988;152:72-80.
Xing J, Chen JD. Alterations of gastrointestinal motility in obesity. Obes Res. 2004;12(11):1723-1732.
Mushref MA, Srinivasan S. Effect of high fat-diet and obesity on gastrointestinal motility. Ann Transl Med. 2013;1(2):14.
Arhan P, Devroede G, Jehannin B, et al. Segmental colonic transit time. Dis Colon Rectum. 1981;24(8):625-629.
Bouchoucha M, Odinot JM, Devroede G, Landi B, Cugnenc PH, Barbier JP. Simple clinical assessment of colonic response to food. Int J Colorec Dis. 1998;13(5-6):217-222.
Camilleri M, Thorne NK, Ringel Y, et al. Wireless pH-motility capsule for colonic transit: prospective comparison with radiopaque markers in chronic constipation. Neurogastroenterol Motil. 2010;22(8): 874-882.
Cook IJ, Furukawa Y, Panagopoulos V, Collins PJ, Dent J. Relationships between spatial patterns of colonic pressure and individual movements of content. Am J Physiol Gastrointest Liver Physiol. 2000;278(2):G329-341.
Dinning PG, Szczesniak MM, Cook IJ. Proximal colonic propagating pressure waves sequences and their relationship with movements of content in the proximal human colon. Neurogastroenterol Motil. 2008;20(5):512-520.
Southwell BR, Clarke MC, Sutcliffe J, Hutson JM. Colonic transit studies: normal values for adults and children with comparison of radiological and scintigraphic methods. Pediatr Surg Int. 2009;25(7):559-572.
Lundin E, Graf W, Garske U, Nilsson S, Maripuu E, Karlbom U. Segmental colonic transit studies: comparison of a radiological and a scintigraphic method. Colorectal Dis. 2007;9(4):344-351.
Hiroz P, Schlageter V, Givel JC, Kucera P. Colonic movements in healthy subjects as monitored by a Magnet Tracking System. Neurogastroenterol Motil. 2009;21(8):838-e857.
Worsoe J, Fynne L, Gregersen T, et al. Gastric transit and small intestinal transit time and motility assessed by a magnet tracking system. BMC Gastroenterol. 2011;11:145.